Abstract：
This review aims to gather and disseminate updated information regarding hepatitis A virus (HAV) in Latin America (LA) in the last 11 years, including seroprevalence, post-vaccination studies, virus detection in aqueous matrices and food samples, and outbreak reports. Only 24 seroprevalence studies were published between 2012 and 2023 with 55%-100% reported prevalences of anti-HAV IgG. Among the 25 LA countries, only eight of them have introduced HAV vaccines into their immunisation programs. Outbreaks of hepatitis A occurred between 2017-2019, mainly affecting men who have sex with men in Argentina, Brazil and Chile, probably as a consequence of the abrupt decline of young adults\' immunity. This could be due to that young adult have never been infected in childhood (due to socio-health improvements) and are above the cut-off ages to be included when the vaccination programs were introduced. Although scarce, studies focused on environmental and food HAV surveillance have shown viral presence in these samples. Surface waters presented HAV detections between 1.2% and 86.7%, and untreated wastewaters between 2.8% and 70.9%. Genotypes found in all cases were IA and IC. The only wastewater-based epidemiology study showed to be a useful tool as a complement of traditional epidemiological surveillance. Only four LA countries have looked for HAV in food samples, with genome detection rates between 9% and 33%. Latin American HAV circulation scenario is changing. In countries where socioeconomic and sanitary conditions have not improved, the virus persists with high endemicity and the access to the vaccine should be re-evaluated by local governments. In countries where access to clean water, better sanitary conditions and HAV immunisation programs have been implemented, the number of cases among young adults seems to be increasing, alerting health authorities.
摘要：
本综述旨在收集和传播有关过去11年拉丁美洲（LA）甲型肝炎病毒（HAV）的最新信息。包括血清阳性率,疫苗接种后的研究，在水性基质和食品样品中检测病毒，和疫情报告。在2012年至2023年之间，仅发表了24项血清阳性率研究，报告了55％-100％的抗HAVIgG流行率。在洛杉矶的25个国家中，其中只有8人将HAV疫苗引入其免疫计划。甲型肝炎暴发发生在2017-2019年，主要影响阿根廷男男性行为者，巴西和智利，可能是由于年轻人免疫力的突然下降。这可能是由于年轻人在儿童时期从未被感染（由于社会健康状况的改善），并且超过了引入疫苗接种计划时要包括的截止年龄。虽然稀缺，针对环境和食品HAV监测的研究表明，这些样本中存在病毒。地表水检测到HAV的比例在1.2%到86.7%之间，未经处理的废水在2.8%至70.9%之间。在所有病例中发现的基因型为IA和IC。唯一的基于废水的流行病学研究表明，作为传统流行病学监测的补充，是一种有用的工具。只有四个洛杉矶国家在食物样本中寻找HAV，基因组检测率在9%至33%之间。拉丁美洲的HAV流通情景正在发生变化。在社会经济和卫生条件没有改善的国家，该病毒持续存在，并具有很高的地方性，地方政府应重新评估获得疫苗的机会。在获得清洁水的国家，实施了更好的卫生条件和HAV免疫计划，年轻人的病例数量似乎在增加，警告卫生当局。
