Changing patterns of hepatitis A prevalence within the Saudi population over the last 18 years

To determine the seroprevalence of Hepatitis A (HAV) amongst Saudi children and compare it with previously reported prevalence data from the same population.

A total of 1357 students were randomly selected between the ages of 16 and 18 years (689 males and 668 females) from three different regions of Saudi Arabia (Madinah, Al-Qaseem, and Aseer) and tested for anti-HAV-IgG.

The overall prevalence of anti-HAV-IgG among the study population was 18.6%. There was no difference between males and females but there was a significant difference in the seroprevalence (P = 0.0001) between the three different regions, with Madinah region showing the highest prevalence (27.4%). When classified according to socioeconomic status, lower class students had a prevalence of 36.6%, lower middle class 16.6%, upper middle class 9.6%, and upper class 5.9% (P = 0.0001). Comparing the current study results with those of previous studies in 1989 and 1997 involving the same population, there was a marked reduction in the overall prevalence of HAV from 52% in 1989, to 25% in 1997, to 18.6% in 2008 (P < 0.0001).

Over the last 18 years, there has been a marked decline in the prevalence of HAV in Saudi children and adolescents. The current low prevalence rates call for strict adherence to vaccination policies in high-risk patients and raises the question of a universal HAV vaccination program.