Table 4.

Seroprevalence of HAV (77 studies).

Studies by country	Data period, year(s)	Study population (number, age restrictions)	HAV seroprevalence (IgG), % (n*)
Afghanistan
Carmoi et al., 2009134	2008	102 anicteric pts, 5–65 y	99% (101) • <15 y: 91.7% • ≥15 y: 100%
Djibouti
Fox et al., 1988124	1987	400 healthy adults	98.5% (394)
Egypt
El-Karaksy et al., 200877 and El-Karaksy et al., 200678	2004	101 children with chronic liver disease (CLD), <18 y	85.1% (86) • <5 y: 62.1% • ≥5 y: 94.4%
Al-Aziz et al., 200875	2002–2003	296 children with minor illnesses, 2.5–18 y	61.4% (181) • 2.5–6 y: 53.1% • 6–9 y: 56.4% • 9–18 y: 73.8%
Salama et al., 200781	2003–2004	426 children with minor medical problems,3–18 y	86.2% (367) <6 y: 64.3% 6–10 y: 85.3% 11–15 y: 90.3% >15 y: 90%
Darwish et al., 199676	1994	155 healthy community residents, 1–67 y	100% (155) • 1–3 y: 100% • ≤67 y: 100%
Kamel et al., 199579	1992	1,259 healthy community residents, all ages	97.2% (1224) • 0–4 y: 92.7% • 5–9 y: 97.8% • 10–14 y: 97.9% • 15–19 y: 97.5% • 20–24 y: 96.6% • 25–29 y: 97.9% • 30–34 y: 95.5% • 35–39 y: 100% • 40–44 y: 93.3% • 45–49 y: 100% • 50–54 y: 97.6% • 55–59 y: 93.3% • 60–64 y:100% • 65–69 y: 100% • >70 y: 100%
Omar et al., 200080	n.r.	228 community residents, preschool children	26.3% (60)
Iran
Mirzaei et al., 201660	2014–2015	108 hemophilic pts, 4–85 y	77.8% (84)
Hesamizadeh et al., 201653	2014	559 volunteer blood donors, >18 y	70.7% (395) • 18–27 y: 26.7% • 28–37 y: 59.8% • 38–47 y: 91.2% • >47 y: 94.8%
Hosseini Shokouh et al., 201574	2012–2014	270, healthy medical students, 18–30 y	34.8% (94)
Vasmehjani et al., 201573	2012–2013	159, CLD pts, 21–68 y	79.2% (126) • 21–30 y: 28.6% • 31–40 y: 91.4% • 41–50 y: 93.9% • <50 y: 95%)
Izadi et al., 201655	2011–2013	1,554, healthy soldiers, 18–60 y	80.3% (1,248) • <20 y: 72.2% • 20–30 y: 79.1% • >30 y: 92.4%
Farajzadegan et al., 201452	2003–2013	11,857 cumulative population of 16 studies (systematic review), all ages	51%–66%
Jahanbakhsh et al., 201856	2012	569 homeless adults, 18–60 y	94.3% (nr) • <42 y: 90.3% • ≥42 y: 98.1%
Asaei et al., 201548	2011–2012	1,030, healthy individuals, 0.5–95 y	66.2% (682) • 6–15 y: 18.3% • 16–29 y 79.4% • 30–55 y: 94.3% • ≥56 y: 98.2%
Bayani et al., 201350	2011–2012	466 healthy healthcare workers	71% (330) • 20–29 y: 57.8% • 30–39 y: 77.1% • >40 y: 86.3%
Rabiee et al., 201363	2011	1,813, healthy university students	39.8% (722)
Shoaei et al., 201269	2010–2011	117, chronic hepatitis C pts	94.9% (111) • ≤30 y: 93.1% • 31–40 y: 93.3% • 41–50 y: 100% • 51–60 y: 100% • ≥61 y: 100%
Vakili et al., 201472	2010	1,028, healthy 1st year medical students,17-27 y	68.5% (704)
Saffar et al., 201267	2010	984, community residents, 1–30 y	19.2% (189) • 1–2.9 y: 5.7% • 3–6.9 y: 9.1% • 7–10.9 y: 20.4% • 11–17.9 y: 34.8% • 18–30 y: 68.4%
Mostafavi et al., 201662 and Hoseini et al., 201654	2009–2010	2,494, national health survey participants,10–18 y	50.4%–78.8% across provinces 64% (1,597)
Sofian et al., 201070	2009	1,065, pediatric hospital pts, 0.5–20 y	61.6% • 0.5–1.9 y: 61.5% • 2–5.9 y: 51.7% • 6–10.9 y: 52.9% • 11–15.9 y: 65.2% • 16–20 y: 85.0%
Taghavi et al., 201171	2008–2009	1,050, pre-marriage lab analysis, 15–63 y	88.2% (927) • <20 y: 79.3% • 20–30 y: 91.3% • >30 y: 99%
Ramezani et al., 201164	2008	351, blood donors, 17–60 y	94.9% (333)
Saneian et al., 201468	2007	361, healthy medical students	75.3% (272)
Alian et al., 201147	2007	1,034, community residents, 1–25 y	38.9% (402) • 1–5 y: 8.9% • 5–15 y: 15.8% • 15–25 y: 64.3%
Mohebbi et al., 201261	2006–2007	551, community residents, 1–83 y	90.0% (496) • <30 y: 85.7% • 30–60 y: 90.7% • >60 y: 93.9%
Merat et al., 201059	2006	1,869, community residents, 18–65 y	86%
Davoudi et al., 201051	2005–2006	247 HIV+, 5–74 y	96.3% (238)
Ataei et al., 200849	2006	816, community residents, >6 y	8.3%
Roushan et al., 200765	2004–2005	392, HBsAg+ pts, 10–70 y	82.1% (332) • 10–19 y: 59.4% • 20–29 y: 89.8% • >29 y: 97.5%
Mehr et al., 200458	2002	1,018, children in pediatric hospital, 0.5–15 y	22.3% (227)
Saberifiroozi et al., 200566	n.r.	204, pts in liver clinic, adults	98% (200)
Jordan
Hayajneh et al., 2015127	2008	3,066, community residents, 0–85 y	51% • ≤1 y: 24% • 1–2 y: 26% • 2–4 y: 32% • 5–9 y: 44% • 10–14 y: 63% • 15–19 y: 78% • >20 y: 94%
Kuwait
Alkhalidi et al., 2009118	2003–2004	2,851, healthy adults	28.6% (816) • 18–27 y: 24.2% • 28–40 y: 51% • 41–60 y: 56.5%
Lebanon
Melhem et al., 2015104	2012–2013	283, blood donors	72% • 19–29 y: 60% • 30–39 y: 77% • 40–49 y: 94% • 50–59 y: 91%
Bizri et al., 2006102	1999–2000	902, school children, 14–18 y	71.3% (643)
Kalaajieh et al., 2000103	1996–1998	740, pediatric clinic pts, 0.5–15 y	29.3% (217) • 0.5–6 y: 14.7–21% • 7–15 y: 37.6–40.1%
Sacy et al., 2005105	1999–2000	606, healthy volunteers visiting or working in four hospitals, 1–30 y	43.2% (262) • 1–5 y: 10.5% • 6–10 y: 27.7% • 11–15 y: 57.4% • 16–20 y: 70.1% • 21–30 y: 78.1%
Shamma’a et al., 1982107	n.r.	772, mixed sample of pts	• Lebanese adults: 97.7% (474/485) • Pediatric group: 79.5% (136/171) • Foreign adults: 38.8% (45/116)
Libya
Gebreel et al., 1983135	1979–1981	400, school children, 3–18 y	60%–100%
Morocco
Bouskraoui et al., 2009136	2005–2006	150, children, 0.5-14 y	51% • ≤6 y: 45.2% • >6–14 y: 70.3%
Palestine
Yassin et al., 2001137	n.r.	396, school children, 6–14 y	93.7% • 6 y: 87.8% • 14 y: 97.5%
Pakistan
Aziz et al., 200795	2002–2004	380, children from squatter settlements,<18 y	≥14 y: 100%
Agboatwalla et al., 199494	1990–1991	258, healthy children (239) and adults (19)	55.8% (144) • <5 y: 41% (98/239) • 30–50 y: 100% (19/19)
Hamid et al., 200296	n.r.	233, adult outpatients with CLD	• 97.8% (228)
Saudi Arabia
Alshabanat et al., 201331	2006–2010	44,679, viral hepatitis pts, all ages	17% (7,566)
Al-Faleh et al., 200821	2007–2008	1,357, school children, 16–18 y	18.6% (253)
El-Gilany et al., 201039	2006–2007	950, children attending regular vaccination schedule, 1–6 y	33.8% (321)
Almuneff, et al., 200629	2001–2005	4,006, healthcare workers	67%
Almuneef et al., 200630	2005	2,399, all ages	28.9% (694) • <8 y: 7.1% • 8–11 y: 14.5% • 12–15 y: 30.6% • ≥16 y 52%
Jaber, 200641	2004	527, aged 4–14 y	•28.7%
Al-Ghamdi et al., 200426	2003	650, children − 1st year primary school	8.2% (53)
Fathalla et al., 200040	1987–1999	11,674, healthy children and adults (18–50 y)	86% (10,029) • children: 65% • adults: 78.8% Detailed in children: • <6 y: 3% • 6–<8 y: 62% • 8–<10 y: 71% • 10–<12 y: 83% • 12–<18 y: 93%
Al-Faleh et al., 199924	1997	5,355, community residents, children 1–12 y	25% (1,331) • 1–2 y: 16% • 3–4 y: 22% • 5–6 y: 25% • 7–8 y: 29% • 9–10 y: 34% • 11–12 y: 34%
Khalil et al., 199842	1995–1996	592, children in regular appointments or inpatient care, <16 y	30.2% (179) • 0.5–2 y: 12.5% • 3–4 y: 14.7% • 5–6 y: 20.3% • 7–8 y: 40.4% • 9–10 y: 32% • 11–12 y: 44.3% • 13–15 y: 48.6%
Al Rashed, 199723	1989	4,375, community residents, children, 1–10 y	52.4%
Ashraf et al., 198635	1985	55, hemodialysis pts, all ages	100%
Ashraf et al., 198636	1984–1985	395, healthy blood donors or minor illness pts, all ages	89% (353) • <0.5 y 65.5% • 0.5–2 y: 60% • 3–5 y: 83.3% • 6–12 y: 97.8% • >13 y: 100%
Babaeer et al., 201138	n.r.	1,050, pts, >2 y	33.1% (348) • 2–5 y: 17% • 6–9 y: 21.1% • 10–14 y: 28.8% • 15–19 y: 27.2% • 20–24 y: 34.3% • 25–29 y: 38.2% • 30–34 y: 47.7% • >35 y: 49.2%
Al-Faleh et al., 201022	n.r.	1,157, school children, 16–18 y	16.4% (190)
Arif, 199633	n.r.	1,418, community residents, all ages	68.0% (964) 1–12 y: Riyadh, 24.7%; Gizan, 35.1% >13 y: Riyadh, 77.6%; Gizan, 90.9%
Ramia, 198645	n.r.	1,015, Riyadh residents, all ages	82.5% (837) • <1 y: 67.9% • 1–4 y: 38.6% • 5–9 y: 61.3% • 10–15 y: 81.5% • 16–19 y: 83.5% • 20–29 y: 91% • 30–39 y: 93.5% • ≥40 y: 95%
Somalia
Hassan-Kadle et al., 2018121	[4 studies published from 1984 to1994]	Participants in the 4 studies, all ages	90.2% • <1 y: 61.5% • 1–10 y: 91.9% • 11–19 y: 96.3% • 20–39 y: 91.3% • ≥40 y: 87%
Bile et al., 1992122	n.r.	672, children in 2 residential institutions, <18 y	By institution: • 96% (Shebeli) • 59% (Societe Organization Sociale)
Mohamud et al., 1992123	n.r.	593, 0-83 y	•90%
Syria
Antaki et al., 2000128	n.r.	849, all ages	89% (754) • 1–5 y: 50% • 6–10 y: 81% • 11–15 y: 95% • 16–20 y: 94% • 21–30 y: 97% • 31–40 y: 98% • 41–50 y: 100%
Tunisia
Neffatti et al., 2017110	2014–2015	216 pregnant women, 19-46 y	98.6% (212)
Louati et al., 2009109	2000 & 2007	376 blood donors, 18–30 y		2000	2007
			18–20 y	91.9%	80.6%
			21–25 y	93.7%	84.9%
			>26 y	99.2%	92.1%
			Total	94.9%	85.9%
Rezig et al., 2008111	n.r.	2,482, community residents, children and young adults	87.9% (2,180) • 5- <10 y: 83.9% • 10–15: 90.5% • 16–25 y: 91.9%
Letaief et al., 2005108	2002	2,400, school children, 5–20 y	60% • 5–10 y: 44% • 10–15 y: 58% • 15–20 y: 83%
United Arab Emirates
Sheek-Hussein et al., 2012130	2011–2012	261, healthy medical students	21%
Sharar et al., 2008131	2004–2005	367 children attending hospital, 1–12 y	20.1% (74) • 1–6 y: 10.2% • 6–12 y: 31.5%
Yemen
Bawazir et al., 2010132	2005	538, pts attending hospitals, all ages	86.6% (466) • 0–1 y: 53% • <18 y: 80.8% • ≥18 y: 98.8%

CLD, chronic liver disease; HAV, hepatitis A virus; HBsAg, surface antigen of the hepatitis B virus; HIV, human immunodeficiency virus; IgG, immunoglobulin G; n, the number of study participants who were anti-HAV positive (* if available); n.r. not reported; pts, patients; y, year(s).