Abstract
Hepatitis A virus (HAV) is transmitted via the fecal-oral route from contaminated food or water. As part of the most recent survey of viral hepatitis burden in Thailand, we analyzed the current seroprevalence of HAV in the country and compared with data dating back to 1971. From March to October, 2014, a total of 4,260 individuals between one month and 71 years of age from different geographical regions (North = 961; Central = 1,125; Northeast = 1,109; South = 1,065) were screened for anti-HAV IgG antibody using an automated chemiluminescent microparticle immunoassay. Overall, 34.53% (1,471/4,260) possessed anti-HAV IgG antibody, and the age-standardized seroprevalence was 48.6%. Seroprevalence rates were 27.3% (North), 30.8% (Central), 33.8% (Northeast) and 45.8% (South) and were markedly lower than in the past studies especially among younger age groups. The overall trend showed an increase in the age by which 50% of the population were anti-HAV IgG antibody: 4.48 years (1971–1972), 6 (1976), 12.49 (1990), 36.02 (2004) and 42.03 (2014).This suggests that Thailand is transitioning from low to very low HAV endemicity. Lower prevalence of HAV correlated with improved healthcare system as measured by decreased infant mortality rate and improved national economy based on increased GDP per capita. The aging HAV immuno-naïve population may be rendered susceptible to potential HAV outbreaks similar to those in industrialized countries and may benefit from targeted vaccination of high-risk groups.
Highlights
Hepatitis A virus (HAV) infection is estimated at 1.5 million individuals annually worldwide [1]
A study published 40 years ago found that most Thais were infected with HAV before reaching adulthood [17]
Our study revealed that as the healthcare and economic status of Thailand improved, the prevalence of HAV antibodies in the population steadily declined
Summary
Hepatitis A virus (HAV) infection is estimated at 1.5 million individuals annually worldwide [1]. HAV belongs to the family Picornaviridae and the genus Hepatovirus [2]. It is a non-enveloped virus with a 7.5 kb single-stranded positive-sense RNA genome. It is classified into six genotypes, designated I-VI. All genotypes represent a single serotype [4]. The major transmission route for HAV is through consumption of contaminated food or water, occasional transmission from person to person (through sexual intercourse or blood transfusion) has been reported [5,6,7,8,9]. High prevalence of HAV is often associated with poor hygiene, lack of sanitation and low socio-economic status [10]
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