Hepatit A Epidemiyolojisi ve Duyarlı Nüfusta Değişim

Year 2022, , 315 - 320, 30.12.2022

Abdullatif Sirin , Salih Tokmak , Kübra Akan , Celal Ulaşoğlu , Feruze Enç

https://doi.org/10.18678/dtfd.1196325

Cited By: 1

Abstract

Amaç: Aşılama ve hijyen koşullarının iyileşmesi sayesinde hepatit A (HepA) insidansı azalmıştır. Bununla birlikte, hastalığın başlangıç yaşı çocukluk çağından yetişkinlik çağına doğru kaymıştır. HepA olan çocuklar hafif semptomatik iken erişkinlerde ise hastalığın seyri şiddetli olabilir. Bu çalışmanın amacı, HepA seroprevalansındaki değişimi incelemek ve HepA'ya duyarlı olan popülasyonu belirlemektir.
Gereç ve Yöntemler: Bu çalışmada, 2016 ve 2019 yılları arasında anti-Hepatit A virüsü immünoglobulin G (anti-HAV IgG) testi çalışılmış olan toplam 10132 hastanın verileri geriye dönük olarak incelendi ve çalışmaya dahil edildi. Hastalar yaşlarına göre beş gruba ayrıldı ve bu yaş grupları arasında seropozitiflik oranları karşılaştırıldı. Sağlık çalışanlarının ilgili verileri de ayrıca değerlendirildi.
Bulgular: Genel seropozitiflik oranı %60,1 (n=6088) idi. Seropozitiflik oranı 18 ile 24 yaş aralığında %29,0 (n=944) olarak, 25 ile 29 yaş aralığında %49,6 (n=837) olarak, 30 ile 34 yaş aralığında %60,6 (n=689) olarak, 35 ile 39 yaş aralığında %76,6 (n=784) olarak ve ≥40 yaş grubunda %93,3 (n=2834) olarak bulundu. Seropozitiflik oranı, <30 ve ≥30 yaş gruplarında, sırasıyla, %36,1 (n=1781) ve %82,9 (n=4307) olarak bulundu (p<0,001).
Sonuç: Son yıllarda, HepA seroprevalansında önemli bir değişiklik olmuştur. Bu değişiklik, olası HepA salgınlarına duyarlı olan genç bir yetişkin popülasyonun ortaya çıkmasına neden olmuştur. Bu nedenle seronegatif genç yetişkinler HepA açısından risk altında kabul edilebilir ve rutin aşılama yapılması düşünülebilir.

Keywords

hepatit A, hepatit A virüsü, hepatit A aşısı

The Change in the Susceptible Populations with the Shift in Hepatitis A Epidemiology

Abstract

Aim: The incidence of hepatitis A (HepA) has decreased due to vaccination and improved hygiene conditions. However, the age of onset of the disease has shifted from childhood to adulthood. Children with HepA are mildly symptomatic, whereas the course of the disease in adults may be severe. The aim of this study was to examine the change in HepA seroprevalence and identify the population susceptible to HepA.
Material and Methods: A total of 10132 patients who were tested anti-Hepatitis A virus immunoglobulin G (anti-HAV IgG) between 2016 and 2019 were reviewed retrospectively, and included in this study. The patients were divided into five groups according to their age, and seropositivity rates were compared between age groups. The relevant data of the healthcare professionals were also evaluated separately.
Results: The overall seropositivity rate was 60.1% (n=6088). The seropositivity rate was found 29.0% (n=944) in the 18 to 24 years range, 49.7% (n=837) in the 25 to 29 years range, 60.6% (n=689) in the 30 to 34 years range, 76.6% (n=784) in the 35 to 39 years range, and 93.3% (n=2834) in the ≥40 years groups. The seropositivity rate was found 36.1% (n=1781) and 82.9% (n=4307) in patients <30 and ≥30 years groups, respectively (p<0.001).
Conclusion: In recent decades, there has been a significant change in HepA seroprevalence. This change has resulted in the emergence of a young adult population susceptible to possible HepA outbreaks. Thus, seronegative young adults may be considered at risk for HepA and routine vaccination may be considered.

Keywords

hepatitis A, hepatitis A virus, hepatitis A vaccine

References

• Hendrickx G, Van Herck K, Vorsters A, Wiersma S, Shapiro C, Andrus JK, et al. Has the time come to control hepatitis A globally? Matching prevention to the changing epidemiology. J Viral Hepat. 2008;15(Suppl 2):1-15.
• Abutaleb A, Kottilil S. Hepatitis A: Epidemiology, natural history, unusual clinical manifestations, and prevention. Gastroenterol Clin North Am. 2020;49(2):191-9.
• Matheny SC, Kingery JE. Hepatitis A. Am Fam Physician. 2012;86(11):1027-34.
• American Academy of Pediatrics Committee on Infectious Diseases. Hepatitis A vaccine recommendations. Pediatrics. 2007;120(1):189-99.
• Jacobsen KH. Globalization and the changing epidemiology of hepatitis A virus. Cold Spring Harb Perspect Med. 2018;8(10):a031716.
• Nothdurft HD. Hepatitis A vaccines. Expert Rev Vaccines. 2008;7(5):535-45.
• Ceran N, Yüksel Kocdogan F, Mert D, Erdem I, Dede B, Adaleti R, et al. Hepatitis a seroprevalence in children and young adults in Istanbul, Turkey: Seroprevalence change and associated factors. J Viral Hepat. 2012;19(1):72-6.
• Ceyhan M, Yildirim I, Kurt N, Uysal G, Dikici B, Ecevit C, et al. Differences in hepatitis A seroprevalence among geographical regions in Turkey: A need for regional vaccination recommendations. J Viral Hepat. 2008;15(Suppl 2):69-72.
• Türker K, Balci E, Bati S, Hasçuhadar M, Savaş E. In Our country, the changing epidemiology of hepatitis A infection. Türk Mikrobiyol Cem Derg. 2011;41(4):143-8. Turkish.
• Köroğlu M, Demiray T, Terzi HA, Altındiş M. Seroprevalence of hepatitis A among different age groups in Sakarya and review of the literature. Viral Hepat J. 2014;20(3):110-4.
• Kader Ç, Göçmen AY, Demir MI, Çolak NY, Gök SE, Arıkan FI, et al. Hepatitis A immunity in Yozgat, Turkey. Ann Saudi Med. 2019;39(1):37-41.
• Demiray T, Köroğlu M, Jacobsen KH, Özbek A, Terzi HA, Altındiş M. Hepatitis A virus epidemiology in Turkey as universal childhood vaccination begins: Seroprevalence and endemicity by region. Turk J Pediatr. 2016;58(5):480-91.
• Melhem NM, Talhouk R, Rachidi H, Ramia S. Hepatitis A virus in the Middle East and North Africa region: A new challenge. J Viral Hepat. 2014;21(9):605-15.
• Yoon JG, Choi MJ, Yoon JW, Noh JY, Song JY, Cheong HJ, et al. Seroprevalence and disease burden of acute hepatitis A in adult population in South Korea. PLoS One. 2017;12(10):e0186257.
• Gossner CM, Severi E, Danielsson N, Hutin Y, Coulombier D. Changing hepatitis A epidemiology in the European Union: new challenges and opportunities. Euro Surveill. 2015;20(16):21101.
• Nelson R. Hepatitis A outbreak in the USA. Lancet Infect Dis. 2018;18(1):33-4.
• Kutlu R, Terlemez A, Karademirci MM. Evaluation of seroprevalence of hepatitis A and hepatitis B in dentistry faculty students. Konuralp Tıp Derg. 2018;10(1):41-7.
• Nelson NP, Weng MK, Hofmeister MG, Moore KL, Doshani M, Kamili S, et al. Prevention of Hepatitis A virus infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020. MMWR Recomm Rep. 2020;69(5):1-38.
• Freedman M, Kroger A, Hunter P, Ault KA; Advisory Committee on Immunization Practices. Recommended adult immunization schedule, United States, 2020. Ann Intern Med. 2020;172(5):337-47.
• Luyten J, Van de Sande S, de Schrijver K, Van Damme P, Beutels P. Cost-effectiveness of hepatitis A vaccination for adults in Belgium. Vaccine. 2012;30(42):6070-80.
• Suijkerbuijk AW, Lugnér AK, van Pelt W, Wallinga J, Verhoef LP, de Melker HE, et al. Assessing potential introduction of universal or targeted hepatitis A vaccination in the Netherlands. Vaccine. 2012;30(35):5199-205.
• Curran D, de Ridder M, Van Effelterre T. The impact of assumptions regarding vaccine-induced immunity on the public health and cost-effectiveness of hepatitis A vaccination: Is one dose sufficient? Hum Vaccin Immunother. 2016;12(11):2765-71.
• Andani A, van Damme P, Bunge EM, Salgado F, van Hoorn RC, Hoet B. One or two doses of hepatitis A vaccine in universal vaccination programs in children in 2020: A systematic review. Vaccine. 2022;40(2):196-205.
• Zhang L. Hepatitis A vaccination. Hum Vaccin Immunother. 2020;16(7):1565-73.