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Risk factors for sporadic hepatitis A infection: a systematic review and meta-analysis

2020Journal article Open access
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dc.contributor.authorThébault, Anne
dc.contributor.authorRoque-Afonso, Anne Marie
dc.contributor.authorKooh, Pauline
dc.contributor.authorCadavez, Vasco
dc.contributor.authorGonzales-Barron, Ursula
dc.contributor.authorPavio, Nicole
dc.date.accessioned2018-02-19T10:00:00Z
dc.date.accessioned2021-02-27T18:06:08Z
dc.date.available2018-01-19T10:00:00Z
dc.date.available2021-02-27T18:06:08Z
dc.date.issued2020
dc.description.abstractHepatitis A virus (HAV) is responsible for common acute viral hepatitis worldwide. Improvement in sanitation and use of efficient vaccines have reduced HAV incidence in developed countries. However, naive adult population are most susceptible to severe outcomes, and high endemic areas persist in developing regions. The transmission of HAV through the fecal-oral route is established. However, considering evolving consumption habits and global market exchange of food, investigations on risk factors associated with HAV infection are needed. Thus, a systematic review and a meta-analysis of case-control, cohort and transversal studies was performed to determine the main risk factors associated with sporadic HAV infection. Relevant scientific articles were identified through systematic literature search and subjected to a methodological quality assessment. Mixed-effects meta-analyses models were adjusted by population type to appropriate data partitions. HAV infections are defined by serological testing. The quality assessment stage selected 78 studies investigating risk factors for sporadic infections with hepatitis A conducted between 1985 and 2013. This meta-analysis confirmed that HAV infections are mostly related to inter-human transmissions, either due to contact with an ill person, through oral-anal sex practice, or lack of personal hygiene. Travel to endemic countries, occupational exposure such as working in child daycare, and exposure to wastewater were associated with HAV infection. As HAV can persist in the environment, it was not surprising that consumption of untreated drinking water, shellfish consumed raw, and crop products were risk factors. Food contamination could be due to the use of contaminated water (fruits, vegetables) or originate from infected food handlers at every point of the food chain (from picking to serving). Eating or drinking outside were associated with HAV infection. A lack of recent case-control studies was identified, with only three studies eligible between 2011 and 2017. Case-control studies required a more precise definition of risk factors such as type of crop product, and storing/preparation information (e.g. washed, frozen). The frequency of consumption or duration of environmental exposure could also better inform relationship between exposure and risk of infection. In a context of epidemiological change of HAV, international travel and trade of foods, future case-control studies are needed and should focus on populations at risk of severe infections and acute cases.en_EN
dc.description.sponsorshipU. Gonzales-Barron and V. Cadavez are grateful to the Foundation for Science and Technology (FCT, Portugal) and FEDER under programme PT2020 for the financial support to CIMO (UID/AGR/00690/2019).
dc.description.versioninfo:eu-repo/semantics/publishedVersionen_EN
dc.identifier.citationThébault, Anne; Roque-Afonso, Anne Marie; Kooh, Pauline; Cadavez, Vasco; Gonzales-Barron, Ursula; Pavio, Nicole (2020). Risk factors for sporadic hepatitis A infection: a systematic review and meta-analysis. Microbial Risk Analysis. ISSN 2352-3522. p. 1-13en_EN
dc.identifier.doi10.1016/j.mran.2020.100155en_EN
dc.identifier.urihttp://hdl.handle.net/10198/23431
dc.language.isoeng
dc.peerreviewedyesen_EN
dc.relationMountain Research Centre
dc.subjectCase-control studiesen_EN
dc.subjectCohort studiesen_EN
dc.subjectHAVen_EN
dc.subjectMeta-regressionen_EN
dc.subjectResearch synthesisen_EN
dc.titleRisk factors for sporadic hepatitis A infection: a systematic review and meta-analysisen_EN
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleMountain Research Centre
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UID%2FAGR%2F00690%2F2019/PT
oaire.fundingStream6817 - DCRRNI ID
person.familyNameCadavez
person.familyNameGonzales-Barron
person.givenNameVasco
person.givenNameUrsula
person.identifierR-000-HDG
person.identifier.ciencia-id441B-01AB-A12E
person.identifier.ciencia-id0813-C319-B62A
person.identifier.orcid0000-0002-3077-7414
person.identifier.orcid0000-0002-8462-9775
person.identifier.ridA-3958-2010
person.identifier.scopus-author-id9039121900
person.identifier.scopus-author-id9435483700
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.rightsopenAccessen_EN
rcaap.typearticleen_EN
relation.isAuthorOfPublication57b410e9-f6b7-42ff-ab3d-b526278715eb
relation.isAuthorOfPublication17c6b98f-4fb5-41d3-839a-6f77ec70021a
relation.isAuthorOfPublication.latestForDiscovery17c6b98f-4fb5-41d3-839a-6f77ec70021a
relation.isProjectOfPublicationd6683ba1-d253-48e4-968e-35106ce7b750
relation.isProjectOfPublication.latestForDiscoveryd6683ba1-d253-48e4-968e-35106ce7b750

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