PREVALENCE OF ANTI-HAV ANTIBODIES IN CHIL DREN LIVING IN GERMANY ORIGINATING FROM REGIONS ENDEMIC FOR HAV - CONSEQUENCES FOR HEPATITIS-A VACCINATION

Objectives: Hepatitis A vaccination has recently become available for the paediatric age group. Children with parents from the Mediterranean region travelling to endemic areas are at high risk for infection wit h hepatitis A virus (HAV). New epidemiological data are necessary to a ssess the indication for active immunisation in this group. Methods: T hree hundred ninety-eight children belonging to families from Mediterr anean countries who live permanently in Germany and 295 German childre n as a control group (ages 11 month to 7 years) were screened for HAV antibody titers using a quantitative assay. All children tested were t reated in our clinic for reasons not related to hepatitis A and additi onal information such as place of birth, family and living conditions and travel history were recorded. Results: In the group of children fr om Mediterranean families it was possible to demonstrate an age-depend ent increase in anti-HAV prevalence peaking at 30 % at school age. In comparison to a previous study from 1983 the present age-dependant inc rease in anti-HAV was slower and weaker. In contrast, only 0% to 4.7% of the children in the German control group were positive and the anti -HAV-prevalence was not dependent on age. Conclusion: Inapparent infec tions in children may be an unknown source of infection even for adult s. Our data suggest that a significant proportion of children from Med iterranean families living in Germany do not have detectable antibody titers to HAV. Therefore, we strongly recommend active immunisation pr ior to travelling to countries of high endemicity.