THE CURRENT EPIDEMIOLOGY OF HEPATITIS-A INFECTION IN SOUTH-AFRICA - IMPLICATIONS FOR VACCINATION

Testing stored sera from various categories of individuals has shown t hat among the Black population hepatitis A virus (HAV) infection is un iversal and most adult Black subjects are immune. Infection probably o ccurs early in life, consistent with the epidemiological pattern seen in the developing world. By contrast, seroprevalence of HAV infection in adult White subjects increases with age, reflecting an epidemiologi cal pattern seen in the developed world. White subjects working in a v irological laboratory and White medical students had comparatively low seroprevalences of HAV infection and could therefore represent groups at risk. Hepatitis A vaccine is likely to be available in South Afric a in the near future and could be offered to these groups. Pre-vaccina tion immunity screening would be a cost-effective strategy.