Seroprevalence of hepatitis A virus antibodies among children and adolescents living in Northern Thailand: an implication for hepatitis A immunization

Natchaya Kunanitthaworn, Oramai Mueangmo, Jutamad Saheng, Worawan Wongjak, Tanin Lertsiriladakul, Tanachot Chaito, Pasawat Nantarat, Tavitiya Sudjaritruk, Natchaya Kunanitthaworn, Oramai Mueangmo, Jutamad Saheng, Worawan Wongjak, Tanin Lertsiriladakul, Tanachot Chaito, Pasawat Nantarat, Tavitiya Sudjaritruk

Abstract

This cross-sectional study aimed to assess seroprevalence of hepatitis A virus (HAV) antibodies and identify factors associated with HAV seropositivity among children and adolescents aged 1-18 years who resided in Chiang Mai, Thailand. Sociodemographic characteristics, sanitation/hygiene, and history of HAV vaccination were collected. Anti-HAV IgG antibody was determined, and a level ≥ 1.0 S/CO defined HAV seropositivity. We enrolled 300 participants; median age 8.7 years, 54% male, and 13% overweight (BMI z-score: + 1 to + 2 standard deviation [SD]). Sixty-five participants (22%) were vaccinated against HAV. Overall, 84/300 participants (28%) demonstrated HAV seropositivity, of whom 55/65 (85%) and 29/235 (12%) were among vaccinated and unvaccinated participants (P < 0.001), respectively. Previous HAV vaccination (adjusted odds ratio [aOR] 47.2; 95% CI 20.0-111.8) and overweight (aOR 4.4; 95% CI 1.7-11.3, compared with normal weight [BMI z-score: - 2 to + 1 SD]) were significantly associated with seropositivity of HAV. In the stratified analyses, crowded bedroom (aOR 3.2; 95% CI 1.3-7.8, per one person increase) and overweight (aOR 5.0; 95% CI 1.8-13.7) were factors associated with HAV seropositivity among vaccinated and unvaccinated participants, respectively. Seroprevalence of HAV antibodies in healthy Thai children and adolescents was relatively low. Recommendation of HAV vaccination for these populations, particularly those with high-risk conditions, should be considered.

Conflict of interest statement

The authors declare no competing interests.

© 2023. Springer Nature Limited.

Figures

Figure 1
Figure 1
Seroprevalence and geometric mean concentrations of hepatitis A virus antibodies among study participants, stratified by age group and hepatitis A vaccination status of study participants. (a) Seroprevalence of hepatitis A virus antibodies among vaccinated participants; (b) seroprevalence of hepatitis A virus antibodies among unvaccinated participants; (c) geometric mean concentrations of anti-hepatitis A virus IgG among vaccinated participants with hepatitis A virus seropositivity; (d) geometric mean concentrations of anti-hepatitis A virus IgG among unvaccinated participants with hepatitis A virus seropositivity. Proportions are shown as colored bar charts, and the corresponding 95% confidence intervals are shown as black horizontal bars. Geometric mean concentrations are shown as colored data points, and the corresponding 95% confidence intervals are shown as black horizontal bars. Chi-squared test was performed to compare the proportions of participants with hepatitis A virus seropositivity between age groups. Log-linear regression analysis was performed to compare the geometric mean concentrations of anti-hepatitis A virus IgG of participants between age groups. GMC geometric mean concentration, HAV hepatitis A virus, S/CO signal to cut-off ratio, 95% CI 95% confidence interval.

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