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Lancet Gastroenterol Hepatol. 2019 Apr;4(4):315-323. doi: 10.1016/S2468-1253(19)30014-7.

Mass migration to Europe: an opportunity for elimination of hepatitis B virus?

Author information

1
Department of Microbiology and Immunology, Rega Institute, Laboratory of Clinical and Epidemiological Virology, KU Leuven, Leuven, Belgium.
2
Laboratory of Evolutionary and Computational Virology, KU Leuven, Leuven, Belgium.
3
Biosafety Development Group, Cellular Sciences Department, Amgen, Thousand Oaks, CA, USA.
4
Laboratory of Evolutionary and Computational Virology, KU Leuven, Leuven, Belgium; Spatial Epidemiology Lab, Université Libre de Bruxelles, Brussels, Belgium.
5
Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran.
6
Department of Medicine III, Rheinisch-Westfälische Technische Hochschule-University Hospital Aachen, Aachen, Germany.
7
Department of Gastroenterology and Hepatology, University Hospitals KU Leuven, Leuven Belgium.
8
Department of Microbiology and Immunology, Rega Institute, Laboratory of Clinical and Epidemiological Virology, KU Leuven, Leuven, Belgium; Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: mahmoudreza.pourkarim@kuleuven.be.

Abstract

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.

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