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REVIEW ARTICLE
Year : 2016  |  Volume : 5  |  Issue : 2  |  Page : 75-80

Changing seroepidemiology of hepatitis A infection and its prevention in endemic regions


Department of Medicine, Assam Medical College, Dibrugarh, Assam, India

Correspondence Address:
Anup Kumar Das
Department of Medicine, Assam Medical College, Dibrugarh - 786 002, Assam
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-344X.180427

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Hepatitis A is the most common cause of acute viral hepatitis worldwide although a preventive vaccine is available. Infection generally confers life-long immunity. It causes severe, often fatal, disease in adults, especially in those with underlying liver dysfunction, but is mostly asymptomatic in children. Endemicity is determined by anti-hepatitis A seroprevalence in different regions of the world. Hence, industrialized nations fall under hypoendemic category, but tropical, Asian, or African countries are hyperendemic. Hyperendemic countries have an adult population who develop immunity to hepatitis A as they are usually infected in childhood due to poor sanitation, in contrast to developed nations where adults remain susceptible. Vaccination strategies differ across the world depending on the endemicity. Usually, universal vaccination is still not advocated in endemic developing countries, unlike in USA or Europe. However, data are emerging from developing nations such as India where more adults are probably becoming susceptible to hepatitis A due to improving economy, better sanitation, and personal hygiene. Hence, the global seroepidemiology of hepatitis A is changing in many developing nations giving rise to unique nonimmune adolescent and adult populations emerging in endemic regions, thereby conferring a risk of developing severe hepatitis A. Abstracts, articles, and cross references were examined in search engines including PubMed and chapters from standard textbooks and monographs. This narrative review of some relevant recent information on this shifting seroepidemiology in endemic areas discusses changes in national and regional vaccination strategies with public health implications.


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