Development of a risk prediction score for screening for HBV, HCV and HIV among migrants in France (STRADA study)

Abstract

Abstract Background: Migrants from high HIV, HBV or HCV endemicity regions, have a great burden of these infections and related diseases in the host countries. This study aimed to assess the predictive capacity of the TROD Screen questionnaire for HIV, HBV and HCV infections among migrants arriving in France. Methods: An observational and multicenter study was conducted between January 2017 and March 2020 among migrants in centers of the French Office for Immigration and Integration (OFII). A self-questionnaire on demographic characteristics, personal medical history and sexual behaviors was completed. Participants were tested for HIV, HBV and HCV with rapid tests. For each infection, the test performance was assessed using receiver operating characteristics curves, using area under the curve (AUC) as a measure of accuracy. Results: Among 21133 regular migrants seen in OFII centers, 15343 (72.6%) were included in the study. The mean age of the participants was 35.6 years (SD±11.1). The prevalence [95%CI] of HBV, HCV and HIV was 2.0% [1.8–2.2], 0.3% [0.2–0.4], and 0.3% [0.2–0.4] respectively. Based on the sensitivity–specificity curve analysis, the cutoffs point [95%CI] chosen for the risk score were: for HBV infection in men, 2.5 [95%CI: 2.5; 7.5]; for HBV infection in women, 6.5 [95%CI: 0.5; 6.5]; for HCV infection, 9.5 [95%CI: 9.5; 12.5]; and for HIV infection, 10.5 [95%CI: 10.0; 18.5]. Test performance was highest for HIV (AUC=82.15%, 95%CI 74.54%; 87.99%), followed by that for HBV in men (AUC=79.22%, 95%CI 76.18%; 82.26%), for HBV in women (AUC=78.83, 95%CI 74.54%; 82.10%) and that for HCV (AUC=75.95%, 95%CI 68.58%; 83.32%). Conclusion: The TROD screen questionnaire showed good overall performance for predicting HIV, HBV and HCV infections among migrants in OFII centers. It could be used to optimize screening for these infections and to propose rapid screening test to those who are at high risk