Godoy P, Carmona G, Manzanares S, Jane M, Borràs E, Camps N, Álvarez J, Barrabeig I, Sala M-R, Rius C, Minguell S, Carol M, Ferras J, Domínguez A
Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain.
CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
J Viral Hepat. 2018 Sep;25(9):1001-1007. doi: 10.1111/jvh.12900. Epub 2018 Apr 26.
At the end of 1998, universal hepatitis A+B vaccination of 12 year olds was introduced in Catalonia. The aim was to examine trends in hepatitis A during 2005-2015 and assess risk factors by age group. We carried out an observational epidemiological study of the incidence and risk factors of hepatitis A reported to the surveillance system. Information on exposure was recorded for each case for the 2-6 weeks before symptom onset. Spearman's coefficient was used to evaluate the trends of rates. The chi-square test was used to compare categorical. We studied 2621 hepatitis A cases; the age mean was 26.6 years (SD=18.2), and >50% of cases were in the 20-49 years age group. The incidence decreased from 3.28/100 000 in 2005 to 1.50/100 000 in 2015. The rate for women decreased over time (P = .008), but the reduction was not significant in men (P = .234). Men consistently had higher rates than women with the biggest difference being in the 20-34 years age group (rate 8.8 vs 2.8). The greatest risk factor was travel to an endemic country (42.1%) in the 0-19 years age group and male-to-male sexual contact (18.6%) in the 20-49 years age group. The case fatality rate in adults aged >49 years was 0.4%. In conclusion, the vaccination programme of preadolescents resulted in a reduction in hepatitis A cases. However, a significant amount of cases still appear in immigrants and men who have sex with men. Hepatitis A in adults is an emerging health problem that will require new strategies.
1998年底，加泰罗尼亚地区开始对12岁儿童实施甲型和乙型肝炎联合疫苗接种。目的是研究2005年至2015年期间甲型肝炎的发病趋势，并按年龄组评估风险因素。我们对监测系统报告的甲型肝炎发病率和风险因素进行了一项观察性流行病学研究。记录了每个病例在症状出现前2至6周的暴露信息。采用Spearman系数评估发病率趋势。采用卡方检验比较分类变量。我们研究了2621例甲型肝炎病例；平均年龄为26.6岁（标准差=18.2），超过50%的病例在20至49岁年龄组。发病率从2005年的3.28/10万降至2015年的1.50/10万。女性发病率随时间下降（P = 0.008），但男性发病率下降不显著（P = 0.234）。男性发病率始终高于女性，最大差异出现在20至34岁年龄组（发病率8.8对2.8）。最大的风险因素是0至19岁年龄组前往流行国家旅行（42.1%）和20至49岁年龄组男性之间的性接触（18.6%）。49岁以上成年人的病死率为0.4%。总之，青春期前儿童的疫苗接种计划导致甲型肝炎病例减少。然而，大量病例仍出现在移民和男男性行为者中。成人甲型肝炎是一个新出现的健康问题，需要新的策略。
