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Issue 7, 2007
HOT TOPICS IN VIRAL HEPATITIS
Hepatitis A virus: still a hot topic?
| Publ. date: | 2007 |
| ISBN: | 978-88-89881-49-1 |
| ISSN: | 1973-9648 |
| E-ISSN: | 2036-0932 |
| DOI: | 10.4147/HTV-070700 |
Abstract
Hepatitis A is an acute viral disease that has been documented since Greek and Roman times. Despite widespread improvement in human waste management and great success of immunization campaigns with the killed hepatitis A vaccine, hepatitis A is still a significant cause of morbidity and even mortality and therefore remains a hot topic for virologists.
An estimated 1.4 million people still contract the disease globally each year, but epidemiological patterns vary considerably depending on geographical location. In developing countries, poor sanitation is behind the frequent occurrence of hepatitis A in nearly all young children. Infections are mostly asymptomatic and create high herd immunity in the population. On the other hand, in developed countries, high hygiene and health-care standards have resulted in a sharp decline in hepatitis A virus (HAV) infection rates and consequent loss of immunity in the general population. This has set the scene for infection to occur at increased rates in adults, who are more likely to suffer from severe liver disease. For developed countries, international travelers and immigrants from HAV endemic regions are a potential source of infections, justifying the phrase “hepatitis A is traveling to us.”
This monograph reviews recent insights into HAV virology, epidemiology, clinical features, and the latest evidence on vaccination against hepatitis A.
Table of contents
Foreword
This issue is devoted to the virological, clinical and epidemiological aspects of hepatitis A virus (HAV) infection. Hepatitis A is an acute viral disease that has been documented since Greek and Roman times. It occurs worldwide and transmission is primarily related to levels of sanitation and hygiene. Despite widespread improvement in human waste management, it is estimated that 1.4 million people still contract the disease globally each year. However, epidemiological patterns vary considerably depending on geographical location. In developing countries, poor sanitary and environmental conditions are behind the frequent occurrence of hepatitis A in nearly all young children, often before the age of 5. In these regions, most infections are asymptomatic and stimulate the production of longlasting protective antibodies, which create high herd immunity in the population. Consequently, outbreaks are rare. At the other extreme, in developed countries with high health care standards, improvements in socioeconomic and overall hygiene have resulted in a sharp decline in HAV infection rates among children, and a consequent loss of herd immunity in the general population. This has set the scene for infection to occur at increased rates in adults, who are more likely to suffer from severe liver disease that in some cases may progress to liver failure. In developed countries, hepatitis A infection is typically contracted by high-risk groups such as international travelers to areas with high endemicity. These same individuals then become a potential source of infection for others once they return home. In addition, increasing rates of emigration from HAVendemic countries (not to mention increasing importation of exotic foods) are believed to represent an additional source of risk for hepatitis A to occur in areas of low endemicity, justifying the phrase “hepatitis A is traveling to us”. I therefore believe that hepatitis A is still a hot topic, and that specialists and general practitioners alike should remain alert to the prompt identification of this most ancient cause of epidemic jaundice.
ARTICLES
Hepatitis A virology
Verena Gauss-Müller
HAV: general epidemiology, routes of transmission and groups at risk
Angela Bechini, Sara Boccalini, Paolo Bonanni
HAV: epidemiology in the Southern Hemisphere
Hugo Cheinquer, Nelson Cheinquer, Christina H. Targa Ferreira
Clinical features of hepatitis A
Angela Bechini, Sara Boccalini, Paolo Bonanni
Vaccination against hepatitis A: a review of the evidence
Angela Bechini, Sara Boccalini, Paolo Bonanni
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Editor-in-chief
Francesco Negro - DO, MPH
Over the last 20 years, there have been great strides in the treatment of viral hepatitis. Both the discovery of the hepatitis C and E viruses, with the characterization of their genomes, and the avai...
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