Seroprevalence of hepatitis A immunity among brazilian adult patients with liver cirrhosis: is HAV vaccination necessary?

Abstract

BACKGROUND: Patients with chronic liver disease have a higher risk of fulminant hepatitis when infected with hepatitis A virus, and vaccination of these patients against such infection is recommended. In Brazil, mainly in the South and Southeast regions, the epidemiology of hepatitis A (HA) has shifted from high to intermediate endemicity, which would have implication on policy of HA vaccination for these populations. OBJECTIVE: To verify the prevalence of HA immunity in adult patients with liver cirrhosis (LC), in Uberlândia MG, a city of Southeastern Brazil. METHODS: Between December 2005 and December 2006, 106 patients with LC were consecutively evaluated. In addition, 75 individuals without LC or alcoholism were evaluated (control group - CG). RESULTS: Total anti-HAV (ELISA methods) was positive in 104 (98.1%) patients with LC (82 men, 24 women; mean age, 53.3 ± 11.9 years) and in 74 (98.7%) individuals of the CG (55 men, 20 women; mean age, 47 ± 11.6 years), p > 0.05. CONCLUSIONS: For patients with chronic liver disease, in the geographic regions and age groups evaluated, routine vaccination against hepatitis A is not recommended. Moreover, the serum determination of total anti-HAV, used to assess immunity, is five times cheaper than vaccination against hepatitis A and, for this reason, should precede vaccination

Hepatitis A infection in patients with chronic viral liver disease: a cross-sectional study in Jahrom, Iran

“…In the current study, the prevalence of IgG anti-HAV in the general healthy population aged between 21 and 30 years, and ⩾31 years was found to be similar to that of CLD patients, which parallels that of developing and developed countries [26, 32, 33]. In this study there was no significant difference in the anti-HAV rate between the two groups of CLD patients and the general population (79·2% vs .…”

Is Evaluation of Hepatitis A Immunity Required or Not?

“…passive prophylaxis can be done with immune globulin for a short time pre-and post-exposure to the hepatitis A virus and it can be used any time that a vaccine is not available. Centers for Disease Control and Prevention (CDC) also currently advocates that vaccine or immune globulin can be used as a post-exposure prophylaxis (13,14). With exposure of a person to the virus whether they are suspected to be immune or not, a prophylaxis can be given to provide immunity to the HAV (2,8).…”

“…Moreover, immunoglobulin is effective as a vaccine but it is not approved for general prevention purposes, therefore for mass prophylaxis vaccination is advocated (13). In developing countries such as Iran following improvements in food and water hygiene, children's immunity has reduced, therefore hepatitis A vaccination should be considered and an immune survey should be done every few years to help health managers decide when to provide universal vaccination against the HAV (14,15). epidemiology measures that produce information about HAV infection levels in different parts of the world is important for health authorities in order to provide prevention policies of HAV infection rates especially in developing countries (16).…”