Viral Hepatitis

Abstract

Refugees have been born in, or have lived in, regions highly endemic for the five main viral hepatitides A, B, C, D, and E, compared to the developed countries where they relocate. National guidelines for medical screening and vaccination, including guidelines for viral hepatitis in newly arrived refugees to the USA, are developed by the Centers for Disease Control and Prevention Division of Global Migration and Quarantine (CDC/DGMQ). Hepatitis B and C develop chronic infections, which are contagious and mostly silent and cause significant morbidity and mortality. Safe and effective hepatitis B vaccination and medications effective for treatment of hepatitis B and curative for hepatitis C have started to improve the goal of controlling morbidity and reducing new infections. Routine screening for hepatitis B is recommended for all refugees, and hepatitis C screening is recommended for those with increased risk and from high-prevalence regions and countries. Hepatitis D requires hepatitis B for replication and adds serious complications to chronic hepatitis B. Hepatitis D has a low prevalence, and asymptomatic screening is not indicated. Screening for acute hepatitis A and E is not needed for newly arrived refugees due to their short infection cycle. This chapter reviews these screening guidelines as well as characteristics of the different viral hepatitides, serology testing, and vaccination recommendations for refugees.