Viral hepatitis in the Arctic.
OBJECTIVE
Summarize research on viral hepatitis in indigenous populations in the Arctic.


METHODS
Literature review.


METHODS
Medline search from 1966-2003.


RESULTS
High prevalence rates of total hepatitis A antibody of > 50% and of hepatitis B of between 22% in Alaska and 42% in Greenland for total infection and between 3% in Canada and 12% in Siberia for chronic infection have been reported. Universal childhood vaccination with hepatitis A vaccine beginning at age 2 have stopped epidemics of HAV in Alaska and newborn hepatitis B immunization programs in Alaska and Canada have reduced new infections. However, in all Arctic countries several thousand persons chronically infected with HBV remain at risk for the development of cirrhosis and hepatocellular carcinoma. Prevalence rates of hepatitis C (HCV) reported are <1.4% in the Arctic. Hepatitis D virus, which co-infects with HBV, has been found in 40% of persons with HBV in Greenland.


CONCLUSIONS
High rates of viral hepatitis A, B, C, and D are found in the Arctic. Effective vaccines against HAV, HBV and HDV can prevent transmission of these viruses. In addition, new antiviral therapies for HBV and HCV can be used effectively to treat many chronically infected patients.
McMahon
Brian J
BJ
Viral Hepatitis Program, Alaska Native Medical Center Anchorage, Alaska 99508, USA. bdm9@cdc.gov
D001110:Arctic Regions / Q000453:epidemiology; D022362:Hepatitis A Vaccines / Q000008:administration & dosage; D017325:Hepatitis B Vaccines / Q000008:administration & dosage; D006525:Hepatitis, Viral, Human / Q000145:classification / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D015995:Prevalence
D022362:Hepatitis A Vaccines; D017325:Hepatitis B Vaccines