Abstract. Serial changes in hepatitis A virus (HAV) and B virus (HBV) markers were determined from 1970 to 1996 in healthy Japanese residents of a rural area of Okinawa, Japan. All 190 serum samples taken in 1970, 791 in 1980, 708 in 1988, and 523 in 1996 from residents 0 to more than 60 years of age were tested for antibody to HAV (anti-HAV), antibody to hepatitis B core antigen (anti-HBc), and hepatitis B surface antigen (HBsAg). The ageadjusted prevalences of anti-HAV and anti-HBc decreased significantly from 83. 9% and 74.9%, respectively, in 1970 to 39.7% and 36.6%, respectively, in 1996. In residents Յ 29 years of age, the prevalences of anti-HAV and antiHBc decreased significantly from 65.3% and 83.8%, respectively, in 1970 to 0.7% and 8.2%, respectively, in 1996. The age-adjusted HBsAg prevalence decreased significantly from 8.2% in 1980 to 4.1% in 1988. These results indicate that exposure to HAV and HBV infections among Okinawa residents less than 29 years of age is decreasing, probably because of improvements in socioeconomic conditions since 1970. Infection with HBV may be eliminated there in the near future.Hepatitis A virus (HAV) infection is transmitted primarily by the fecal-oral route.1 The prevalence of HAV infection is influenced mainly by general hygiene, especially in relation to toilet facilities, water supplies, and food preparation, factors that reflect living standards and socioeconomic status. 2,3 Infection with HAV was endemic in Japan before 1970, but has since become less common. In Asian countries where hepatitis B virus (HBV) infection is hyperendemic, most people are infected during childhood through either perinatal or child-to-child transmission. [4][5][6][7] Although the average estimated carrier rate was 2-3% in the 1970s, placing Japan in the intermediate range for hepatitis B endemicity, 8 the mean carrier rate is now less than 2%.
9Infections with HAV and HBV have been extensively studied in various parts of the world, but long-term demographic data for all age groups have rarely been documented. Our previous reports confirmed that Okinawa, Japan was highly endemic for HAV and HBV infections. 10,11 We also reported remarkable decreases in the prevalences of these viral infections in children and young adults in Okinawa from 1970Okinawa from to 1988 Determining changes in the prevalences of HAV and HBV infections with time is necessary if infection trends are to be predicted. We studied changes in the frequency of HAV and HBV infections over the 26-year period from 1970 to 1996 in Okinawa, Japan, an area previously endemic for these viral infections.