Karabey Mehmet, Alacam Sema, Karabulut Nuran, Uysal Hayriye, Gunduz Alper, Aydina Ozlem Altuntas
From the Department of Virology, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey.
From the Department of Microbiology, Istanbul University Faculty of Medicine, Istanbul, Turkey.
Ann Saudi Med. 2024 Nov-Dec;44(6):386-393. doi: 10.5144/0256-4947.2024.386. Epub 2024 Dec 5.
Hepatitis A infections continue to be a major global public health problem. The epidemiology and seroprevalence of hepatitis A virus (HAV) have important public health implications. This study aimed to retrospectively examine the hepatitis A cases and hepatitis A seroprevalence in our region in our hospital with the highest number of inpatient and outpatient cases in Istanbul.
Determination of hepatitis A cases and seroprevalence.
Cross-sectional.
Tertiary care.
A total of 39 385 individuals who were tested for Anti-HAV IgM and Anti-HAV Total (IgM+IgG) antibodies between May 2020 and September 2023 and were included in this study. Hepatitis A specific IgM and Total (IgM+IgG) antibodies were determined using the enzyme-linked immunosorbent assay method.
Hepatitis A seroprevalence.
46 721.
The study included a total of 46 721 samples from 39 385 individuals who were tested for hepatitis A serology. The median age of the 39385 individuals included in the study was 28 (interquartile range [IQR]; 22-46), with 58.74% being female and 4.07% (n=1163) being foreign nationals. Reactivity was detected in 91 of the 25 442 patients tested for HAV-IgM. Among these patients, 33 (0.13%) had acute hepatitis A infection, while 58 (0.23%) were considered false positives. Of the acute hepatitis A patients, 13 (0.09%) were women, and 22 (0.80%) were children. Acute hepatitis A was most commonly observed in the 6-9 and 15-18 age groups, with 7 cases each. The seroprevalence rate of hepatitis A was 67.23% among 33 683 individuals. Of those tested for HAV-Total, 13 132 (64.92%) were women, and 2533 (64.88%) were children. The lowest seroprevalence rate among age groups (35.91%) was in the 15-18 age year range, while the highest seroprevalence (98.34%) was detected in individuals aged 60 years and above.
With a seroprevalence rate of 67.23%, our region is still considered a medium-endemic area for hepatitis A, and it is crucial to continue administering the HAV vaccine as currently included in the childhood vaccination schedule in our country. Additionally, the significantly low hepatitis A seropositivity, particularly in the 15-18 and 19-24 age groups, indicates the need to promote catch-up vaccination for young adults. Since our study covers a large population, it can serve as a guide regarding the serological status of hepatitis A in Istanbul.
Since vaccination information for the study population was not available, it was not possible to distinguish between seropositivity due to vaccination or natural immunity. Despite being conducted in Istanbul, a cosmopolitan city, and in the largest city hospital, the results may not be representative of the entire country.
甲型肝炎感染仍然是一个主要的全球公共卫生问题。甲型肝炎病毒（HAV）的流行病学和血清流行率具有重要的公共卫生意义。本研究旨在回顾性研究我院所在地区的甲型肝炎病例和甲型肝炎血清流行率，我院是伊斯坦布尔住院和门诊病例数最多的医院。
确定甲型肝炎病例和血清流行率。
横断面研究。
三级医疗保健机构。
共有39385名个体在2020年5月至2023年9月期间接受了抗-HAV IgM和抗-HAV总抗体（IgM+IgG）检测，并纳入本研究。采用酶联免疫吸附测定法测定甲型肝炎特异性IgM和总抗体（IgM+IgG）。
甲型肝炎血清流行率。
46721。
该研究共纳入了39385名接受甲型肝炎血清学检测个体的46721份样本。纳入研究的39385名个体的中位年龄为28岁（四分位间距[IQR]；22-46岁），其中58.74%为女性，4.07%（n=1163）为外国公民。在25442名接受HAV-IgM检测的患者中，有91人检测出反应性。在这些患者中，33人（0.13%）患有急性甲型肝炎感染，而58人（0.23%）被认为是假阳性。在急性甲型肝炎患者中，13人（0.09%）为女性，22人（0.80%）为儿童。急性甲型肝炎最常见于6-9岁和15-18岁年龄组，各有7例。在33683名个体中，甲型肝炎的血清流行率为67.23%。在接受HAV总抗体检测的人群中，13132人（64.92%）为女性，以及2533人（64.88%）为儿童。各年龄组中最低的血清流行率（35.91%）出现在15-18岁年龄组，而最高的血清流行率（98.34%）出现在60岁及以上的个体中。
血清流行率为67.23%，我们地区仍被认为是甲型肝炎的中流行地区，继续按照我国目前儿童疫苗接种计划接种HAV疫苗至关重要。此外，甲型肝炎血清阳性率显著较低，特别是在15-18岁和19-24岁年龄组，这表明有必要推动对年轻人进行补种疫苗。由于我们的研究涵盖了大量人群，它可以作为伊斯坦布尔甲型肝炎血清学状况的指南。
由于无法获得研究人群的疫苗接种信息，因此无法区分血清阳性是由于接种疫苗还是自然免疫。尽管该研究在国际化大都市伊斯坦布尔的最大城市医院进行，但结果可能不代表整个国家。
