Non-Western Dutch Migrants Have Extra HCV Risk

By David Douglas

NEW YORK (Reuters Health) May 17 - First-generation non-Western migrants to Holland are at increased risk for hepatitis C virus (HCV) compared to the native population and should be targeted for screening, Dutch researchers report.

But most of the strains they carry are uncommon in Europe, and the extra risk disappears in the second generation, according to coauthor Dr. Anouk T. Urbanus.

Second generation non-Western migrants in the Netherlands "can be considered similar to the general population with respect to screening, meaning that screening should only be considered when risk factors for HCV are present," Dr. Urbanus told Reuters Health by email.

To assess rates of HCV in Amsterdam's immigrant population, Dr. Urbanus, of the city's Public Health Service, and colleagues examined data from three local surveys plus a national one. The Amsterdam surveys had been administered to 3895 heterosexual attendees at a sexually transmitted disease clinic, a random sample of 4,563 pregnant women and a population-based random sample of 1,309 inhabitants. The fourth survey was of a population-based random sample of 4,428 people living in the Netherlands.
About a third of participants were non-Western. This proportion varied from 14.1% nationally to 63.3% in the Amsterdam population, according to an April 13th online paper in the Journal of Hepatology
Overall HCV prevalence ranged from 0.3% to 0.6%. First-generation non-Western migrants were more likely to be HCV-positive (0.7% to 2.3%) than Westerners (0.1% to 0.4%).

Other than in the smallest survey (of 1,309 Amsterdam residents), second-generation non-Western migrants had a lower HCV prevalence than first-generation migrants. Their prevalence was comparable to that in Western migrants and the Dutch population in general.

Phylogenetic analysis showed that the majority of the HCV-positive, first-generation non-Western non-European migrants were infected with endemic strains rarely observed in Europe. This suggests, say the researchers that "transmission likely took place in the country of origin, causing introduction but no further transmission of endemic HCV strains in the Netherlands."

"Our study indicates that once living in the Netherlands, intrafamilial transmission of HCV does not take place anymore," Dr. Urbanus said.

The results, she concluded, "possibly also apply for non-Western migrants living in other low HCV prevalence countries."

SOURCE: http://bit.ly/mxn5HP

J Hepatol 2011.