title: 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.
authors.affiliation: Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Canada.
authors.forename: Suraj
authors.initials: S
authors.lastname: Sharma
authors.affiliation: International Centre for Migration, Health and Development, Geneva, Switzerland.
authors.forename: Manuel
authors.initials: M
authors.lastname: Carballo
authors.affiliation: Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Canada.
authors.forename: Jordan J
authors.initials: JJ
authors.lastname: Feld
authors.affiliation: Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Canada; Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Harry L A
authors.initials: HL
authors.lastname: Janssen
mesh_terms: D004641:Emigration and Immigration; D014943:Global Health; D006525:Hepatitis, Viral, Human / Q000453:epidemiology*; D006801:Humans; D009017:Morbidity; D015995:Prevalence
keywords: Cirrhosis; Immigration; Viral hepatitis