Hepatitis A virus epidemiology in Turkey as universal childhood vaccination begins: seroprevalence and endemicity by region

Abstract

This paper presents the results of a comprehensive examination of current distribution of Hepatitis A virus (HAV) seroprevalence and endemicity in Turkey and the possible links between HAV endemicity and socioeconomic development. We performed a systematic search in online resources published between January 2000 and August 2015. The 22 provinces were able to be assigned a hepatitis A endemicity level based on this systematic review. The incidence rates for symptomatic hepatitis A infection are higher in the eastern part of Turkey than in the western and central region. These differences in socioeconomic indicators by region suggest the likelihood of lower seroprevalence rates in the western parts of the country and higher rates in the eastern region. Turkey's current policy of recommending hepatitis A immunization for all children without contraindications is an appropriate one and is likely to remain the best option for at least the next decade or two.