Changing Epidemiological Characteristics of Hepatitis A in Zhejiang Province, China: Increased Susceptibility in Adults

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2016 Apr 20

PMID 27093614

Citations 13

Authors

Zhifang Wang

Yaping Chen

Shuyun Xie

Huakun Lv

Affiliations

Soon will be listed here.

Abstract

Background: Hepatitis A is a common acute hepatitis caused by hepatitis A virus (HAV). Annually, it affects 1.4 million people worldwide. Between 1991 and 1994, HAV infections were highly endemic in Zhejiang Province (China), with 78,720 reported HAV infections per year. Hepatitis A vaccine came on the market in 1995 and was implemented for voluntary immunization. Since 2008, hepatitis A vaccine has been integrated into the national childhood routine immunization program.

Objective: To understand the current epidemiological profile of hepatitis A in Zhejiang Province since hepatitis A vaccine has been available for nearly two decades.

Methods: This study used the 2005-2014 National Notifiable Diseases Reporting System data to evaluate the incidence rate of notified hepatitis A cases in Zhejiang Province.

Results: The overall trend of incidence rate of notified hepatitis A cases significantly decreased from 2005 to 2014 (P< 0.001). During the study period, the reported incidence rate in individuals aged ≤19 years declined to the historically lowest record in 2014. Compared with individuals aged ≤19 years, those aged ≥20 years showed the highest incidence rate (P< 0.001). Majority of HAV infected cases were Laborers, accounting for approximately 70% of reported cases.

Conclusions: Childhood immunization strategy with hepatitis A vaccine seemed to be effective in decreasing notified hepatitis A incidence rate in individuals aged ≤19 years. Those aged ≥20 years were observed to be the most susceptible population. The vast majority of hepatitis A cases were notified among Laborers. Therefore, we strongly suggest that future preventive and control measures should focus more on adults, particularly Laborers, in addition to the current childhood hepatitis A vaccination programme.

Citing Articles

Global burden and trends of viral hepatitis among women of childbearing age from 1990 to 2021.

Yang S, Zhong L, Huang L, Lin S, Li Y Front Microbiol. 2025; 16:1553129.

PMID: 40061861 PMC: 11885505. DOI: 10.3389/fmicb.2025.1553129.

Trends and projections of Hepatitis A incidence in eastern China from 2007 to 2021: an age-period-cohort analysis.

Peng H, Wang Y, Wei S, Kang W, Zhang X, Cheng X Front Public Health. 2024; 12:1476748.

PMID: 39697280 PMC: 11652658. DOI: 10.3389/fpubh.2024.1476748.

The Shifting Epidemiology of Hepatitis A in the World Health Organization Western Pacific Region.

Gloriani N, de Paz-Silava S, Allison R, Takashima Y, Avagyan T Vaccines (Basel). 2024; 12(2).

PMID: 38400187 PMC: 10891653. DOI: 10.3390/vaccines12020204.

Assessing the effectiveness of the expanded hepatitis A vaccination program in China: an interrupted time series design.

Wu Y, Wang P, Huang Y, Chen J, Chang Y, Li J BMJ Glob Health. 2024; 9(2).

PMID: 38320803 PMC: 10859990. DOI: 10.1136/bmjgh-2023-013444.

Assay Sensitivity Difference Can Induce Anti-Hepatitis A Virus IgM Non-Reactive But Total (IgM and IgG) Reactive Results in Early Acute Hepatitis A.

Kim S, Yoo K, Huh J J Korean Med Sci. 2022; 37(37):e287.

PMID: 36163480 PMC: 9512680. DOI: 10.3346/jkms.2022.37.e287.

References

Tavoschi L, Severi E, Niskanen T, Boelaert F, Rizzi V, Liebana E . Food-borne diseases associated with frozen berries consumption: a historical perspective, European Union, 1983 to 2013. Euro Surveill. 2015; 20(29):21193. DOI: 10.2807/1560-7917.es2015.20.29.21193. View

Naing N . Easy way to learn standardization : direct and indirect methods. Malays J Med Sci. 2012; 7(1):10-5. PMC: 3406211. View

Chen H . [Hepatitis A outbreak with arca as the vehicle of transmission]. Zhonghua Liu Xing Bing Xue Za Zhi. 1991; 12(2):87-90. View

Fiore A, Wasley A, Bell B . Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2006; 55(RR-7):1-23. View

Xu Z, Wang X, Liu C, Li Y, Zhuang F . Decline in the risk of hepatitis A virus infection in China, a country with booming economy and changing lifestyles. J Viral Hepat. 2008; 15 Suppl 2:33-7. DOI: 10.1111/j.1365-2893.2008.01026.x. View

Wasley A, Fiore A, Bell B . Hepatitis A in the era of vaccination. Epidemiol Rev. 2006; 28:101-11. DOI: 10.1093/epirev/mxj012. View

Brown G, Persley K . Hepatitis A epidemic in the elderly. South Med J. 2002; 95(8):826-33. View

Lam E, McCarthy A, Brennan M . Vaccine-preventable diseases in humanitarian emergencies among refugee and internally-displaced populations. Hum Vaccin Immunother. 2015; 11(11):2627-36. PMC: 4685677. DOI: 10.1080/21645515.2015.1096457. View

Bruni R, Taffon S, Equestre M, Chionne P, Madonna E, Rizzo C . Key Role of Sequencing to Trace Hepatitis A Viruses Circulating in Italy During a Large Multi-Country European Foodborne Outbreak in 2013. PLoS One. 2016; 11(2):e0149642. PMC: 4764681. DOI: 10.1371/journal.pone.0149642. View

10.

Wick J . Hepatitis in the elderly: still a scourge. Consult Pharm. 2012; 27(7):472-81. DOI: 10.4140/TCP.n.2012.472. View

11.

Cao J, Wang Y, Song H, Meng Q, Sheng L, Bian T . Hepatitis A outbreaks in China during 2006: application of molecular epidemiology. Hepatol Int. 2009; 3(2):356-63. PMC: 2716766. DOI: 10.1007/s12072-008-9116-8. View

12.

Cui F, Hadler S, Zheng H, Wang F, Zhenhua W, Yuansheng H . Hepatitis A surveillance and vaccine use in China from 1990 through 2007. J Epidemiol. 2009; 19(4):189-95. PMC: 3924108. DOI: 10.2188/jea.je20080087. View

13.

Fangcheng Z, Xuanyi W, Mingding C, Liming J, Jie W, Qi J . Era of vaccination heralds a decline in incidence of hepatitis A in high-risk groups in China. Hepat Mon. 2012; 12(2):100-5. PMC: 3321316. DOI: 10.5812/hepatmon.838. View

14.

Gossner C, Severi E, Danielsson N, Hutin Y, Coulombier D . Changing hepatitis A epidemiology in the European Union: new challenges and opportunities. Euro Surveill. 2015; 20(16). DOI: 10.2807/1560-7917.es2015.20.16.21101. View

15.

Zhang L, Wang X, Bai J, Fang G, Liu L, Zhang Y . An outbreak of hepatitis A in recently vaccinated students from ice snacks made from contaminated well water. Epidemiol Infect. 2008; 137(3):428-33. DOI: 10.1017/S0950268808001337. View

16.

Mantovani S, Delfino B, Martins A, Oliart-Guzman H, Pereira T, Branco F . Socioeconomic inequities and hepatitis A virus infection in Western Brazilian Amazonian children: spatial distribution and associated factors. BMC Infect Dis. 2015; 15:428. PMC: 4608050. DOI: 10.1186/s12879-015-1164-9. View

17.

Franco E, Meleleo C, Serino L, Sorbara D, Zaratti L . Hepatitis A: Epidemiology and prevention in developing countries. World J Hepatol. 2012; 4(3):68-73. PMC: 3321492. DOI: 10.4254/wjh.v4.i3.68. View

18.

Tsou T, Liu C, Huang J, Tsai K, Chang H . Change in hepatitis A epidemiology after vaccinating high risk children in Taiwan, 1995-2008. Vaccine. 2011; 29(16):2956-61. DOI: 10.1016/j.vaccine.2011.02.001. View

19.

Jacobsen K, Koopman J . The effects of socioeconomic development on worldwide hepatitis A virus seroprevalence patterns. Int J Epidemiol. 2005; 34(3):600-9. DOI: 10.1093/ije/dyi062. View