Hepatitis A virus seroprevalence among children and adolescents in a high-burden HIV setting in urban South Africa

Abstract

Abstract Background Hepatitis A virus (HAV) infection is one of the most important global causes of viral hepatitis. Recent reviews suggested that HAV endemicity in South Africa could be shifting from high to intermediate. Methods A hospital-based HAV-seroprevalence study was conducted between February 2018 to December 2019, in Pretoria, South Africa. Systematic sampling was done of children and adolescents (1–15 years) who attended outpatient services. Participants with a known HIV-status and valid HAV-serology results were included. Results Of 1220 participants, the median age was 7-years (IQR: 4–11) with 648 (53.11%) male and 572 (46.89%) female. Of 628 (51.48%) HIV-infected participants, most (329, 71.83%) were both immunologically and virologically controlled or with low level viremia (74, 16.16%). Almost three-quarters (894, 73.28%) were living in formal dwellings, and just over half (688, 56.39%) had access to clean water sources inside the house. Increasing age was associated with testing IgG-positive (OR 1.24; 95% CI 1.21–1.28), with 19.8% of participants one year of age compared with 86.7% of participants 15-years of age. Conclusions This study suggests that South Africa has an intermediate HAV-seroprevalence with rates < 90% by 10-years of age (68.6%). Increased age and informal dwellings are statistically associated with HAV-seropositivity, whilst HIV-status does not significantly influence HAV-seropositivity.