Vaccination contre l'hépatite A

Hepatitis A epidemiology has greatly changed over the last decades, since the improved life standards and hygiene have lead developed countries to a moderate endemicity level by the increased susceptibility of the populations to hepatitis A virus (HAV) infection. Despite the decrease of hepatitis A incidence, sporadic cases and outbreaks continue to occur, that causes a substantial burden in terms of morbidity, mortality and costs. Since 1992, when inactivated vaccines against HAV have been marketed, public health services may react opportunely. Available for adults and children from one year of age, these vaccines are highly immunogenic after a single dose and well tolerated. A two-dose schedule is recommended at 6 to 18-month intervals, without booster in healthy individuals. Pre-vaccination serologic testing is usually unnecessary until age 45. In France, HAV vaccination is recommended for persons exposed to occupational or particular risks; travelers are the most important target. A comprehensive strategy for elimination could be considered but it would need the implementation of a national system for acute hepatitis surveillance.