Murphy Trudy V, Denniston Maxine M, Hill Holly A, McDonald Marian, Klevens Monina R, Elam-Evans Laurie D, Nelson Noele P, Iskander John, Ward John D
Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC.
MMWR Suppl. 2016 Feb 12;65(1):29-41. doi: 10.15585/mmwr.su6501a6.
Hepatitis A virus (HAV) disease disproportionately affects adolescents and young adults, American Indian/Alaska Native and Hispanic racial/ethnic groups, and disadvantaged populations. During 1996-2006, the Advisory Committee on Immunization Practices (ACIP) made incremental changes in hepatitis A (HepA) vaccination recommendations to increase coverage for children and persons at high risk for HAV infection. This report examines the temporal association of ACIP-recommended HepA vaccination and disparities (on the absolute scale) in cases of HAV disease and on seroprevalence of HAV-related protection (measured as antibody to HAV [anti-HAV]). ACIP-recommended childhood HepA vaccination in the United States has eliminated most absolute disparities in HAV disease by age, race/ethnicity, and geographic area with relatively modest ≥1-dose and ≥2-dose vaccine coverage. However, the increasing proportion of cases of HAV disease among adults with identified and unidentified sources of exposure underscores the importance of considering new strategies for preventing HAV infection among U.S. adults. For continued progress to be made toward elimination of HAV disease in the United States, additional strategies are needed to prevent HAV infection among an emerging population of susceptible adults. Notably, HAV infection remains endemic in much of the world, contributing to U.S. cases through international travel and the global food economy.
甲型肝炎病毒（HAV）疾病对青少年和青壮年、美国印第安人/阿拉斯加原住民以及西班牙裔种族/族裔群体和弱势群体的影响尤为严重。在1996 - 2006年期间，免疫实践咨询委员会（ACIP）对甲型肝炎（HepA）疫苗接种建议进行了逐步调整，以提高儿童和HAV感染高危人群的疫苗接种覆盖率。本报告研究了ACIP推荐的HepA疫苗接种与HAV疾病病例中的差异（绝对尺度）以及HAV相关保护的血清流行率（以甲型肝炎抗体[抗 - HAV]衡量）之间的时间关联。在美国，ACIP推荐的儿童HepA疫苗接种通过相对适度的≥1剂和≥2剂疫苗接种覆盖率，消除了按年龄、种族/族裔和地理区域划分的HAV疾病中大多数绝对差异。然而，在有明确和不明暴露源的成年人中，HAV疾病病例比例不断增加，这凸显了考虑在美国成年人中预防HAV感染新策略的重要性。为了在美国消除HAV疾病方面继续取得进展，需要采取额外策略来预防新兴易感成年人群体中的HAV感染。值得注意的是，HAV感染在世界许多地区仍然是地方病，通过国际旅行和全球食品经济导致美国出现病例。
