Department of Microbiology and Immunology, Rega Institute, Laboratory of Clinical and Epidemiological Virology, KU Leuven, Leuven, Belgium.
Laboratory of Evolutionary and Computational Virology, KU Leuven, Leuven, Belgium.
Lancet Gastroenterol Hepatol. 2019 Apr;4(4):315-323. doi: 10.1016/S2468-1253(19)30014-7.
People from low-to-middle income countries have been migrating to western Europe on a large scale in recent years. Data indicate that the number of first-time asylum applications by non-EU members increased from 290 000 in 2011 to more than 1·3 million in 2015. During the peak period of migration, The Global Health Sector Strategy on Viral Hepatitis was adopted by WHO. Viral hepatitis, and particularly hepatitis B virus (HBV), is an important disease because of its high prevalence and associated mortality. In some cases, HBV can be carried by refugees arriving from regions of high and intermediate prevalence. Refugees with HBV might not show clinical symptoms and not be diagnosed in destination countries with a low prevalence, where screening is not regularly done. Although transmission to the host population is low, dedicated surveillance and tailored public health policies are required. It is important to note that some of the countries that receive many migrants do not have a universal HBV vaccination programme. In this Viewpoint, we argue that the current large-scale movement from regions with high or intermediate HBV prevalence should be taken as an opportunity to achieve viral hepatitis elimination targets, by establishing a well prepared infrastructure for HBV screening, vaccination, and treatment.
近年来，中低收入国家的人们大规模迁往西欧。数据显示，2011 年首次申请庇护的非欧盟成员国人数从 29 万增加到 2015 年的 130 多万。在移民高峰期，世卫组织通过了《全球卫生部门病毒性肝炎战略》。病毒性肝炎，特别是乙型肝炎病毒（HBV），是一种重要的疾病，因为它的高流行率和相关死亡率。在某些情况下，HBV 可能会被来自高流行和中流行地区的难民携带。在 HBV 低流行的目的地国家，HBV 难民可能没有出现临床症状，也没有被诊断出来，因为这些国家没有定期进行筛查。尽管向宿主人群的传播率较低，但仍需要进行专门的监测和制定有针对性的公共卫生政策。值得注意的是，一些接收大量移民的国家没有普遍的乙型肝炎疫苗接种计划。在本观点中，我们认为，目前从高或中 HBV 流行地区的大规模流动，应被视为通过建立乙型肝炎病毒筛查、疫苗接种和治疗的充分准备的基础设施，实现消除病毒性肝炎目标的机会。
