Changing sero-epidemiology of hepatitis A in Asia Pacific countries: A systematic review. (March 2018)

• Record Type: Journal Article
• Authors: Gripenberg, Marissa; Aloysia D'Cor, Naveena; L'Azou, Maïna; Marsh, Grenville; Druelles, Sophie; Nealon, Joshua
• Is Part Of: International journal of infectious diseases. Volume 68(2018)
• Page Start: 13
• Page End: 17
• Publication Date: 2018-03
• Subjects: Hepatitis A -- Seroprevalence -- Asia Pacific -- Epidemiology; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2017.12.021
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Hepatitis A severity increases with age, and immunity is life-long. Decreased endemicity could result in increased age and severity of cases. The Asian literature shows increasing age at first exposure, suggesting a transition in endemicity. Extensive gaps in the literature were identified for some countries. The public health impacts of this changing epidemiological context should be examined. Abstract: Objectives: Hepatitis A is a viral liver disease whose prevalence is associated with low socio-economic and hygiene levels due to its faecal–oral transmission. Severity increases with age, and immunity is life-long. Decreased endemicity could result in increased age and severity of cases. A literature review was conducted to describe changes in age-stratified hepatitis A seroprevalence in Asia Pacific countries from 1980 to 2016, and to identify gaps in the literature. The PRISMA guidelines were followed. Methods: The PubMed database was searched for studies on age-specific hepatitis A seroprevalence in 17 Asia Pacific countries. All studies published in the English language, reporting human hepatitis A seroprevalence levels in any age group, were included. Results: Seventy-three publications from 11 countries were identified. A trend of increasing age at first exposure over time was observed, particularly in developed countries such as Japan, Taiwan, Thailand, and Korea, suggesting a transition in terms of endemicity. Conclusions: Extensive gaps in the literature were identified between countries and year of publication, indicating the need for further research. Decreasing hepatitis A exposure and thus immunity conferred during childhood, may render older populations susceptible to infection. The public health and economic value of vaccination against hepatitis A should be assessed within this changing epidemiological context.