A Study of Hepatitis A Seroprevalence in a Paediatric and Adolescent Population of the Province of Florence (Italy) in the Period 2017-2018 Confirms Tuscany a Low Endemic Area.

Beatrice Zanella,Marco Menicacci,Paolo Bonanni,Sara Boccalini,Duccio Giorgetti,Francesco Puggelli,Emilia Tiscione,Benedetta Bonito,Massimiliano Alberto Biamonte,Alessandra Ninci,Giovanna Mereu,Working Group Aoumeyer Working Group Aoumeyer,Working Group Ausltc Working Group Ausltc,Working Group Dhs Working Group Dhs,Angela Bechini

doi:10.3390/vaccines9101194

Beatrice Zanella, Marco Menicacci + Show 13 more

Open Access

https://doi.org/10.3390/vaccines9101194

Copy DOI

Abstract

Background: Italy is considered an area with very low HAV (hepatitis A virus) endemicity. Currently in Italy the anti-HAV vaccine is recommended only for specific risk groups and there is no universal vaccination program. The aim of this study was to assess the level of immunity against hepatitis A in a sample of children and adolescents from the province of Florence. Methods: A total of 165 sera were collected from subjects aged 1 to 18 years, proportionally selected according to the general population size and stratified by age and sex. A qualitative evaluation of anti-HAV antibodies was performed using the enzyme-linked immunosorbent assay (ELISA). Anamnestic and vaccination status data were also collected. Results: Our study showed a hepatitis A seroprevalence of 9.1% in the enrolled population. A statistically significant difference in the prevalence of anti-HAV was found between Italian and non-Italian subjects. About half of the population having anti-HAV antibodies was reported to be vaccinated, and no cases of hepatitis A were found. Conclusions: The data from our study confirmed Tuscany as an area with low HAV endemicity and showed that hepatitis A seroprevalence is significantly higher in foreign children and adolescents. The presence of more seropositive subjects than those vaccinated was probably due to a natural immunization achieved through a subclinical infection and/or to underreporting of the surveillance systems.

Highlights

Hepatitis A is a serious infectious disease caused by the hepatitis A virus (HAV), which infects the hepatocytes
Transmission can occur in countries where the risk of infection from food or water is low through outbreaks among men who have sex with men (MSM) and persons who inject drugs (PWIDs)
The age of sexual debut in Italy is around 17 years [30], and our analysis showed that most subjects aged 15–18 years were not protected against the Hepatitis A virus and remained susceptible to the disease

Summary

Introduction

Hepatitis A is a serious infectious disease caused by the hepatitis A virus (HAV), which infects the hepatocytes. HAV is an RNA virus and is generally transmitted through the fecaloral route due to contamination of food and water. Unlike the hepatitis B and C viruses, HAV does not cause a chronic infection. The post-infection and post-vaccination immunity are assessed through the detection of total anti-HAV (IgG) antibodies [1]. Is considered an area with very low HAV (hepatitis A virus) endemicity. About half of the population having anti-HAV antibodies was reported to be vaccinated, and no cases of hepatitis A were found. Conclusions: The data from our study confirmed Tuscany as an area with low HAV endemicity and showed that hepatitis A seroprevalence is significantly higher in foreign children and adolescents. The presence of more seropositive subjects than those vaccinated was probably due to a natural immunization achieved through a subclinical infection and/or to underreporting of the surveillance systems

Objectives

Methods

Results

Discussion

Conclusion