A serosurvey of Hepatitis A (HAV IgG Positive), Riyadh children

Between April 1995 and February 1996 the prevalence of anti-HAV antibody was determined in children presenting to clinics in Suliemania children hospital and three health centers in Riyadh city. A blood sample was taken to test for the presence of IgG and a questionnaire concerning personal and epidemiological data relating to hepatitis A was completed.

Of 592 children aged 6 months to 15 years, 30% (95% C1=23%, 34%) had anti-HAV IG. The proportions of children positive for HAV varied 3249% in the 7-15 age range compared with 13-20% aged 6 and below. Children with current jaundice or a personal history of jaundice were significantly more likely to be HAV positive (p=0.001 and p=0.006, respectively). Children with lower social level had a higher anti-HAV prevalence than other children (p<0.05) but there was no difference in prevalence by residential environment. Saudi Arabian children had a lower anti-HAV prevalence (28%) than other nationalities (p<0.05).

Ten years ago, HAV was endemic in the region with an anti-HAV prevalence of over 90%. In comparison, the current results show a halving of the rate in children. Presumably the decrease is due to recent, rapid improvements in living conditions including safe water and sanitary sewage disposal. These results suggest a susceptible adolescent and young adult population exist since this age group is more often affected with symptomatic HAV infections than with inapparent infections. Medical practitioners in Saudi Arabia should expect to see higher numbers of symptomatic HAV infections. In this situation a HAV vaccine policy needs to be addressed.