Modern epidemiology of hepatitis A in the north‐western region of the Russian Federation

Abstract

The epidemiological features of hepatitis A virus (HAV) infection were studied in eleven territories located in the north-western region of the Russian Federation. The dynamics of HAV infection in Russia and in the region were evaluated during a 17-year period. The age-specific incidence was calculated and 229 305 patients with acute HAV were identified. The analysed database included HA mixed with other viral hepatitis infections: it included information about 8 809 HAV patients. Special attention has been paid to the sero-epidemiological studies conducted in St Petersburg city. These studies included analysis of age-specific incidence in persons 20 years of age and older during 6 years and testing of blood sera from 1 892 healthy persons for IgG anti-HAV. In general there is a trend to reduction of HAV incidence in Russia, and in the north-western region, high indices were registered in some provinces in different years. It was established three types of age-specific incidence distribution: predominated incidence in 3-14 years of age (first type), 15-29 years of age (second type) and uniform distribution in different age groups (third type). It was shown that decrease of HAV incidence in children and young adults lead to the reduction of sero-positivity level in the groups 20+ years of age. These characteristics should be taken in account to define indications for HAV vaccine prophylaxis. HAV infection in 10-13% of cases mixed with acute or chronic hepatitis B and C in the last 15 years in St Petersburg. In the middle of 1990s, HAV mostly mixed with acute viral hepatitis of different aetiology, but in the modern time predominated type of mixture was presented by HAV and chronic HBV and HCV infections. The obtained results are useful for viral hepatitis surveillance and control.

Has the time come to control hepatitis A globally? Matching prevention to the changing epidemiology

“…Increased access to safe water and adequate sanitation, usually in urban but not rural areas, has decreased HAV infections among children resulting in growing populations of susceptible persons. As a consequence of this epidemiological shift, countries have reported an increased incidence of symptomatic and fulminant HepA with significant morbidity and mortality among susceptible children from urban populations [1–6]. In some developing countries circulation of HepA virus is enhanced due to the co‐existence of populations with low and high socio‐economic conditions.…”

Epidemiology of hepatitis A in Finland in 1990–2007

“…In St. Petersburg region of neighboring Russia, the seropositivity numbers were much higher, at about 20% for 10-year olds and 70% for 40-year olds in 1998 [Mukomolov et al, 2001]. In 2006 the seropositivity numbers were still high, at 28.3% for those aged 20-29, 39.6% for those aged 30-39, and 71.9% for those aged 40þ [Shliakhtenko et al, 2008]. A previous review has shown that the figures by region in the rest of Europe are higher than in Finland [Jacobsen and Koopman, 2004].…”

Increased circulation of hepatitis A virus genotype IIIA over the last decade in St Petersburg, Russia

“…In Russia, the most significant changes in recent years in the epidemiology of hepatitis A were observed in north‐west Russia and in St Petersburg, the central city of this region. The highest incidence rate was registered in St Petersburg in 2004 (93.4 per 100,000), decreasing thereafter to 17.5 per 100,000 in 2007 [Shliakhtenko et al, 2008] and even to 7.7 per 100,000 in 2009. The latest HAV seroepidemiological study in the city was conducted in 2009 [Mukomolov et al, 2010] and revealed a dramatic reduction in immunity to HAV in the population of the city.…”