Hepatitis C and Migration: A Public Health Challenge

Hepatitis C (HCV) is a major cause of liver cirrhosis and hepatocellular carcinoma [1]. Globally between 130 and 150 million people are estimated to be infected with the virus [2,3], and around 500,000 people die each year from HCV-related liver diseases. Despite the burden HCV imposes on national healthcare systems and budgets, HCV has failed to attract the type and level of attention it calls for from health policy makers, healthcare workers, and indeed the public at large. HCV's relatively slow evolution and the fact that the symptoms associated with it are typically late in presenting have possibly detracted from it being seen as an urgent problem [4]. In Europe, where in 2013 over 30,000 new cases of infection were reported, there is agreement that HCV has been systematically under-reported, in part because of the lack of screening and underreporting [5]. Major advances in treatment options, however, have helped to highlight the problem of HCV and a number of Calls for Action by the Hepatitis B and C Public Policy Association in 2010 [6], 2012 [7] and 2016 [8], WHO resolutions [9] and guidelines [10], as well as a meeting by the Viral Hepatitis Prevention Board [11] have all called for more attention to the problem. All these calls for action have mentioned the growing role of migration as a possible driver of the epidemic.