Hepatitis A incidence and hospital-based seroprevalence in Italy: a nation-wide study

Ansaldi, Filippo; Bruzzone, Bianca; Rota, Maria Cristina; Bella, Antonino; Atti, Marta Luisa Ciofi degli; Durando, Paolo; Gasparini, Roberto; Icardi, Giancarlo

doi:10.1007/s10654-007-9198-y

Cited by 25 publications

(16 citation statements)

References 42 publications

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“…These estimates comply with the seroprevalence data reported in (Ansaldi et al, 2008), where an average value of 67.7% is reported for Southern Italy. Figure 3b shows the fraction of recovered individuals per age cohort, compared with national seroprevalence data (Ansaldi et al, 2008). Age at infection of symptomatic individuals is shown in Figure 3c.…”

Section: Baseline Scenariossupporting

confidence: 91%

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An individual-based model of hepatitis A transmission

Ajelli

Merler

2009

Journal of Theoretical Biology

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Viral hepatitis A, as other endemic diseases, represents a public health priority worldwide. To study long-time scale human pathogens through individual-based simulations requires the development of a dynamic network of contacts. In this work, we introduce an individual-based model accounting for the birth and death of the individuals, the generation of new households, and the educational career of the individuals, in order to investigate viral hepatitis A dynamics in the most affected Italian areas. Intervention options such as targeted vaccination, social distancing measures (e.g. closure of day care centers and kindergartens) and improvements in standards of living and hygiene are evaluated. Results show that a very low vaccination coverage is sufficient to control hepatitis A in Italy, while its elimination is not possible since new cases are continuously imported from high endemicity areas outside the country. Finally, the considered social distancing measures can be counterproductive since the fraction of recovered individuals does not decline while the age at infection increases, thus augmenting the probability of developing acute symptoms. Preprint submitted to Elsevier 31 March 2009A c c e p t e d m a n u s c r i p t

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Section: Baseline Scenariossupporting

confidence: 91%

“…1 In light of a recent study on the HAV seroprevalence in Italy (Ansaldi et al, 2008), the estimation of R 0 given by were slightly revised.…”

Section: Baseline Scenariosmentioning

confidence: 99%

An individual-based model of hepatitis A transmission

Ajelli

Merler

2009

Journal of Theoretical Biology

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“…[6] It was higher in southern Regions most likely because of the common and widely spread habit to eat raw seafood and to the higher environmental fecal contamination. [7] …”

Section: Introductionmentioning

confidence: 99%

Serosurveillance of hepatitis A in a region which adopted the universal mass vaccination

Gallone

Desiante²,

Gallone³

et al. 2017

Medicine

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Hepatitis A is a common infectious disease worldwide that was endemic in many regions of Southern Italy, such as Apulia region. After a large hepatitis A outbreak occurred between 1996 and 1997, in Apulia an active-free immunization program that was targeted to new-borns and adolescents was started. The aim of this study is to investigate the hepatitis A seroprevalence in the adult Apulian population 18 years after the immunization program introduction, in order to evaluate the risk of new epidemics onset.The study was carried out from May 2011 to June 2012 among blood donors from Department of Transfusion Medicine and Blood Bank of Policlinico General Hospital in Bari. Participants signed a written consent and filled out a questionnaire including items on demographic characteristics, risk factors, disease memory, and raw food consumption. Serum samples, collected from each patient, were tested for anti-HAV using the chemiluminescent microparticle immunoassay. Vaccination status against hepatitis A was checked on Regional Digital Immunization Registry (GIAVA).In total 1827 donors agreed to participate (77.7% male) with a mean age of 38.4 ± 11.7 years. However, 1172 (64.1%) donors were seropositive with no difference by sex. The highest proportion of seronegative subjects was in the 27 to 35 years age group. 91.8% of 1-dose vaccinated subjects (n = 190/207; 95%CI = 87.2–95.1) and 96.1% (n = 171/178; 95%CI = 92.1–98.1) of 2-doses vaccinated subjects were immune to the disease. Sensitivity of disease memory in unvaccinated subjects was 14.4% (95%CI = 12.2–16.7), specificity was 97.8% (95%CI = 96.3–98.8), positive predictive value was 91% (95%CI = 85.3–95), and negative predictive value was 42.6% (95%CI = 40–45.2). Raw seafood consumption in unvaccinated subjects was associated with the anti-HAV IgG positivity (OR = 2.1; 95%CI = 1.7–2.7; z = 7.4; P < 0.0001).The vaccination program seems to have changed the virus circulation pattern, with a higher seronegativity rate among subjects not included in the vaccination strategy: 67% of susceptible subjects were among younger people aged 27 to 35 years. Immunization program implementation with a catch-up strategy may be needed to avoid a possible increase of hepatitis A incidence and outbreaks in Apulia. Epidemiological surveillance should be continued and vaccination should actively be offer for free to all the cases contacts, in order to prevent new outbreaks onset.

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“…In developed countries, transmission shifts to older age groups, and seroprevalence increases during adulthood. In Europe, the seroprevalence of HAV is reported to range from 32% (in Italy and Ukraine) to 88% (in Kosovo) [5][6][7][9][10][11][12]. There are, however, very few published studies on the seroprevalence of HAV in Croatia, and these have been limited to specific population groups [13][14].…”

Section: Introductionmentioning

confidence: 99%

Seroepidemiology of Hepatitis A in the Croatian Population

Vilibić-Čavlek¹,

Kučinar²,

Ljubin‐Sternak

et al. 2012

Hepat Mon

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BackgroundHepatitis A virus (HAV) has a worldwide distribution, although this distribution tends to be uneven among geographical regions and population groups. The prevalence of anti-HAV antibodies in the general population varies widely among countries. In Europe, the seroprevalence of HAV is reported to range from 32% to 88%.ObjectivesThe aim of this study was to determine the seroprevalence of HAV among the general Croatian population.Materials and MethodsDuring a 2-year period (2008-2009), a total of 791 serum samples were tested for the presence of anti-HAV total (IgM+IgG) and anti-HAV IgM antibodies using an automated enzyme-linked fluorescent assay (Mini Vidas; bioMérieux, Marcy l'Etoile, France).ResultsThe overall anti-HAV seroprevalence was 41.6%. The observed difference in the seroprevalence rates among male and female patients was not statistically significant (44% vs. 39.6%, P = 0.218). A marked increase in anti-HAV seropositivity with age was observed (P < 0.001). The seroprevalence did not differ significantly between participants residing in rural regions (45.3%) and those residing in urban regions (40.6%, P = 0.292).ConclusionsOur results corroborate those of seroprevalence studies in other developed countries. More than half of the Croatian population (59.4%) is susceptible to HAV infection. Older age is an important predictor for being anti-HAV positive.

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Hepatitis A incidence and hospital-based seroprevalence in Italy: a nation-wide study

Cited by 25 publications

References 42 publications

An individual-based model of hepatitis A transmission

An individual-based model of hepatitis A transmission

Serosurveillance of hepatitis A in a region which adopted the universal mass vaccination

Seroepidemiology of Hepatitis A in the Croatian Population

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