The prevalence of antibodies to hepatitis A virus and its determinants in The Netherlands: a population-based survey.
The prevalence of antibodies to hepatitis A virus was assessed in a Dutch nationwide sample (n = 7367). A questionnaire was used to study the association with various sociodemographic characteristics. Overall, 33.8% (95% CI 31.6-36%) of the population had hepatitis A antibodies. The seroprevalence was less than 10% in people under 35; it increased from 25% at 35 years to 85% at 79 years. For those 15-49 years of age, Turks (90.9%) and Moroccans (95.8%) had greater seroprevalence than autochthonous Dutch (20.2%) and other Western people (25%). Low or middle socio-economic status, as indicated by the highest educational level achieved, was associated with greater seroprevalence, independently of age and reported immunization (OR 2.11 and 1.45; 95% CI 1.67-2.67 and 1.11-1.89, respectively). These data suggest autochthonous Dutch and other Westerners born after World War II were exposed to hepatitis A during childhood less frequently than older birth cohorts. Thus, more susceptibility is likely in the coming decades. Since this means a greater risk of outbreaks in future years, and since morbidity and mortality are more frequent in older persons, studying the cost effectiveness of selective and general vaccination might be worthwhile.
Termorshuizen
F
F
Department of Infectious Diseases Epidemiology, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
Dorigo-Zetsma
J W
JW
de Melker
H E
HE
van den Hof
S
S
Conyn-Van Spaendonck
M A
MA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003710:Demography; D004196:Disease Outbreaks; D016021:Epidemiologic Studies; D005006:Ethnicity; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology / Q000276:immunology*; D017957:Hepatitis A Virus, Human / Q000276:immunology*; D006801:Humans; D007114:Immunization; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012923:Social Class
D000914:Antibodies, Viral