A seroprevalence survey of viral hepatitis was conducted in Bucharest, Romania, between April and July 1990 on a systematic sample of 1355 persons drawn from the general population and groups at higher risk of infection. Sera were tested for hepatitis A, B, and C (HAV, HBV and HCV, resp.) markers using an enzyme-linked immunosorbent assay (ELISA) method. The prevalences of HAV and HBV markers were high in all groups. A total of 47% of the adults from the general population and 39.8% of the children aged 0-16 years had at least one HBV marker. Of the pregnant women 7.8% were positive for hepatitis B surface antigen. Among infants (0-3 years of age) living in orphanages, the prevalence of at least one HBV marker was 54.6%. The findings also confirmed that HCV was circulating in Romania. The results are consistent with national surveillance data and confirm that viral hepatitis is a major public health problem in Romania. Preventive measures will have to include HBV immunization of infants, with an appropriately targeted immunization strategy being determined through further epidemiological studies.
PIP: Viral hepatitis is a major public health problem in all parts of the world. Infections with hepatitis B are of particular concern since such infection in some individuals can lead to chronic liver disease, cirrhosis of the liver, and hepatocellular carcinoma. Comparative studies of the morbidity rates of hepatitis B and hepatitis A virus infections in various European countries indicate that these diseases are highly endemic in Romania. A 300 case per 100,000 population incidence was reported in 1989 national surveillance data for all types of viral hepatitis. A seroprevalence survey of viral hepatitis was conducted in Bucharest, Romania, during April-July 1990 on 1355 people from both the general population and groups at higher risk of infection. The low-risk sample was comprised of 201 individuals aged 0-16 years who had been admitted to the hospital for the first time in their life and who had a noninfectious diagnosis; 200 healthy adults who were attending premarital or recruitment medical examinations; and 204 pregnant women attending antenatal clinics. 214 children younger than three years old selected at random from the five orphanages in Bucharest and 336 medical personnel working at any of four health facilities in the city comprised the high-risk sample. ELISA was used to identify markers of hepatitis A, B, and C in sera. The prevalences of hepatitis A and B markers were high in all low-risk groups, with a past history of acute hepatitis reported by 10.5% of healthy adults. The prevalence of anti-hepatitis A markers increased with age. Almost two-thirds of the subjects younger than 20 years old had been infected with hepatitis A, 50.7% of the 77 children under 5 years old were positive for at least one hepatitis B virus marker, and 34.8% of individuals aged 5-19 years demonstrated seropositivity for hepatitis B virus. 47% of adults from the general population had at least one marker for hepatitis B, 7.8% of pregnant women were seropositive for hepatitis B surface antigen, and 54.6% of the infants aged 0-3 years living in orphanages had at least one marker for hepatitis B. Hepatitis C is circulating in the country. These results are consistent with national surveillance data and confirm that viral hepatitis is a major public health problem in Romania. Prevention measures must include hepatitis B immunization of infants, with an appropriately targeted immunization strategy determined through further epidemiological studies.