Beutels M, Van Damme P, Vranckx R, Meheus A
WHO Collaborating Centre for Prevention and Control of Viral Hepatitis, Department of Epidemiology and Community Medicine, University of Antwerp, Wilrijk, Belgium.
Acta Gastroenterol Belg. 1998 Jan-Mar;61(1):4-7.
The purpose of this study was to obtain data on the prevalence of hepatitis A in Flanders, Belgium, in order to analyse any change in the epidemiological pattern of hepatitis A virus (HAV) in the region, and to determine at which age pre-vaccination testing would be useful. To meet these goals, a sero-epidemiological survey was conducted: 4058 serum samples were collected from a random sample of the general population in 1993-94. The overall age-standardised prevalence was 51.3%. Among non-Belgians (N = 245), the age-standardised anti-HAV prevalence was 66.4%, significantly higher than the 49.6% anti-HAV prevalence found in Belgians (N = 3186). Among Belgians, seroprevalence increased with age: from 5.4% in the youngest age group (0-14 years) to over 80% in the two oldest age groups (55-64 years and > or = 65 years). Prevalence rates were as high as 31.7% in the 25-34 year old age category, and 60.8% in the 35-44 year old age category. The age-specific prevalence figures among Belgians and non-Belgians reflect two different epidemiological patterns: the epidemiological pattern of a low endemic region for Belgians and the epidemiological profile of an intermediate endemic region forn non-Belgians. The age-specific prevalence figures in Belgians were compared with the 1979 and 1989 anti-HAV prevalence figures in Belgian first-time blood donors. A clear epidemiological shift showing decreasing HAV prevalence in the youngest age groups was found. If we accept that pre-vaccination screening is useful at a 35% prevalence rate, all persons over 35 years of age should be screened before vaccination.
本研究的目的是获取比利时弗拉芒地区甲型肝炎的流行数据，以分析该地区甲型肝炎病毒（HAV）流行病学模式的任何变化，并确定在哪个年龄段进行接种前检测会有用。为实现这些目标，开展了一项血清流行病学调查：1993年至1994年从普通人群的随机样本中收集了4058份血清样本。总体年龄标准化患病率为51.3%。在非比利时人（N = 245）中，年龄标准化抗-HAV患病率为66.4%，显著高于在比利时人（N = 3186）中发现的49.6%的抗-HAV患病率。在比利时人中，血清阳性率随年龄增加：从最年轻年龄组（0 - 14岁）的5.4%增至两个最年长年龄组（55 - 64岁和≥65岁）的80%以上。25 - 34岁年龄组的患病率高达31.7%，35 - 44岁年龄组的患病率为60.8%。比利时人和非比利时人按年龄划分的患病率数字反映了两种不同的流行病学模式：比利时人的低流行地区流行病学模式和非比利时人的中等流行地区流行病学概况。将比利时人按年龄划分的患病率数字与1979年和1989年比利时首次献血者的抗-HAV患病率数字进行了比较。发现了一个明显的流行病学转变，即最年轻年龄组的HAV患病率下降。如果我们认为接种前筛查在患病率为35%时有用，那么所有35岁以上的人在接种前都应接受筛查。
