Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
Sci Rep. 2023 Jun 16;13(1):9762. doi: 10.1038/s41598-023-36739-4.
Children play an important role in hepatitis A virus (HAV) transmission but, due to frequent asymptomatic or mild courses, these infections are underrecognized in routine surveillance. Here, we analyzed hepatitis A (HA) seroprevalence, vaccination status and demographic determinants and estimated previous HAV infections in a cross-sectional population-based study of children and adolescents with residence in Germany 2014-2017, performing weighted univariable and multivariable logistic regression. Of 3567 participants aged 3-17 years, serological results were available for 3013 (84.5%), vaccination records for 3214 (90.1%) and both for 2721 (76.3%). Of 2721 with complete results, 467 (17.2%) were seropositive, thereof 412 (15.1%) with and 55 (2.0%) without previous HA vaccination, indicating previous HAV infection. Seropositivity was associated with age, residence in Eastern states, high socioeconomic status and migration background with personal migration experience. Participants with migration background and personal migration experience also had the highest odds ratios for previous HAV infection. Germany remains a country with very low HA endemicity. The current vaccination recommendations focusing on individuals with a high risk for HAV exposure (e.g. travelers to endemic countries) or severe disease appear appropriate. Migration and travel patterns as well as the endemicity in other countries influence the domestic situation, warranting further monitoring.
儿童在甲型肝炎病毒（HAV）传播中发挥着重要作用，但由于其经常无症状或症状较轻，这些感染在常规监测中容易被忽视。在此，我们分析了 2014-2017 年期间居住在德国的儿童和青少年的甲型肝炎（HA）血清流行率、疫苗接种状况和人口统计学决定因素，并估计了他们之前的 HAV 感染情况，通过加权单变量和多变量逻辑回归进行了分析。在 3567 名年龄在 3-17 岁的参与者中，有 3013 名（84.5%）的血清学结果可用，3214 名（90.1%）的疫苗接种记录可用，2721 名（76.3%）两者都有。在 2721 名有完整结果的参与者中，有 467 名（17.2%）呈血清阳性，其中 412 名（15.1%）有和 55 名（2.0%）无之前的 HA 疫苗接种史，表明之前感染过 HAV。血清阳性与年龄、居住在东部各州、高社会经济地位和移民背景以及个人移民经历有关。具有移民背景和个人移民经历的参与者之前感染 HAV 的可能性也最高。德国仍然是一个甲型肝炎低度流行的国家。目前的疫苗接种建议侧重于那些有 HAV 暴露高风险（例如前往流行地区的旅行者）或有严重疾病风险的个体，这种做法似乎是恰当的。移民和旅行模式以及其他国家的流行情况影响着国内形势，需要进一步监测。
