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Gut 59:1009-1011 doi:10.1136/gut.2009.206763
  • Leading article

Global hepatitis, migration and its impact on Western healthcare

  1. Graham R Foster2
  1. 1Division of Gastroenterology, The Aga Khan University, Karachi, Pakistan
  2. 2Queen Mary's University of London, Bart's and The London School of Medicine, London, UK
  1. Correspondence to Dr Furqaan Ahmed, Division of Gastroenterology, The Aga Khan University, 128-C K.D.A. Scheme #1, Karachi, Pakistan 75350; furqaan{at}hotmail.com
  • Revised 8 May 2010
  • Accepted 10 May 2010

The World Health Organization estimates that approximately 350 million people are infected with the hepatitis B virus (HBV)1 and that over 170 million individuals are chronically infected with the hepatitis C virus (HCV).2 The majority of those who are infected live in the developing world and, although the incidence of these infections is declining in many Western countries,3 these viruses continue to spread in many countries. For example in Egypt, parenteral therapy for schistosomiasis administered between 1961 and 1986 led to an epidemic of chronic hepatitis C4 and recent reports suggest that the incidence is increasing once again in Egypt due to the reuse of needles for medical injections and other iatrogenic causes.5 6 It is therefore probable that the current discrepancy between disease burden in developed and developing nations will continue to widen and here we argue that the reduction in disease burden in the developed world should not lead to a reduction in engagement with these viruses.

Migration is one of the defining issues of our times. For example, more than 5 million Canadians were born outside the country and approximately 250 000 new immigrants arrive in Canada each year. With an increasingly interconnected world due to travel and migration, health trends in one location have both local and global implications since infectious diseases do not remain geographically isolated. There is a paucity of data on many migration related health issues but there is a growing body of data demonstrating an increase in the burden of migration-related chronic viral hepatitis in Western societies. The UK Hepatitis Foundation estimated in 2007 that the number of hepatitis B cases in the UK doubled in the previous 6 years chiefly due to migration of infected people,7 many from the new member states of the European Union where …