Hepatitis A virus (HAV) is responsible for common acute viral hepatitis worldwide. Improvement in sanitation and use of efficient vaccines have reduced HAV incidence in developed countries. However, naive adult population are most susceptible to severe outcomes, and high endemic areas persist in developing regions. The transmission of HAV through the fecal-oral route is established. However, considering evolving consumption habits and global market exchange of food, investigations on risk factors associated with HAV infection are needed. Thus, a systematic review and a meta-analysis of case-control, cohort and transversal studies was performed to determine the main risk factors associated with sporadic HAV infection. Relevant scientific articles were identified through systematic literature search and subjected to a methodological quality assessment. Mixed-effects meta-analyses models were adjusted by population type to appropriate data partitions. HAV infections are defined by serological testing. The quality assessment stage selected 78 studies investigating risk factors for sporadic infections with hepatitis A conducted between 1985 and 2013. This meta-analysis confirmed that HAV infections are mostly related to inter-human transmissions, either due to contact with an ill person, through oral-anal sex practice, or lack of personal hygiene. Travel to endemic countries, occupational exposure such as working in child daycare, and exposure to wastewater were associated with HAV infection. As HAV can persist in the environment, it was not surprising that consumption of untreated drinking water, shellfish consumed raw, and crop products were risk factors. Food contamination could be due to the use of contaminated water (fruits, vegetables) or originate from infected food handlers at every point of the food chain (from picking to serving). Eating or drinking outside were associated with HAV infection. A lack of recent case-control studies was identified, with only three studies eligible between 2011 and 2017. Case-control studies required a more precise definition of risk factors such as type of crop product, and storing/preparation information (e.g. washed, frozen). The frequency of consumption or duration of environmental exposure could also better inform relationship between exposure and risk of infection. In a context of epidemiological change of HAV, international travel and trade of foods, future case-control studies are needed and should focus on populations at risk of severe infections and acute cases.

甲型肝炎病毒（HAV）是全球常见的急性病毒性肝炎的病因。改善卫生条件和使用有效疫苗已降低了发达国家的甲肝病毒发病率。但是，未成年成年人口最容易受到严重后果的影响，发展中地区仍然存在高流行地区。HAV通过粪-口途径传播。但是，考虑到不断发展的消费习惯和全球食品市场交换，需要对与HAV感染相关的危险因素进行调查。因此，进行了病例对照，队列研究和横向研究的系统评价和荟萃分析，以确定与散发性HAV感染相关的主要危险因素。通过系统的文献检索确定了相关的科学文章，并进行了方法学质量评估。根据人群类型将混合效应荟萃分析模型调整为适当的数据分区。HAV感染是通过血清学检测确定的。质量评估阶段选择了78项研究，调查了1985年至2013年间甲型肝炎偶发感染的危险因素。这项荟萃分析证实，HAV感染主要与人际传播有关，这可能是由于与病者通过口服接触而引起的。 -肛交或缺乏个人卫生习惯。到流行国家旅行，职业暴露（如在儿童日托中工作）以及暴露于废水中均与HAV感染相关。由于HAV可以在环境中持续存在，消费未经处理的饮用水，贝类消费生食以及农作物是危险因素，这不足为奇。食品污染可能是由于使用了被污染的水（水果，蔬菜）引起的，或者是由于食品链中每个环节（从采摘到食用）受感染的食品加工者造成的。在外面进食或饮水与HAV感染有关。发现缺乏近期的病例对照研究，只有三项研究在2011年至2017年之间合格。病例对照研究需要更准确地定义风险因素，例如农作物产品的类型以及存储/制备信息（例如洗涤，冷冻等）。 ）。消费的频率或环境暴露的持续时间也可以更好地说明暴露与感染风险之间的关系。在HAV流行病学变化的背景下，