Changing epidemiology of hepatitis A virus in Indian children

Abstract

Previous studies from India have observed an increased incidence of hepatitis A virus (HAV) infection in the adult and adolescent population compared with children, indicating a shift in epidemiology of HAV. However, no HAV seroprevalence study has been conducted in India over the past decade. This prospective, multicenter, cross-sectional study was conducted in 928 children (aged 18 months to 10 years), to estimate the age-related seroprevalence of HAV across different regions of India. The present study also evaluated the impact of various factors such as age, socioeconomic class (SEC), education, source of drinking water, and excreta disposal on HAV seroprevalence. Overall, 348 (37.5%) children were seropositive for anti-HAV antibodies. Seroprevalence of HAV in the 6- to 10-year age group (50.3%) was higher (P=0.000) than in the 18-month to 6-year age group (30.3%). SEC and educational status of the parents were significantly associated with HAV seropositivity (P=0.000 for both). An increase in seroprevalence was observed with an increase in age in all SECs (P<0.000–0.001 for all) except upper SEC (P=0.124). Fewer subjects using a private toilet within the house (33.1%) were seropositive than subjects using an open field (75%) for excreta disposal. In conclusion, the present study observed a transition in the seroprevalence of HAV, with a higher seropositivity in older children. Age, SEC, source of drinking water, and education status of parents were significantly associated with HAV seroprevalence.