Hepatitis A: How We Are after the Introduction of Vaccines

Abstract

Hepatitis A is a disease known for a long time. It has a universal distribution, although it has a higher prevalence in places with poor sanitary conditions due to its main form of transmission: fecal-oral. The local health conditions also influence the age of acquisition of the disease and, therefore, its clinical presen-tation, because the disease in young children is usually asymptomatic. It is a viral disease whose prevention is possible through improvements in the population’s basic sanitation conditions and vaccination. Since the introduction of vaccines, it has been possible to see a reduction in its incidence, especially in places where universal vaccination of children has been instituted. In recent years immunoglobulin therapy is being replaced by vaccination in pre- and postexposure prophylaxis (PEP), except in specific situations. Its incidence, even in developing countries, has decreased after introduction of hepatitis A vaccine. The vaccine is recommended in two doses for children, starting at the age of 1. Argentina and, more recently, Brazil have adopted the universal vaccination of all children upon completion of 12 months of age in a single-dose regimen. Despite this breakthrough isolated outbreaks in homeless and drug users are still described in developed countries.