National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain.
Unitat Medicina Tropical I Salut Internacional Vall d´Hebron-Drassanes, PROSICS, Av de Drassanes 17-21, 08001, Barcelona, Spain.
Travel Med Infect Dis. 2019 May-Jun;29:51-57. doi: 10.1016/j.tmaid.2019.02.001. Epub 2019 Feb 6.
Continuous growth of mobile populations has influenced the global epidemiology of infectious diseases, including chronic and acute viral hepatitis.
A prospective observational multicentre study was performed in a Spanish network of imported infections. Viral hepatitis cases from January 2009 to September 2017 were included.
Of 14,546 records, 723 (4.97%) had imported viral hepatitis, including 48 (6.64%) acute cases and 675 (93.36%) chronic cases. Of the 48 acute cases, 31 were travellers and immigrants returning from visiting friends or relatives (VFR), while 19 (61%) were acute Hepatitis A or Hepatitis B. Only 18.2% of VFR immigrants and 35% of travellers received pre-travel advice. Acute hepatitis was more frequent in VFR immigrants (AOR 2.59, CI95% 1.20-5.60) and travellers (AOR 2.83, CI95% 1.46-5.50) than immigrants. Of the 675 Chronic cases, 570 were immigrants, and 439 (77%) had chronic Hepatitis B. Chronic hepatitis was more frequent in immigrants (AOR 20.22, CI95% 11.64-35.13) and VFR immigrants (AOR 11.12, CI95% 6.20-19.94) than travellers.
Chronic viral hepatitis was typical of immigrants, acute viral hepatitis was common among travellers, and VFR immigrants had mixed risk. Improving pre-travel consultation and screening of immigrants may contribute to preventing new cases of viral hepatitis and avoiding community transmission.
流动人口的持续增长影响了传染病的全球流行病学，包括慢性和急性病毒性肝炎。
在西班牙输入性感染网络中进行了一项前瞻性观察性多中心研究。纳入 2009 年 1 月至 2017 年 9 月期间的病毒性肝炎病例。
在 14546 份记录中，有 723 例（4.97%）为输入性病毒性肝炎，包括 48 例（6.64%）急性病例和 675 例（93.36%）慢性病例。在 48 例急性病例中，有 31 例是旅行者和移民，他们是探亲访友（VFR）返回，其中 19 例（61%）为急性甲型肝炎或乙型肝炎。只有 18.2%的 VFR 移民和 35%的旅行者接受了旅行前咨询。VFR 移民（AOR 2.59，95%CI 1.20-5.60）和旅行者（AOR 2.83，95%CI 1.46-5.50）患急性肝炎的风险高于移民。在 675 例慢性病例中，有 570 例为移民，其中 439 例（77%）患有慢性乙型肝炎。移民（AOR 20.22，95%CI 11.64-35.13）和 VFR 移民（AOR 11.12，95%CI 6.20-19.94）患慢性肝炎的风险高于旅行者。
慢性病毒性肝炎多见于移民，急性病毒性肝炎常见于旅行者，而探亲访友移民则具有混合风险。改善旅行前咨询和移民筛查可能有助于预防新的病毒性肝炎病例发生，并避免社区传播。
