Hepatology Section, Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, 10th Floor QEQM Wing, St Mary's Hospital Campus, Imperial College London, South Wharf Street, London W2 1NY, England.
Department of Gastroenterology and Hepatology, Charité University Medical Center, Berlin, Germany.
Bull World Health Organ. 2021 Apr 1;99(4):280-286. doi: 10.2471/BLT.20.260919. Epub 2021 Jan 21.
By 2040, deaths from chronic viral hepatitis worldwide are projected to exceed those from human immunodeficiency virus infection, tuberculosis and malaria combined. The burden of this disease is predominantly carried by low-resource countries in Africa and Asia. In resource-rich countries, the epidemiological spread of viral hepatitis is partially driven by migrant movements from areas of high endemicity. In the last decade, Member States of the European Union and the European Economic Area have experienced an unprecedented influx of migrants, which has resulted in the polarization of political views about migration. In addition, the coronavirus disease 2019 pandemic has worsened the economic and health conditions of migrants and contributed to hostility to ensuring their health rights. Moreover, the implementation of hostile laws in some host nations has increased the vulnerability of marginalized migrant subgroups, such as asylum seekers and undocumented individuals. These developments have complicated the historical challenge of identifying high-risk migrant groups for screening and treatment. However, if European countries can apply the simplified assessment tools and diagnostic tests for viral hepatitis that have been used for decentralized screening and monitoring in resource-poor countries, the uptake of care by migrants could be dramatically increased. Given the global calls for the elimination of viral hepatitis, European nations should recognize the importance of treating this vulnerable migrant population. Political and health strategies need to be adapted to meet this challenge and help eliminate viral hepatitis globally.
到 2040 年,全球因慢性病毒性肝炎导致的死亡人数预计将超过艾滋病毒感染、结核病和疟疾死亡人数之和。这种疾病的负担主要由非洲和亚洲资源匮乏的国家承担。在资源丰富的国家,病毒性肝炎的流行病学传播部分是由高流行地区移民流动造成的。在过去十年中,欧盟成员国和欧洲经济区经历了前所未有的移民潮,这导致了对移民问题的政治观点两极分化。此外,2019 年冠状病毒病大流行使移民的经济和健康状况恶化,并导致人们不愿意确保他们的健康权利。此外,一些东道国实施的敌对法律增加了边缘化移民群体(如寻求庇护者和无证件者)的脆弱性。这些发展使确定有筛查和治疗风险的移民高危群体的历史挑战更加复杂。然而,如果欧洲国家能够应用在资源匮乏国家用于分散筛查和监测的简化乙型肝炎评估工具和诊断检测方法,那么移民接受治疗的比例可能会大大提高。鉴于全球呼吁消除病毒性肝炎,欧洲国家应认识到治疗这一脆弱移民群体的重要性。政治和卫生战略需要适应这一挑战,以帮助在全球消除病毒性肝炎。