[Prevalence of hepatitis A, B, C virus markers in Réunion (south hospital and Saint Pierre prison)]

Abstract

We studied the prevalence of Hepatitis A, B, C in different groups in the population of the South of Reunion Island. The aims of this study were the following: to estimate the prevalence of Hepatitis C virus (HCV) (anti-HCV antibodies) and Hepatitis B virus (HBV) (anti-HBc, HBs Ag and anti-HBs) in a population of 1455 women, who delivered in the Centre hospitalier Sud Reunion (CHSR), to estimate the prevalence of these two viruses in a population selected for risk factors (100 prisoners), to estimate the prevalence of Hepatitis A in a group of 400 persons (aged 0 to 19) hospitalised in CHSR since 1st January 1998 (100 for each 5-year age bracket), to research risks factors in these populations and immunity. The overall prevalence of anti-HCV was 0.14% in pregnant women and risk factor associated was found in 28.9% of this population (2.9% history of transfusion, 0.21% drug users). In the group of prisoners seroprevalence was 2%, far below that of prisoners in France. Anti-HCV seroprevalence is weak in Reunion Island and very inferior to seroprevalence in the French population as in other Indian Ocean islands. This is due to the low risk of parenteral transmission. Anti-HBc was found in 90 serum samples from women (overall prevalence 6.35%) and of these 90 positive samples, 9 were positive for HBs Ag (overall prevalence 0.63%), 68 were positive for anti-HBs (4.81%) and 22 (1.54%) were anti-HBc isolated (without HBs Ag and anti-HBs). The overall prevalence of anti-HBs was 62.8%. In the population of 100 prisoners, 2 were HBs Ag positive, 10 anti-HBc positive (2 anti-HBc isolated, 2 associated with HBs Ag, 6 with anti-HBs). The prevalence of anti-HBs was 22%. The major risk factor observed in this population of prisoners was tattooing and/or piercing (46%). These results show that: Reunion island is an area of low endemicity for HBV virus. The measure of protective inoculation is well followed. i.v. drug abuse and previous transfusion are weak routes of transmission. In the group aged 0 to 19, overall prevalence of anti-HAV was 11.9% with the highest rate found among 15 to 19 year-olds (25%). Seroprevalence falls with socio-economic progress. At the present time, the endemic is intermediate in Reunion Island. Given immunity levels within the young population, there is a risk of outbreak. This risk is due to the conditions in Reunion Island, but also to people who travel to other Indian Ocean countries where endemicity is high. It is thus very important that a vaccination strategy be determined.