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World J Hepatol. Mar 27, 2012; 4(3): 68-73
Published online Mar 27, 2012. doi: 10.4254/wjh.v4.i3.68
Hepatitis A: Epidemiology and prevention in developing countries
Elisabetta Franco, Cristina Meleleo, Laura Serino, Debora Sorbara, Laura Zaratti
Elisabetta Franco, Laura Zaratti, Department of Public Health, University Tor Vergata, via Montpellier 1, 00133 Rome, Italy
Cristina Meleleo, Laura Serino, Debora Sorbara, Specialization School for Hygiene and Preventive Medicine, University Tor Vergata, via Montpellier 1, 00133 Rome, Italy
Author contributions: Franco E designed the research; Meleleo C, Serino L, Sorbara D and Zaratti L performed the literature search and evaluation; all authors contributed to writing the paper.
Correspondence to: Elisabetta Franco, MD, Professor of Hygiene, Department of Public Health, University Tor Vergata, via Montpellier 1, 00133 Rome, Italy.
Telephone: +39-06-72596122 Fax: +39-06-2025285
Received: February 28, 2011
Revised: March 14, 2012
Accepted: March 17, 2012
Published online: March 27, 2012

Hepatitis A is the most common form of acute viral hepatitis in the world. Major geographical differences in endemicity of hepatitis A are closely related to hygienic and sanitary conditions and other indicators of the level of socioeconomic development. The anti-hepatitis A virus (HAV) seroprevalence rate is presently decreasing in many parts of the world, but in less developed regions and in several developing countries, HAV infection is still very common in the first years of life and seroprevalence rates approach 100%. In areas of intermediate endemicity, the delay in the exposure to the virus has generated a huge number of susceptible adolescents and adults and significantly increased the average age at infection. As the severity of disease increases with age, this has led to outbreaks of hepatitis A. Several factors contribute to the decline of the infection rate, including rising socioeconomic levels, increased access to clean water and the availability of a hepatitis A vaccine that was developed in the 1990s. For populations with a high proportion of susceptible adults, implementing vaccination programs may be considered. In this report, we review available epidemiological data and implementation of vaccination strategies, particularly focusing on developing countries.

Keywords: Hepatitis A, Developing countries, Endemicity, Seroprevalence, Vaccine