Hepatitis A in the Eastern Mediterranean Region: a comprehensive review.

What is the context?Hepatitis A is a viral liver disease caused by the hepatitis A virus.It is generally transmitted by ingestion of contaminated food or water or through contact with an infected person.Disease severity increases with age. Children under 6 years of age are usually asymptomatic, while adults are the most affected.Limited information exists on the number of cases and transmission of hepatitis A in the Eastern Mediterranean region, which includes 21 countries and Palestine, as defined by the World Health Organization.What is new?We performed a literature review to summarize data on hepatitis A disease in the Eastern Mediterranean region over the last 40 years (1980-2020). As information for many countries is scarce or outdated, most of the data is from Egypt, Iran and Saudi Arabia.We found that: Hepatitis A virus is the most common cause of acute viral hepatitis.Hepatitis A exposure varied according to the country's income level.Low- and middle-income countries showed a universal immunity to hepatitis A virus, although this is not the case anymore.What is the impact?Hepatitis A infections have decreased worldwide. Lower exposure to the virus has led to an increase in the susceptible population (including adolescent and adults).Hepatitis A vaccination for children and high-risk groups such travelers should be considered in the Eastern Mediterranean region.