Seroprevalence of anti-hepatitis A virus antibody in Iraq

Background: Hepatitis A virus infection is widespread in Iraq, therefore, assessing its seroprevalence is important for infection control at the community level.Aims: To determine hepatitis A virus seroprevalence in a representative sample in Duhok Governorate, northern Iraq; evaluate changes in the epidemiological pattern; and assess factors associated with its seropositivity.Methods: This cross-sectional study was conducted from July 2020 to November 2021. Random cluster sampling was used to select participants aged 5-74 years. Hepatitis A virus immunoglobulin G (IgG) was determined among the participants and demographic data were collected on sex, residency (urban or rural), age, history of jaundice, number of family members (<= five or > five), and sources of drinking water.Results: A total of 1052 participants (625 males and 427 females) were enrolled. The overall seroprevalence of hepatitis A virus IgG was 68.3%: 24.4% in ages 5-10 years; 38.3% in ages 11-15; 86.9% in ages 16-20; 85.4% in ages 21-30; 95.3% in ages 31-40; and 89.2% in ages > 40 years. Factors significantly associated with hepatitis A virus IgG positivity were rural residence, male sex and family size greater than five (all P < 0.01).Conclusion: Hepatitis A virus seroprevalence in Iraq has been declining since the past decade, indicating intermediate -to-low endemicity of hepatitis A virus. However, people are still many susceptible, indicating the need for hepatitis A virus vaccination in the country.