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Prevalence and risk factors of active hepatitis C infection among at-risk migrant populations in Madrid, Spain, 2019 to 2023
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Pablo Ryan1,2,3,4,*
, Jorge Valencia1,5,*
, Felipe Pérez-García4,6,7,*
, Marta Quero-Delgado8
, Guillermo Cuevas1
, Samuel Manzano1
, Samuel Estévez1
, Isidoro Martínez4,8,**
, Daniel Sepúlveda-Crespo4,8,**
, Salvador Resino4,8,**
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View Affiliations Hide AffiliationsAffiliations: 1 Hospital Universitario Infanta Leonor, Madrid, Spain 2 Universidad Complutense de Madrid (UCM), Madrid, Spain 3 Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain 4 Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain 5 Unidad de Reducción de Daños ‘SMASD’, Madrid, Spain 6 Servicio de Microbiología Clínica, Hospital Universitario Príncipe de Asturias, Madrid, Spain 7 Universidad de Alcalá, Facultad de Medicina, Departamento de Biomedicina y Biotecnología, Madrid, Spain 8 Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain* These authors contributed equally to this article and share first authorship.** These authors contributed equally to this article and share last authorship.Correspondence:Salvador Resinosresino isciii.es
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Citation style for this article: Ryan Pablo, Valencia Jorge, Pérez-García Felipe, Quero-Delgado Marta, Cuevas Guillermo, Manzano Samuel, Estévez Samuel, Martínez Isidoro, Sepúlveda-Crespo Daniel, Resino Salvador. Prevalence and risk factors of active hepatitis C infection among at-risk migrant populations in Madrid, Spain, 2019 to 2023. Euro Surveill. 2025;30(29):pii=2500150. https://doi.org/10.2807/1560-7917.ES.2025.30.29.2500150 Received: 28 Feb 2025; Accepted: 03 Jun 2025
SDG 3: hepatitis
Abstract
Hepatitis C virus (HCV) microelimination among at-risk migrants supports global elimination goals.
To evaluate risk factors, prevalence and trends of active HCV infection among at-risk migrants screened for HCV in Madrid from 2019–23.
At-risk migrants (born outside Spain, living in country < 10 years regardless of legal status), were screened for HCV via mobile units with rapid antibody testing, and confirmed by RNA testing. Recruitment of this convenience sample focused on migrant centres, shelters, harm reduction centres and social service sites. Primary outcome was active HCV prevalence. Risk factors analysed included origin, alcohol use, no stable income, drug use and sexual behaviour. Data were analysed using general linear models with negative binomial distribution and p values adjusted for multiple comparisons (q values).
Among 2,288 migrants, 6.5% (149/2,288) had anti-HCV antibodies, 47.0% (70/149) of whom tested positive for HCV-RNA; 81.4% (57/70) began antiviral therapy. Overall prevalence of active HCV infection was 3.1% (70/2,288). Injection drug use (non-active vs never used (aIRR: 7.3; 95% CI: 2.7–12.7) and active (aIRR: 14.7; 95% CI: 6.7–32.1)), European origin (vs non-European; aIRR: 5.8; 95% CI: 2.7–12.7) and alcohol misuse (vs no misuse; aIRR: 1.8; 95% CI: 1.1–2.9) were main risk factors. Prevalence showed no significant change during 2019–23 in the overall population and across risk groups.
At-risk migrants screened in Madrid had a high prevalence of active HCV infection. This is higher than reported estimates for the general Spanish population and supports the need to enhance targeted HCV prevention, screening and treatment strategies among migrant populations.

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