A Seroprevalence Study for HBV in Pregnant Women in Greece: High Risk Migrant Groups and Opportunities for Intervention

Background: Perinatal transmission of HBV leads to chronic infection in up to 90% of neonates. Focused prenatal screening and appropriate treatment of pregnant women and neonates is necessary for the elimination of hepatitis B, as was stated in the 2017 WHO Action Plan for HBV. Information on seroprevalence of HBV in Greece, especially in pregnant women, is scarce and rather outdated. Seroprevalence data specifically for high-risk groups, such as immigrants, is necessary for proper public health planning and elimination of vertical transmission and this study will struggle to fill the gap that exists in Greece. Methods: HBsAg status of pregnant women delivering during 2017 in Crete was studied. Seroprevalence was estimated for the whole population and each ethnic group separately. Results: The mean age of the participants was 30.38 (±6) years. Their origin was Greek (76.76 %), Albanian (10.18%), Bulgarian (3.79%), Roma population (2.44%), Russia and Former Republics of Russia (2.06%), Romanian (1.95%), Central Europe (0.70%) refugees from Syria, Morocco, Egypt (0.55%), and East Asian (0.43%). The HBsAg (+) seroprevalence was 1.5%. The seroprevalence of Greeks was 0.5%, while Albanians, Bulgarians, Romanians and Roma had 4.3%, 5.7%, 2.8%, and 11.1% respectively (p<0.001). Conclusions: Defining specific at-risk groups in each country is fundamental, since MTCT is the principal mode of transmission in high prevalence settings. Our study revealed high seroprevalence in certain migrant groups and Roma women. This information is essential for proper planning of perinatal care in Greece, especially taking into account that these underprivileged groups often lack quality health care.