Incidence trends of viral hepatitis A, B, and C seropositivity over eight years of surveillance in Saudi Arabia.
OBJECTIVE
In Saudi Arabia, viral hepatitis ranked the second most common reportable viral disease in 2007, with almost 9000 new cases diagnosed in that year. The objective of this study was to determine the incidence trends of viral hepatitis seropositivity among the population served by the National Guard Health Affairs (NGHA) hospitals in the central, eastern, and western Saudi Arabia regions.


METHODS
The surveillance system at King Abdulaziz Medical City in Riyadh receives weekly reports of laboratory confirmed hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV) cases from all NGHA-served regions. In this study the viral hepatitis surveillance data for the period from January 2000 through December 2007 were analyzed.


RESULTS
Between 2000 and 2007, a total of 14 224 seropositive cases of viral hepatitis were reported to the surveillance system. The average annual incidence of seropositivity per 100 000 served population was highest for HBV (104.6), followed by HCV (78.4), and lowest for HAV (13.6). Saudis had higher HBV and HAV incidence, but lower HCV incidence compared to non-Saudis. Over the eight years (2000-2007), the incidence of all three viral hepatitis types showed a 20-30% declining trend. Only HAV incidence followed a clear seasonal cyclic pattern.


CONCLUSIONS
Despite the declining trend over the eight-year period, viral hepatitis, especially that caused by HBV and HCV, remains a major public health problem in Saudi Arabia, and has probably been underestimated in previous reports. There is a need for more comprehensive prevention strategies.
Memish
Ziad A
ZA
Department of Infection Prevention and Control, King Abdulaziz Medical City, PO Box 22490, Riyadh 11426, Saudi Arabia. memish@ngha.med.sa
Knawy
Bandar Al
BA
El-Saed
Aiman
A
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D016174:Hepacivirus / Q000276:immunology; D006506:Hepatitis A / Q000453:epidemiology*; D030041:Hepatitis A virus / Q000276:immunology; D006508:Hepatitis Antibodies / Q000097:blood*; D006509:Hepatitis B / Q000453:epidemiology*; D006515:Hepatitis B virus / Q000276:immunology; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D012529:Saudi Arabia / Q000453:epidemiology; D016036:Seroepidemiologic Studies; D017678:Sex Distribution; D055815:Young Adult
D006508:Hepatitis Antibodies