Abstract
ABSTRACT INTRODUCTION: Hepatitis A virus (HAV) has a universal distribution. The prevalence of HAV infection varies greatly according to hygiene and sanitary conditions.OBJECTIVE: To determine the proportion of acute infection of HAV in the state of Bahia during a 5-year period. METHODS: This study was conducted at Central Public Health Laboratory of Bahia (LACEN-BA). All individuals referred for anti-HAV IgM serology from 417 municipalities from January, 2009 to December, 2013 were included. Percentages of HAV positive cases were presented according to age range for each year of the 5-year study and for each of the nine health districts (RHC) of Bahia.RESULTS: 21,175 samples were analyzed. Proportion of HAV infection was 7.2% (1,535 / 21,175) throughout the study period. The highest proportion was in 2009 (17.4%) and the lowest in 2012 (3.8%), demonstrating a decreasing trend (r = 0.7). The highest infection rates was found in children up to 10 years old. HAV infection was more frequent among males among all age groups. 52.4% (184/351) of the municipalities had acute HAV cases diagnosed. The North and West regions had the highest number of cases. CONCLUSION: There was a progressive decrease of approximately 70% in the proportion of acute HAV infection in the state of Bahia during a five-year assessment period. However, children up to 10 years old remain at higher risk, therefore the vaccine should be expanded to reach this age range.
Highlights
Hepatitis A virus (HAV) has a worldwide distribution
Acute HAV infection was more frequent among males, with a male:female ratio varying from 1.2:1 to 1.5:1 among all age groups
The data presented indicate a progressive decrease of approximately 70% in the proportion of acute HAV infection in the state of Bahia during a five-year assessment period: from 17.4% in 2009 to 4.5% in 2013
Summary
Hepatitis A virus (HAV) has a worldwide distribution. Overall, roughly 1.4 million cases of HAV are reported per year[1]. Endemic areas for HAV are classified according to the incidence of infection as high endemicity (up to 45 cases / 100,000 inhabitants), intermediate endemicity (between 15 and 45 cases / 100,000 inhabitants) and low endemicity (less than 15 cases / 100,000 inhabitants)[2]. High endemic rates of infection are found mainly in developing countries with very poor sanitary and hygienic conditions such as parts of Africa, Asia and Central and South America[3]. In these regions, HAV infection is usually acquired during childhood mostly as an asymptomatic infection. Developing countries and regions where sanitary conditions are unequal have intermediate levels of HAV infection, while developed countries with good sanitary and hygienic conditions have low levels[1]
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