Via practica 10/2008

PRESENT CHANGES IN THE VHA AND VHB HEPATITIS EPIDEMIOLOGY IN SLOVAKIA

Out of at least five viral hepatitides, there are vaccines available only against hepatitis A (VHA) and hepatitis B (VHB). These two hepatitis types are widespread around the globe, however, there are great geographic differencies in the prevalence of individual infections. Continuously high VHA morbidity in eastern regions of Slovakia is cumulating in locations with low sanitary standards, where the disease spreads through straight contact mostly within the group of children aged 1–4. The incidence decreases towards the western part of Slovakia, where the disease does not occur in children under 15 years of age and the maximum morbidity affects the group of adults aged 25–34. These regions with decreased circulation of the virus and a high proportion of susceptible persons are an easy target for spreading the infection from other regions of Slovakia and resulting in a high morbidity. The incidence of VHB has been strongly influenced by the universal mass vaccination which was introduced in 1998 for infants and in 2004 for adults. Both before and after the introduction of vaccination, the highest VHB morbidity was recorded in the eastern regions of Slovakia. A change came in 2005 – since then the highest morbidity has been reported in the Bratislava region with the maximum age-specific morbidity in the group of adults aged 25–34. In providing prevention against VHA and VHB, efficient and safe vaccines are available. Due to the present changes in the epidemiology of viral hepatitides, it is important that general practicioners pay attention to this matter and help significantly lower the incidence by means of specific prophylaxis.

Keywords: VHA, VHB, endemicity, epidemiology, vaccination.