Burden of disease and associated complications of hepatitis a in children and adults in Mexico: A retrospective database study

Abstract

Background Hepatitis A virus (HAV) infection is a leading cause of viral hepatitis in children, yet the HAV vaccine is not included in the national immunization program (NIP) in Mexico. This study addresses an identified evidence gap of the burden of hepatitis A disease, complications, and associated costs in Mexico by analyzing surveillance and healthcare data. Data review included disease morbidity (incidence and hospitalization), mortality, and healthcare resource utilization costs. Methods In this observational, retrospective database study, we conducted a systematic screening, extraction, and analysis of outcome data from the national surveillance system in Mexico from January 2000 to December 2019. Results During the analysis period (2000–2019), the average incidence rate/year of HAV cases was 14.7 (5.4–21.5) per 100,000 inhabitants. Children 1–9 years of age (YoA) had the highest average incidence rate/year with 47.8 (14.7–74.5). The average hospitalization rate/year due to HAV infection was 5.8% (2.9–9.6%). Although the highest burden of HAV continued to be in children (1–9 YoA), an increase in incidence and hospitalizations (with complications) in older age groups (≥ 10–64 YoA) was observed. The annual average fatality rate was estimated to be 0.44% (0.26–0.83%) of which 28.8% of deaths were concentrated in adults ≥ 65 YoA. The total direct costs of medical attention due to HAV and related complications were estimated at $382 million Mexican pesos. Conclusion The overall results suggest an uptrend in HAV infections in adolescents/adults compared to children in Mexico. Therefore, as the overall incidence risk of HAV infection decreases, the mean age of infection increases. This consequently increases the risk of severity and complications in older age groups, thus increasing the demand for healthcare resources. Our findings provide evidence for including the inactivated HAV vaccine in the Mexican NIP.

Acute Acalculous Cholecystitis Associated with Hepatitis A Viral Infection: A Case Report

“…Serologic testing, which recognizes the presence of immunoglobulin M (IgM) anti-HAV in the acute phase of infection and immunoglobulin G (IgG) anti-HAV in the convalescent phase of infection, is necessary for a definitive diagnosis of hepatitis A. 2 Although not specific, laboratory testing of cases with acute acalculous cholecystitis as a complication from hepatitis A infection revealed an increase in white blood cells (WBC), C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and anti-HAV IgM. 1,11 Open access under CC-BY-NC-SA 4.0 International License When acute gallbladder inflammation is unrelated to gallstones or sludge, the diagnosis of acalculous cholecystitis is established.…”

“…Transmission through sharing needles and sexual activity is also possible, however this is unusual. [1][2][3][4] Acute cholecystitis is inflammation of the gallbladder wall and is classified into calculus and acalculus. 5 As many as 90-95% of cases are brought on by bile duct stones.…”

“…Only few previous studies have ever reported it. [1][2][3] Even while this condition normally resolves on its own, it can occasionally proceed to gangrene, perforation, and even death. 10 In acute acalculous cholecystitis instances that do not exhibit the traditional signs of acute cholecystitis, delayed identification and treatment can result in serious consequences and high death rates.…”

A community-wide epidemic of hepatitis A virus genotype IA associated with consumption of shellfish in Yantai, eastern China, January to March 2020

“…The reason might be attributable primarily to the beneficial impact of universal childhood vaccination policies against hepatitis A in China since 2008 and the fact that HAV illness in children under 6 years of age is generally asymptomatic. 23 …”

Global outbreaks of foodborne hepatitis A: Systematic review and meta-analysis

“…Extra-hepatic complications such as neurologic, renal and cardiovascular complications have also been observed rarely [ 10 ]. Hospitalizations and complication management (Liver transplantation) associated with HAV could substantially burden the healthcare systems [ 15 , 16 ]. Based on the systematic literature search conducted by the authors, comprehensive literature on the characteristics of foodborne HAV outbreaks and pooled estimates of their health outcomes was lacking at a global level.…”