Epidemiology of hepatitis A in Finland in 1990-2007.

The seroepidemiology of hepatitis A virus (HAV) for the period 1990-2007 and the molecular epidemiology for the period 1994-2007 in Finland were studied. The incidence of hepatitis A has been very low since 1990, at 0.3-3.6/100,000 inhabitants, excluding two outbreaks in 1994-1995 and 2002-2003, both of which were connected to intravenous drug use. Serum samples (3,217) collected in the period 1997-1998 were tested for hepatitis A antibodies to assess the percentage of seropositive Finns. More than 50% of Finns aged over 55 were seropositive for hepatitis A, while less than 5% of those aged under 40 were seropositive. In addition, patient samples (52,012) from the period 1990 to 2007 were assessed for antibodies against HAV. In these samples the proportion of acute HAV infections stayed at around 2% per year (excluding outbreaks), whereas the overall seropositivity for hepatitis A increased from some 30% to 45%, which was most likely due to increased vaccinations. For molecular epidemiology, samples from 1994 to 2007 were analyzed by RT-PCR and sequencing. The results showed that most of the strains (82%) of HAV were of genotype IA but with an increasing number of genotypes IB and IIIA appearing during the last years of the study. All the cases seemed to be travel related and there was no endemic strain circulating in Finland. The low seroprevalence, especially in younger age groups, makes the population vulnerable to infection, which can be compensated for by increasing the number of vaccinations. (c) 2010 Wiley-Liss, Inc