Hepatitis A, B, and C infection in a community of sub-Saharan immigrants living in Verona (Italy).

BACKGROUND: In Italy, about 5% of the population is represented by immigrants. The epidemiology of hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infection in Africa is very different from Europe; the present study aimed to assess the seroprevalence of viral hepatitis infections in sub-Saharan African immigrants living in Verona. METHODS: A total of 182 illegal immigrants were interviewed concerning sociodemographic characteristics and epidemiological information. Their serum was tested for anti-HAV [immunoglobulin (Ig) G and IgM], HBV (HBsAg, anti-HBs, anti-HBc, HBeAg, and anti-HBe), and HCV (anti-HCV) markers. RESULTS: The immigrants (age: 3 mo-60 y) were mostly single and males, with a higher education; only 50% of them declared having a regular job. Anti-IgG HAV+ prevalence was 99.5% (100% HAV positivity in the younger age bracket). As for HBV, 67.6% (123) of the immigrants were naturally infected and 9.3% had chronic infection; 4.4% were anti-HBs+ isolated (vaccinated). For HBV infection (any HBV marker), a significant difference was only found for increasing age ( p < 0.01) and married people ( p < 0.001). A statistically significant prevalence of HBsAg was found among the unemployed ( p < 0.001) and those with a lower education ( p < 0.05). Five cases (2.7%) resulted in HCV+ with no reported specific risk factors and with no significantly different sociodemographic features; these people tended to report a low level of education and unemployment. CONCLUSIONS: HAV and HBV positivity is higher than in the autochthonous population. While HAV positivity merely represents past infection, the high prevalence of HBsAg in immigrants and the presence of HBsAg/HBeAg in the same group may represent a risk for HBV transmission. The HCV positivity rate resulted similar to the prevalence of the Italian population.

HPLC analysis of HbA1c in dried blood spot samples (DBS): a reliable future for diabetes monitoring.

To simplify collection and transport of blood for HbA1c measuring, we have studied the use of a special paper that absorbs a defined volume of capillary blood and quickly dries it (dried blood-spot, DBS). The DBS can be sent to a central laboratory using regular postal service and without temperature control. This system differs greatly from other proposed DBS methods for HbA1c because it overcomes the haemoglobin alterations during the drying and storing processes, that otherwise make this analysis unreliable. We have developed a special treatment of the paper before collection that stabilises the HbA1c molecule excellently in dried blood samples, allowing accurate HPLC analysis even two weeks after collection. This method has been applied in a "blind" study in which HbA1c values determined in 97 DBS coming from an hospital diabetes care centre were compared with those obtained from parallel venous blood samples.