Immigration and viral hepatitis

Abstract

WHO estimates reveal that the global prevalence of viral hepatitis may be as high as 500 million, with an annual mortality rate of up to 1.3 million individuals. The majority of this global burden of disease is borne by nations of the developing world with high rates of vertical and iatrogenic transmission of HBV and HCV, as well as poor access to healthcare. In 2013, 3.2% of the global population (231 million individuals) migrated into a new host nation. Migrants predominantly originate from the developing countries of the south, into the developed economies of North America and Western Europe. This mass migration of individuals from areas of high-prevalence of viral hepatitis poses a unique challenge to the healthcare systems of the host nations. Due to a lack of universal standards for screening, vaccination and treatment of viral hepatitis, the burden of chronic liver disease and hepatocellular carcinoma continues to increase among migrant populations globally. Efforts to increase case identification and treatment among migrants have largely been limited to small outreach programs in urban centers, such that the majority of migrants with viral hepatitis continue to remain unaware of their infection. This review summarizes the data on prevalence of viral hepatitis and burden of chronic liver disease among migrants, current standards for screening and treatment of immigrants and refugees, and efforts to improve the identification and treatment of viral hepatitis among migrants.

Hepatitis B Virus Genotypes, Epidemiological Characteristics, and Clinical Presentation of HBV Chronic Infection in Immigrant Populations Living in Southern Italy

“…It is noteworthy that none of the 1727 immigrants evaluated in the current study and living in Italy for approximately 3 years had been vaccinated. The data of the current study confirmed that HBV screening for immigrants from geographical areas of high or intermediate endemicity was an important preventive measure for public health (37,38).…”

Vaccinations in migrants and refugees: a challenge for European health systems. A systematic review of current scientific evidence

“…Chu et al, in 2013 [28], found migrants representing a substantial proportion of HBsAg positive and chronic cases in six Northern European Countries. Sharma et al (2015) [11] reported that 53% of HBV carriers were born outside the EU. Finally, among HIV positive migrants, HBV prevalence was reported to be 4.5% in UK [31] and 18.6% in France [7].…”

Hepatitis B virus testing and linkage to care in a Canadian urban tertiary referral centre: a retrospective cohort study

“…18,19 Interestingly, many developed countries similarly report suboptimal diagnostic and management rates for chronic HBV infection. [20][21][22][23][24] It is also noteworthy that 19 (1.6%) of our 1214 subjects were found to be coinfected with HCV (i.e., positive for anti-HCV and HCV RNA), another major risk factor for chronic liver disease.…”