title: Declining prevalence of hepatitis A virus antibodies among children from low socioeconomic groups reinforces the need for the implementation of hepatitis A vaccination in Brazil.
abstract: Age-related seroprevalence studies that have been conducted in Brazil have indicated a transition from a high to a medium endemicity of hepatitis A virus (HAV) infection in the population. However, most of these studies have focused on urban populations that experience lower incidence rates of HAV infection. In the current study, the prevalence of anti-HAV antibodies was investigated in children with a low socioeconomic status (SES) that live on the periphery of three capital cities in Brazil. A total of 1,162 dried blood spot samples were collected from individuals whose ages ranged from one-18 years and tested for anti-HAV antibodies. A large number of children under five years old (74.1-90%) were identified to be susceptible to HAV infection. The anti-HAV antibody prevalence reached ≥ 50% among those that were 10-14 years of age or older. The anti-HAV prevalence rates observed were characteristics of regions with intermediate level of hepatitis A endemicity. These data indicated that a large proportion of children with a low SES that live at the periphery of urban cities might be at risk of contracting an HAV infection. The hepatitis A vaccine that is currently offered in Brazil is only available for high-risk groups or at private clinics and is unaffordable for individuals with a lower SES. The results from this study suggest that the hepatitis A vaccine should be included in the Brazilian National Program for Immunisation.
authors.affiliation: Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brasil. clvitral@ioc.fiocruz.br
authors.forename: Claudia Lamarca
authors.initials: CL
authors.lastname: Vitral
authors.forename: Fidel Leonardo Navarro
authors.initials: FL
authors.lastname: Ospina
authors.forename: Solange
authors.initials: S
authors.lastname: Artimos
authors.forename: Juliana Gil
authors.initials: JG
authors.lastname: Melgaço
authors.forename: Oswaldo Gonçalves
authors.initials: OG
authors.lastname: Cruz
authors.forename: Vanessa Salete
authors.initials: VS
authors.lastname: de Paula
authors.forename: Sérgio Bessa
authors.initials: SB
authors.lastname: Luz
authors.forename: Marcos
authors.initials: M
authors.lastname: Freire
authors.forename: Luciane Pinto
authors.initials: LP
authors.lastname: Gaspar
authors.forename: Luciane Almeida
authors.initials: LA
authors.lastname: Amado
authors.forename: Elyne Montenegro
authors.initials: EM
authors.lastname: Engstrom
authors.forename: Camila Dufrayer Fanzeres Monteiro
authors.initials: CD
authors.lastname: Fortes
authors.forename: Tayla Coleta de
authors.initials: TC
authors.lastname: Souza
authors.forename: Marisa Nishitani
authors.initials: MN
authors.lastname: Dias
authors.forename: Ana Maria Coimbra
authors.initials: AM
authors.lastname: Gaspar
authors.forename: Francisco José Dutra
authors.initials: FJ
authors.lastname: Souto
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology* / Q000517:prevention & control; D035922:Hepatitis A Antibodies / Q000097:blood*; D022362:Hepatitis A Vaccines; D017957:Hepatitis A Virus, Human / Q000276:immunology*; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D016036:Seroepidemiologic Studies; D012959:Socioeconomic Factors; D014505:Urban Population
chemical_list: D035922:Hepatitis A Antibodies; D022362:Hepatitis A Vaccines