The prevalence of antibodies to hepatitis A virus and its determinants in The Netherlands: a population-based survey

The prevalence of antibodies to hepatitis A virus was assessed in a Dutch n ationwide sample (n = 7367). A questionnaire was used to study the associat ion with various sociodemographic characteristics. Overall, 33.8 % (95 % CI 31.6-36 %) of the population had hepatitis A antibodies. The seroprevalenc e was less than 10 % in people under 35; it increased from 25 % at 35 years to 85 % at 79 years. For those 15-49 years of age, Turks (90.9 %) and Moro ccans (95.8 %) had greater seroprevalence than autochthonous Dutch (20.2 %) and other Western people (25 %). Low or middle socio-economic status, as i ndicated by the highest educational level achieved, was associated with gre ater seroprevalence, independently of age and reported immunization (OR 2.1 1 and 1.45; 95% CI 1.67-2.67 and 1.11-1.89, respectively). These data sugge st autochthonous Dutch and other Westerners born after World War II were ex posed to hepatitis A during childhood less frequently than older birth coho rts. Thus, more susceptibility is likely in the coming decades. Since this means a greater risk of outbreaks in future years, and since morbidity and mortality are more frequent in older persons, studying the cost effectivene ss of selective and general vaccination might be worthwhile.