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Peer-reviewedCC BYEuropean journal of public health

Hepatitis B screening among asylum seekers: a retrospective cohort study in Modena, Northern Italy.

  • Riccardo Mazzoli1,2
  • Lucia Borsari3
  • Maria La Torre1
  • Zaynalabedin Kahfian3
  • Alessandra Fantuzzi3
  • Marco Vinceti1,2,4
  • Annalisa Bargellini1
  • Tommaso Filippini1,2,5
  • Stefania Paduano1
5 affiliations
  1. 1Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
  2. 2Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
  3. 3Public Hygiene Service, Department of Public Health, AUSL Modena, Modena, Italy.
  4. 4Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States.
  5. 5School of Public Health, University of California Berkeley, Berkeley, CA, United States.
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Abstract

Hepatitis B virus remains a major health challenge among migrants from high-endemic regions arriving in low-endemic countries like Italy. However, more evidence on both infection burden and immunity gaps among asylum seekers is needed to inform prevention policies. We conducted a retrospective cohort study of 739 asylum seekers screened for Hepatitis B virus (HBV) in Modena, Northern Italy, between 2019 and 2023. Serological testing included quantitative determination of HBsAg, HBcAb, and HBsAb, allowing identification of active infection, natural immunity, vaccine-induced immunity, and susceptibility. Demographic characteristics, geographic origin, and migration routes were analyzed in relation to HBV status. Participants were predominantly male (94.7%), with a mean age of 27.2 years, and originated mainly from South Asia (59.4%) and Sub-Saharan Africa (26.1%). Overall HBsAg prevalence was 4.1%, substantially higher than what reported for the Italian general population (<1%). Prevalence was highest among Sub-Saharan African migrants (7.3%), who also showed the greatest proportion of natural immunity (36.3%), while South Asian migrants had a prevalence of 3.6% and Northern African migrants null. Among HBsAg-negative individuals, 57% were susceptible to HBV infection, particularly those from South Asia and Northern Africa. Susceptibility was associated with male sex (OR 4.08, 95% CI 1.34-12.44) and age ≥25 years (OR 2.38, 95% CI 1.40-4.04), consistent with birth before the introduction of universal HBV vaccination in many countries. Most HBsAg-positive individuals reported transit through Libya. Asylum seekers in Italy show a high prevalence of HBV infection alongside substantial immunity deficits. Systematic screening and targeted catch-up vaccination should be prioritized within migrant health services as a key public health intervention.

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Cite

BibTeXRIS
BibTeX
@article{mazzoli2026hepatitis,
  title = {{Hepatitis B screening among asylum seekers: a retrospective cohort study in Modena, Northern Italy.}},
  author = {Riccardo Mazzoli and Lucia Borsari and Maria La Torre and Zaynalabedin Kahfian and Alessandra Fantuzzi and Marco Vinceti and Annalisa Bargellini and Tommaso Filippini and Stefania Paduano},
  journal = {European journal of public health},
  year = {2026},
  month = oct,
  doi = {10.1093/eurpub/ckag188},
  url = {https://europepmc.org/article/MED/42907096},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Hepatitis B screening among asylum seekers: a retrospective cohort study in Modena, Northern Italy.
AU  - Riccardo Mazzoli
AU  - Lucia Borsari
AU  - Maria La Torre
AU  - Zaynalabedin Kahfian
AU  - Alessandra Fantuzzi
AU  - Marco Vinceti
AU  - Annalisa Bargellini
AU  - Tommaso Filippini
AU  - Stefania Paduano
PY  - 2026
DA  - 2026/10/01
JO  - European journal of public health
DO  - 10.1093/eurpub/ckag188
UR  - https://europepmc.org/article/MED/42907096
AB  - Hepatitis B virus remains a major health challenge among migrants from high-endemic regions arriving in low-endemic countries like Italy. However, more evidence on both infection burden and immunity gaps among asylum seekers is needed to inform prevention policies. We conducted a retrospective cohort study of 739 asylum seekers screened for Hepatitis B virus (HBV) in Modena, Northern Italy, between 2019 and 2023. Serological testing included quantitative determination of HBsAg, HBcAb, and HBsAb, allowing identification of active infection, natural immunity, vaccine-induced immunity, and susceptibility. Demographic characteristics, geographic origin, and migration routes were analyzed in relation to HBV status. Participants were predominantly male (94.7%), with a mean age of 27.2 years, and originated mainly from South Asia (59.4%) and Sub-Saharan Africa (26.1%). Overall HBsAg prevalence was 4.1%, substantially higher than what reported for the Italian general population (<1%). Prevalence was highest among Sub-Saharan African migrants (7.3%), who also showed the greatest proportion of natural immunity (36.3%), while South Asian migrants had a prevalence of 3.6% and Northern African migrants null. Among HBsAg-negative individuals, 57% were susceptible to HBV infection, particularly those from South Asia and Northern Africa. Susceptibility was associated with male sex (OR 4.08, 95% CI 1.34-12.44) and age ≥25 years (OR 2.38, 95% CI 1.40-4.04), consistent with birth before the introduction of universal HBV vaccination in many countries. Most HBsAg-positive individuals reported transit through Libya. Asylum seekers in Italy show a high prevalence of HBV infection alongside substantial immunity deficits. Systematic screening and targeted catch-up vaccination should be prioritized within migrant health services as a key public health intervention.
SN  - 1101-1262
SN  - 1464-360X
ER  -