J Korean Med Sci.  2007 Apr;22(2):218-222. 10.3346/jkms.2007.22.2.218.

Emerging Need for Vaccination against Hepatitis A Virus in Patients with Chronic Liver Disease in Korea

• Song HJ
• Kim TH
• Song JH
• Oh HJ
• Ryu KH
• Yeom HJ
• Kim SE
• Jung HK
• Shim KN
• Jung SA
• Yoo K
• Moon IH
• Chung KW

• KMID: 1713168
• DOI: http://doi.org/10.3346/jkms.2007.22.2.218

Abstract

Vaccination against hepatitis A virus (HAV) is recommended for patients with chronic liver disease (CLD), but this has been deemed unnecessary in Korea since the immunity against HAV was almost universal in adults. However, this practice has never been reevaluated with respect to the changing incidence of adult acute hepatitis A. We retrospectively reviewed the medical records of 278 patients with acute hepatitis A diagnosed from January 1995 to November 2005 and prospectively tested 419 consecutive CLD patients from July to December 2005 for the presence of IgG anti-HAV. The number of patients with acute hepatitis A has markedly increased recently, and the proportion of adult patients older than 30 yr has been growing from 15.2% during 1995-1999, to 28.4% during 2000-2005 (p=0.019). Among 419 CLD patients, the seroprevalences of IgG anti-HAV were 23.1% for those between 26 and 30 yr, 64% between 31 and 35 yr, and 85.0% between 36 and 40 yr. These data demonstrate that immunity against HAV is no more universal in adult and substantial proportion of adult CLD patients are now at risk of HAV infection in Korea. Therefore, further study on seeking proper strategy of active immunization against HAV is warranted in these populations.

Keyword

Hepatitis A; Vaccination; Liver Disease; Immunity

MeSH Terms

Risk Factors
Risk Assessment/methods
Middle Aged
Male
Liver Diseases/*epidemiology/*prevention & control
Korea/epidemiology
Infant, Newborn
Infant
Incidence
Humans
Hepatitis A Vaccines/*therapeutic use
Hepatitis A/*epidemiology/*prevention & control
Female
Disease Outbreaks/*prevention & control/*statistics & numerical data
Comorbidity
Communicable Diseases, Emerging/epidemiology/prevention & control
Chronic Disease
Child, Preschool
Child
Aged, 80 and over
Aged
Adult
Adolescent

Figure

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  Fig. 1 Annual case numbers of acute hepatitis A from 1995 to 2005 in our hospital. The number of acute hepatitis A patients have markedly increased in recent years with an eruption in 1998.

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  Fig. 2 Age distributions of acute hepatitis A patients during 1995-1999 and 2000-2005, demonstrating recent increasing trends among adult patients.

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  Fig. 3 Age-specific seroprevalences of anti-HAV antibody in patients with chronic liver disease.

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