Hepatitis A in urban Ireland.
OBJECTIVE
To determine the prevalence of immunity to hepatitis A virus (HAV) infection in urban Ireland and to categorize the region into low, intermediate or high HAV endemicity, and to analyse the significance of certain commonly associated risk factors.


METHODS
Two hundred and thirty three volunteers were recruited from 6 general practices in Dublin, Ireland. There were 44 volunteers in the 10 to 19 yr age group, 40 in the 20 to 29, 42 in the 30 to 39, 43 in the 40 to 49 and 64 in the over 50 age groups. Each participant completed a detailed questionnaire and was tested for anti-HAV total antibody (primarily IgG) using a competitive ELISA assay. Urban Ireland was classified into the appropriate area of HAV endemicity according to the prevalence of immunity by age group. Risk factor differences were analysed for significance using the chi square test and Fisher's exact test.


RESULTS
One hundred and fifty seven (67 per cent) volunteers were immune, of whom 20 (45 per cent) were in the 10 to 19 yr age group, 17 (43 per cent) in the 20 to 29, 30 (71 per cent) in the 30 to 39, 34 (79 per cent) in the 40 to 49 and 59 (92 per cent) in the over 50 age groups. Fifty-five per cent of the individuals studied below the age of 20 yr were non-immune. The immune rates over the age of 30 were significantly greater (p < 0.01) than those in the 10 to 29 age groups. Socioeconomic pattern in the total and 10 to 19 yr age group was a significant (p < 0.0002, p < 0.004 respectively) risk factor for infection.


CONCLUSIONS
This study concludes that urban Ireland is an area of low HAV endemicity with age and socioeconomic status as the significant influences on seropositivity. This survey provides an insight into the changing epidemiology of HAV infection in Ireland and serves as a guide for immunisation of at risk population groups.
Rajan
E
E
Department of Medicine, Royal College of Surgeons and Beaumont Hospital, Dublin.
O'Farrell
B
B
Shattock
A G
AG
Fielding
J F
JF
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology*; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D014505:Urban Population