Changing pattern of hepatitis viral infection in Saudi Arabia in the last two decades.

BACKGROUND: Information on the epidemiology of viral hepatitis B, C and A in the Kingdom of Saudi Arabia (KSA) has accumulated over the last two decades. We review the changing epidemiology of these infections and suggest possible strategies for eradication.
METHODS: We screened Saudi medical journals and Medline for reports dealing with hepatitis B, C and A, and analyzed official of blood donor screening data from the Ministry of Health (MOH) Central Blood Bank and the King Khalid University Hospital (KKUH) Blood Bank.
RESULTS: Several studies from the 1980s found a high endemicity for HBV, with 5% to 10% of the population infected and prevalence varying from one region to another. In children (age 1 to 12 years), the prevalence was almost 7% in 1989, just before the addition of the HBV vaccine to the Extended Program of Immunization (EPI). By 1997, the prevalence of HBV infection in children had declined to 0.3%. Blood donor results have also shown a steady decrease in HBV infection. At KKUH, prevalence declined from 3.7% in 1987 to 1.7% in 2000. Hepatitis C infection has also shown a marked decline among Saudi blood donors at KKUH, HAV infection among children has declined from 50% in 1989 to 25% in 1997, but the infection rate is still high, reaching 50% in a few regions.
CONCLUSIONS: Hepatitis B, C, and A infection has declined in KSA in the last two decades by more than 50%. The reasons for this marked decline are multifactorial. An important reason is the adoption in the last two decades of the MOH strategy for prevention of viral hepatitis infection, which needs to continue. Improvements in the economic status of the population and the decline in illiteracy have also contributed to the decline in viral hepatitis infection.