Academic journal article Central European Journal of Public Health

Prevalence of Viral Hepatitis in Croatian Adult Population Undergoing Routine Check-Up, 2010-2011

Academic journal article Central European Journal of Public Health

Prevalence of Viral Hepatitis in Croatian Adult Population Undergoing Routine Check-Up, 2010-2011

Article excerpt

SUMMARY

Seroprevalence data on viral hepatitis in the general population vary widely. The aim of this study was to determine the prevalence of hepatitis A (HAV), hepatitis B (HBV) and hepatitis C (HCV) viruses in the general Croatian adult population undergoing routine check-ups. The seroprevalence of anti-HAV, anti-HBc and anti-HCV was 40.5%, 7.0% and 0.9%, respectively. HBsAg was found in 0.7% and anti-HBs antibodies in 24.4% of participants. Gender was not associated with HAV, HBV or HCV seropositivity. HAV and HBV seropositivity increased progressively with age (HAV from 11.7% to 90.4%, p<0.001; HBV from 1.7% to 15.8%, p<0.001). Participants from rural areas showed a significantly higher HBV seroprevalence rate than those from urban areas (10.7% vs. 6.1%, p=0.007). Results of univariate and multiple logistic regression showed that older age was a significant predictor for both HAV and HBV seropositivity while rural place of residence was a significant predictor for HBV seropositivity.

Key words: HAV, HBV, HCV, seroprevalence, Croatia

INTRODUCTION

Viral hepatitis infections constitute a global public health problem. More than two billion people are infected with hepatitis A (HAV), hepatitis B (HBV) and hepatitis C (HCV) viruses. HBV and HCV cause 600,000 and 350,000 deaths, respectively, each year (1). In endemic regions, HAV is transmitted primarily through close contact or as result of inadequate sanitation while in low endemic areas HAV infections are commonly linked to travel to endemic areas and to contaminated imported food (2-5). In some European countries, the seroprevalence of HAV varies from 32% to 88% (6-10). HBV is transmitted by parenteral or mucosal exposure to infectious blood or secretions, most often through intravenous drug use (IDU) or sexual contact with an infected person. The seroprevalence of HBV in the general population varies widely between European countries. Prevalence of hepatitis B antigen (HBsAg) is reported to range from less than 1% to 8%, prevalence of hepatitis B core antibodies (anti-HBc) from 1.9% to 22.6% (7, 8, 11-17). The principal mode of HCV transmission is through significant or repeated direct percutaneous exposure to infectious blood or blood products. Seroprevalence of HCV varies in different population groups. Seropositivity is high in high-risk groups such as IDUs, variable among hemodialysis patients and persons with high-risk sexual behaviour and low in voluntary blood donors (16, 18-24).

There are very few published seroepidemiological data on the distribution of viral hepatitis in the general Croatian population. The aim of this study was to determine the seroprevalence of HAV, HBV and HCV among healthy adults who underwent a routine check-up.

MATERIALSAND METHODS

Study Population

During a two-year period (2010-2011), a total of 2,052 consecutive patients aged 20-86 years who underwent a routine check-up (part of physical examination, prior to orthopedic or cardiac surgery, couples undergoing medically assisted reproduction) were tested for the presence of anti-HAV total antibodies, HBsAg, anti-HBs antibodies (anti-HBs), anti-HBc and anti-HCV antibodies, based on the request of the referring physician. No participant showed symptoms of acute hepatitis. There were 924 (45.0%) males and 1,128 (55.0%) females from 4 of 20 Croatian counties (three counties in the Croatian mainland and one county on the Adriatic coast). All participants were of Croatian nationality.

Methods

Anti-HAV, HBsAg, anti-HBs, and anti-HBc total antibodies were detected using an automated enzyme-linked fluorescent assay (Mini Vidas, BioMerieux, Marcy l'Etoile, France). AntiHAV as well as anti-HBc positive participants were tested for the presence of IgM antibodies to confirm or rule out acute HAV and HBV infection (Mini Vidas, BioMerieux, Marcy l'Etoile, France). The results were interpreted according to the manufacturer's recommendations as follows: anti-HAV <15 mIU/ml negative; >15 - <20 equivocal; >20 positive; HBsAg test value <0. …

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