USE OF 3 RECOMMENDED CRITERIA FOR ANTI-HE PATITIS-A ANTIBODY TESTING IN TRAVELERS

To select the travellers most likely to benefit from anti-hepatitis A (HA) antibody testing, the following criteria have been proposed: (A) being born before 1945, (B) a stay over 1 year in a developing country or (C) a history of jaundice. We present a prospective study to asses s the practical use of these criteria. Following a recent survey in th e general population of Lausanne showing HA seroprevalence of 52,6% in the age group over 45, we included an Al criterion (A extended to bir th before 1950). Anti-HA IgG testing and a questionnaire were proposed to all travellers presenting one or more criteria. Results: Out of 11 87 consecutive travellers, 176 (14.8%) had one or more criteria (219 [ 18.5%] when Al was used). Criteria A applied to 8.5% of all travellers , Al to 13.8%, B to 6.3% and C to 3.1%. Only 3% of travellers had more than one criterion. Overall seropre valence among the selected group was 48.3%. Seroprevalence of travellers below 60 years old was under 3 0%, unless a second criterion was present in which case seroprevalence was 10% higher. Eighty percent of travellers with a history of jaundi ce were found to be positive. The use of the recommended criteria spar ed 94 travellers (46.3% of those tested and 7.9% of all travellers) un necessary immunisation. Among travellers older than 60 years, a 30% ec onomy on the total sum for immunising all of them, without any prior t esting was realised. Conclusions: Among the population of travellers c onsulting our travel clinic, the seroprevalence for HA is lower than i n the general population. We recommend that testing should be proposed only to travellers aged over 60, or with a history of jaundice, or to those with a combination of 2 out of 3 criteria.