Frontiers in public health · 2025
Integrating hepatitis B virus, hepatitis C virus and human immunodeficiency virus screening for migrants from endemic countries into travel-related and sexual health care in Amsterdam, the Netherlands.
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Generaal Ellen, Bachour Yara, Klijzing Sara, Cornelissen Akke, Toering Roel, Hoornenborg Elske, Op de Coul Eline, Hamdiui Nora, Meiberg Annemarie, Siedenburg Evelien, Prins Maria
Аннотация
INTRODUCTION: The Health Council of the Netherlands has recommended screening for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) for migrants born in countries endemic for these infections. We investigated the operational feasibility, test uptake and diagnostic outcomes of integrated HBV/HCV/HIV screening into routine care at the Public Health Service (PHS) of Amsterdam.
METHODS: In 2022-2023, visitors born in endemic countries (≥ 18 years) were offered free HBV, HCV and HIV testing at the Travel and Vaccination Center (TVC) of the PHS. In 2021-2022, 1,172 visitors born in an endemic country for HCV (≥ 16 years) were offered free HCV testing at the Center for Sexual Health (CSH), alongside standard free HBV/HIV testing. Countries considered endemic for HBV and HCV had a prevalence of ≥2.0% or ranked among the top-10 endemic countries in the Netherlands. The screening program was considered operationally feasible if inclusion began within six months and ≥25% (TVC) or ≥50% (CSH) of eligible visitors were included within one year. Positivity rate was considered 'low' for prevalence < 2.0%, and 'high' for prevalence ≥ 2.0%.
RESULTS: At the TVC, 298 visitors participated in HBV (n = 264), HCV (n = 293) and/or HIV (n = 290) testing. At the CSH 1,023 visitors underwent HCV testing. Inclusion targets were met. Test uptake at the CSH was 87%; data for TVC were unavailable. At the TVC, we identified five newly diagnosed chronic HBV cases (2.0, 95%CI = 0.6-4.4%) and no new cases for HCV or HIV. At the CSH, one newly diagnosed chronic HCV case was identified (0.1, 95%CI = 0.01-0.5%).
DISCUSSION: Integrating HBV, HCV and HIV screening into routine travel-related care and additional HCV screening into sexual health care is operationally feasible. HBV screening at the TVC showed a high yield, while HCV and HIV yields were low. Routine HBV screening should be further examined in similar settings for migrants from endemic countries, preferably alongside HCV and HIV testing.
METHODS: In 2022-2023, visitors born in endemic countries (≥ 18 years) were offered free HBV, HCV and HIV testing at the Travel and Vaccination Center (TVC) of the PHS. In 2021-2022, 1,172 visitors born in an endemic country for HCV (≥ 16 years) were offered free HCV testing at the Center for Sexual Health (CSH), alongside standard free HBV/HIV testing. Countries considered endemic for HBV and HCV had a prevalence of ≥2.0% or ranked among the top-10 endemic countries in the Netherlands. The screening program was considered operationally feasible if inclusion began within six months and ≥25% (TVC) or ≥50% (CSH) of eligible visitors were included within one year. Positivity rate was considered 'low' for prevalence < 2.0%, and 'high' for prevalence ≥ 2.0%.
RESULTS: At the TVC, 298 visitors participated in HBV (n = 264), HCV (n = 293) and/or HIV (n = 290) testing. At the CSH 1,023 visitors underwent HCV testing. Inclusion targets were met. Test uptake at the CSH was 87%; data for TVC were unavailable. At the TVC, we identified five newly diagnosed chronic HBV cases (2.0, 95%CI = 0.6-4.4%) and no new cases for HCV or HIV. At the CSH, one newly diagnosed chronic HCV case was identified (0.1, 95%CI = 0.01-0.5%).
DISCUSSION: Integrating HBV, HCV and HIV screening into routine travel-related care and additional HCV screening into sexual health care is operationally feasible. HBV screening at the TVC showed a high yield, while HCV and HIV yields were low. Routine HBV screening should be further examined in similar settings for migrants from endemic countries, preferably alongside HCV and HIV testing.