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. 2025 Jun;45(6):e70126.
doi: 10.1111/liv.70126.

Hepatitis B and C Screening and Linkage to Care in Migrants From Endemic Countries in Barcelona Through a Community Action

Anna Not  1   2   3 , Hakima Ouaarab-Essadek  4 , Marcos Montoro  5 , Begoña Treviño  4 , María Buti  6   7 , Rosa M Morillas  7   8 , Antoni E Bordoy  2 , Cinta Folch  3   5 , Xavier Majó  9 , Jordi Casabona  3   5 , Jordi Gómez I Prat  4 , Elisa Martró  1   2   3
Affiliations

Hepatitis B and C Screening and Linkage to Care in Migrants From Endemic Countries in Barcelona Through a Community Action

Anna Not et al. Liver Int. 2025 Jun.

Abstract

Background and aims: Migrants from endemic areas are key populations for hepatitis B virus (HBV) and hepatitis C virus (HCV) infection screening in Europe. This study assessed the feasibility and outcomes of a community action that combined education, screening, and simplified access to care for migrants in Barcelona.

Methods: Adult migrants from Pakistan, Romania, and Senegal were included from 2021 to 2023, through a community action involving education, an epidemiological questionnaire, and rapid testing for HBV surface antigen (HBsAg) and HCV antibodies. If positive, DBS samples were collected for laboratory confirmation. Viremic cases were referred to an International Health Unit (IHU).

Results: Overall, 786 participants were included (346 from Pakistan, 304 from Senegal and 136 from Romania). Previous screening for HBV and HCV was 8.0% and 7.7%, respectively. HBsAg prevalence was 0.9% for migrants from Pakistan, 8.2% for those from Senegal and 1.4% for those from Romania (n = 30/786, 23 new diagnoses). Among these, 69.6% attended the IHU and were HBV-DNA positive, but none met treatment criteria. Anti-HCV prevalence was 3.5%, 0.7% and 1.4% for migrants from Pakistan, Senegal and Romania, respectively (n = 16/768, 12 new diagnoses), and HCV-RNA prevalence was 0.9%, 0.3% and 0.7%, respectively (N = 6, all new diagnoses); 4 (66.6%) cases were linked to treatment and two were cured.

Conclusions: This novel community action successfully reached migrants in a situation of vulnerability and provided them access to testing and care. The high prevalence observed and the limited self-knowledge of their HBV and HCV status justify targeted screening in these groups.

Keywords: community action; dried blood spots (DBS); hepatitis B virus (HBV); hepatitis C virus (HCV); migrants.

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Conflict of interest statement

E.M. has received lecture fees and research grants from Abbott GmbH & Co.K.G., Gilead Sciences, Cepheid and Abbvie, outside of the submitted work. M.B. received fees and research grants from Gilead and Abbvie.

Figures

FIGURE 1
FIGURE 1
HepBClink study design. HBV, hepatitis B virus; HCV, hepatitis C virus; DBS, dried blood spot; HDV, hepatitis D virus.
FIGURE 2
FIGURE 2
Flowchart depicting the recruitment, testing, linkage to care and follow‐up for HBV and HCV according to country of origin. HBV, hepatitis B virus; HCV, hepatitis C virus; IHU, International Health Unit; LFTU, lost to follow‐up; HBsAg, hepatitis B virus surface antigen; HCV‐Ab, antibodies against hepatitis C virus.
FIGURE 3
FIGURE 3
Number of persons needed to screen to find a new diagnosis of viremic HBV or HCV infection. HBV, hepatitis B virus; HCV, hepatitis C virus.
FIGURE 4
FIGURE 4
Degree of agreement (A) and satisfaction (B) of participants with the community action.
See this image and copyright information in PMC

References

    1. World Health Organization , Global Health Sector Strategies on, Respectively, HIV, Viral Hepatitis and Sexually Transmitted Infections for the Period 2022–2030 (World Health Organization, 2022).
    1. World Health Organization , Global Hepatitis Report 2024: Action for Access in Low‐ and Middle‐Income Countries (World Health Organization, 2024).
    1. World Health Organization , Global Health Sector Strategy on Viral Hepatitis 2016–2021. Towards Ending Viral Hepatitis (World Health Organization, 2016).
    1. World Health Organization , Global Hepatitis Report 2017 (World Health Organization, 2017).
    1. EASL , “European Association for the Study of Liver Diseases (EASL). EASL Policy Statement: Addressing the Liver Health Needs of Migrant Populations in Europe,” (2024), https://easl.eu/wp‐content/uploads/2024/06/EASL‐Policy‐Statement‐Migrant....

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