Journal Article

A Population-based Seroprevalence Study of Hepatitis A Virus Using Oral Fluid in England and Wales

M. C. Morris-Cunnington, W. J. Edmunds, E. Miller and D. W. G. Brown

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 159, issue 8, pages 786-794
Published in print April 2004 | ISSN: 0002-9262
Published online April 2004 | e-ISSN: 1476-6256 | DOI:
A Population-based Seroprevalence Study of Hepatitis A Virus Using Oral Fluid in England and Wales

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Population-based seroprevalence studies provide important data on susceptible groups and the potential for future outbreaks. However, the invasive nature of serum collection has limited studies. This paper describes the first postal population-based survey using noninvasive oral fluid technology to collect antibody prevalence data in conjunction with extensive risk factor data to assess the distribution of immunity to common viral infections in England and Wales. These results pertain to hepatitis A virus (HAV). Approximately 5,500 oral fluid samples were collected between August 2001 and May 2002, as well as individual risk factor data through a questionnaire, from persons aged less than 45 years randomly sampled from general practices countrywide. Samples were tested for immunoglobulin G-specific antibody marking a past infection or immunity to HAV using an antibody-capture enzyme-linked immunosorbent assay. The age-specific HAV seroprevalences indicated a low incidence of infection (overall seroprevalence of 18.9% (95% confidence interval: 17.0, 20.9) and of 9.2% (95% confidence interval: 7.1, 11.3) after the exclusion of vaccinees). Vaccination proved the most important determinant of seropositivity. Ethnic minority groups were underrepresented, and adjustment increased the overall prevalence to 20.1% and to 12.1% in unvaccinated individuals. The availability of comprehensive risk factor data allowed the description of two risk profiles related to natural infection and vaccination.

Keywords: hepatitis A virus; immunity; saliva; seroepidemiologic studies; Abbreviations: HAV, hepatitis A virus; GPRF, General Practice Research Framework.

Journal Article.  4642 words.  Illustrated.

Subjects: Public Health and Epidemiology

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