Hepatit A Epidemiyolojisi ve Duyarlı Nüfusta Değişim

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

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