The European Association for the Study of the Liver
(EASL), the World Health Organization (WHO) and the European Centre for Disease Prevention and Control
have issued a
joint statement on viral hepatitis care for refugees from Ukraine.
Refugees from Ukraine have been granted temporary
protection, including access to health care in European Union countries and
other countries in the WHO Europe region.
The statement highlights the need for viral hepatitis care
in refugee populations.
The rate of hepatitis B birth vaccination is lower in
Ukraine than most European Union countries – only 80% of infants had received their
third dose in 2020. Adult prevalence of hepatitis B is around 1% and adult
hepatitis C prevalence is 3%. Prevalence of both viruses is higher in men and
older age groups. Prevalence in people who inject drugs is especially high
(HBsAg 8%, hepatitis C antibody 56% in 2020).
The statement recommends:
settled in the host country, testing for hepatitis B and hepatitis C
should be voluntary and offered to all adult refugees in a
B vaccination should be offered for children and adolescents with unknown
vaccination status or known delayed or missing vaccines, and others with
risk factors who do not have official records or evidence of immunity
should provide free and accessible hepatitis B and hepatitis
C care, including diagnosis and antiviral therapy, as well as
harm reduction services where needed. These services can be provided by
a network of designated healthcare settings that take into account the language,
culture and mental health needs of refugees and may be best provided for
refugees when settled in the host country.
to care with local services for further clinical evaluation and
assessment for treatment should be ensured for all HBsAg-positive and/or
HCV RNA-positive individuals.
- It is essential
that patients already on treatment for hepatitis B and/or hepatitis C should continue
treatment. Therapy for hepatitis B and hepatitis C should be newly
all individuals who meet the criteria for therapy, in accordance with
EASL clinical practice guidelines or local clinical