Published online Dec 28, 2015. doi: 10.4254/wjh.v7.i30.2955
Peer-review started: April 23, 2015
First decision: August 31, 2015
Revised: November 4, 2015
Accepted: December 4, 2015
Article in press: December 8, 2015
Published online: December 28, 2015
Hepatitis B virus (HBV) is the most common cause of hepatitis worldwide, with nearly 350 million people chronically infected and 600000 deaths per year due to acute liver failure occurring during acute hepatitis or, more frequently, in HBV-related liver cirrhosis or hepatocellular carcinoma. Ongoing immigration from countries with a high HBV endemicity to those with a low HBV endemicity warrants particular attention to prevent the spread of HBV infection to the native population. This review article analyzes the epidemiology and virological and clinical characteristics of HBV infection in immigrant populations and in their host countries, and suggests prophylactic measures to prevent the spread of this infection. Among the immigrants from different geographical areas, those from South East Asia and sub-Saharan Africa show the highest prevalences of hepatitis B surface antigen (HBsAg) carriers, in accordance with the high endemicity of the countries of origin. The molecular characteristics of HBV infection in immigrants reflect those of the geographical areas of origin: HBV genotype A and D predominate in immigrants from Eastern Europe, B and C in those from Asia and genotype E in those from Africa. The literature data on the clinical course and treatment of HBsAg-positive immigrants are scanty. The management of HBV infection in immigrant populations is difficult and requires expert personnel and dedicated structures for their assistance. The social services, voluntary operators and cultural mediators are essential to achieve optimized psychological and clinical intervention.
Core tip: Extensive immigration from countries with a high hepatitis B virus (HBV) endemicity to those with a low HBV diffusion warrants particular attention to prevent the spread of HBV infection to the native population. This review article analyzes: (1) the prevalence of subjects with hepatitis B in screened immigrants; (2) the distribution of the HBV genotypes; (3) the cost effectiveness of screening immigrants for hepatitis B; and (4) the clinical and therapeutic approach.