Increasing incidence of hepatitis A in Bangladesh

Abstract

Hepatitis A (HAV) infection is caused by the hepatitis A virus which is transmitted through the fecal-oral route. Life long protective antibodies are present after infection. The number of cases of adult hepatitis A has progressively been increasing during the last several decades in Bangladesh. In addition, the pattern of age-specific seroprevalence of anti-HAV has changed with economic growth. The prevalence of anti-HAV in 20-40 year age range has declined rapidly during the last 3 decades. As a result, this age groups has a high risk for HAV infection and clinically overt hepatitis A is increasing in adolescents and adult. The aim of the present study were to assess whether the proportion of adults with acute HAV infection has been increasing over the years and analyze the seroprevalence of immunoglobulin M(IgM) anti-HAV antibodies in young adults below the age of 20 years as well as in cases of chronic liver disease. Sera collected from 530 patients with acute and chronic liver disease attends the Somorita Hospital Ltd. during the previous 2 years and 6 months (Jan. 2008-Jun. 2010) were tested for various serological markers of acute and chronic hepatitis. In addition, 530 normal healthy attendants of the patients above the age of 20 years were tested for IgM anti-HAV as controls. Of 530 patients with acute hepatitis (13.42%) were positive for immunoglobulin M. The patients who were IgM anti-HAV negative were found to be hepatitis B (106 patients), hepatitis C, (10 patients), hepatitis E (150 patients) and unclassified (273 patients). Although the frequency of HAV infection among young adult (< 20 age) had increased (33.33% to 42.35%) in the 2 years and 6 months period, the frequency of HAV infection among adults had also increased (15.38% to 28.13%) during the same period. This study should be helpful for the identification of high risk population for vaccination of hepatitis A.

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

“…151 As a result, this age group has a high risk for HAV infection, and clinically overt hepatitis A is increasing in adolescents and adults. 152 Although the endemicity of HAV seems to be decreasing, adolescents and adults with high socioeconomic status remain at particularly high risk of symptomatic and severe illness, because individuals of high socioeconomic status have a low chance of HAV infection as children. 152 The clinical manifestations of hepatitis A depend on the age of the host: less than 30% of infected young children showed symptomatic hepatitis, whereas about 80% of infected adults had symptoms of severe acute hepatitis.…”

“…There have been substantial advances in research on liver diseases in Bangladesh and several epidemiological studies have been published in the past two decades. [56][57][58][59][60][61][62]149,150,[152][153][154][155][156][218][219][220]223,[406][407][408] Still, baseline data on incidence, prevalence, risk factors, natural history, and the changing epidemiology of various causes of liver diseases need to be generated. Studies are needed to develop cheap, accessible, point-of-care testing for HBV and HCV, and on preventive measures and new drug treatments for NAFLD.…”

Identification of hepatitis a virus antibody among Bangladeshi children and their correlation with socioeconomic condition

“…5 I n m a ny developing countries of Africa, Asia and Latin America, most infections occur by 5 years of age where seroprevalence approach 90-100% by 10-15 years of age. 1 In Africa, Hendricks et al 6 showed anti-HAV positivity of >90% among the 5-10 year age group among lower class black children. In developing countries, low economic status, high crowding and inadequate water treatment contribute to a high endemicity pattern; more than 90% of the population has acquired natural immunity before 10 years of age, and often shows asymptomatic forms.…”

“…Hepatitis A is an enterically transmitted viral disease world wide distributed. 1 Acute viral hepatitis caused by HAV is an acute, self-limiting infection. 2 Hepatitis A virus infection is very common in early childhood and most of the infections are asymptomatic or mildly symptomatic.…”