病毒性肝炎流行病学及发病机理研究现状

一、流行病学1.甲型肝炎:目前,虽然我国农村地区人群抗-HAV阳性率较高,10岁儿童约80%已感染甲型肝炎病毒(HAV);但在北京、上海等城市,人群抗-HAV阳性率有下降趋势,感染HAV的年龄后移,10岁儿童仅有15%感染HAV,但成人甲肝暴发日趋增多,这一流行病学特点值得重视。     

新疆克拉玛依市0～6岁儿童免疫规划针对传染病抗体水平调查

目的了解新疆克拉玛依市免疫规划针对传染病的抗体水平、预测流行趋势并评价免疫效果,为进一步做好免疫规划工作提供科学依据。方法分层随机抽取克拉玛依市0~6岁儿童143人,采集血标本,检测麻疹、百日咳、白喉、乙型肝炎和甲型肝炎的抗体水平。结果白喉、麻疹、甲型肝炎、乙型肝炎及百日咳Ig G抗体的阳性率依次为100.0%、90.9%、89.9%、79.0%和49.7%,麻疹抗体保护性率为76.9%,麻疹、百日咳、白喉、乙型肝炎、甲型肝炎抗体几何平均浓度(GMC)分别为2 057.3 m IU/ml、34.2 IU/ml、3.6 IU/ml、838.1 m IU/ml、476.5 m IU/ml;不同年龄组麻疹抗体保护率差异有统计学意义(χ~2=40.38,P0.05),麻疹(χ~2=88.80)、百日咳(χ~2=13.96)和甲型肝炎(χ~2=28.14)抗体阳性率差异亦有统计学意义(均P0.05);不同地区人群乙型肝炎抗体阳性率差异有统计学意义(χ~2=12.25,P0.05),不同性别人群百日咳(χ~2=0.32)、白喉(χ~2=0.00)、乙型肝炎(χ~2=2.74)和甲型肝炎(χ~2=0.98)的抗体阳性率差异均无统计学意义(P0.05);不同免疫剂次麻疹(χ~2=70.15)和甲型肝炎(χ~2=19.95)抗体阳性率差异有统计学意义(P0.05),且抗体保护率差异亦有统计学意义(χ~2=24.77,P0.05)。结论新疆克拉玛依市0~6岁儿童麻疹、白喉及甲型肝炎抗体阳性率维持在较高水平,已达到卫生部规定的85%目标,但乙型肝炎和百日咳抗体阳性率偏低,说明此部分人群易受相应传染病的侵袭。     

普洱市部分地区人群弓形虫感染血清流行病学调查

目的 目的 掌握云南省普洱市人群弓形虫感染状况, 为制定弓形虫病防治策略提供依据。 方法 方法 选择普洱市景 东、 景谷和孟连3个县作为调查点, 采用ELISA试剂盒检测人群血清弓形虫IgG抗体。 结果 结果 共检测血清906人份, 弓形 虫IgG抗体阳性率为24.17%。其中30～岁年龄组和60～岁年龄组IgG抗体阳性率较高, 分别为30.30% （60/198） 和 32.08% （17/53）; 不同年龄组间IgG抗体阳性率差异有统计学意义 （χ2 =17.77, P＜0.01）。不同性别、 文化程度、 生活习惯 之间阳性率差异无统计学意义 （P 均＞0.05）。农民、 学生和其他职业的IgG抗体阳性率分别为26.58% （194/730）、 15.49% （22/142） 和8.82% （3/34）, 差异有统计学意义 （χ2 =12.51, P＜0.01）; 猪饲养具有圈养和散养习惯人群的阳性率分别为 23.32% （198/849） 和36.84% （21/57）, 差异有统计学意义 （χ2 =5.33, P＜0.05）。结论 结论 普洱市部分地区人群弓形虫IgG抗 体阳性率较高, 应加强弓形虫病的防控和防治知识的健康教育。     

云南省边境地区人群弓形虫感染血清流行病学调查

目的 了解云南省3个边境地区不同性别、年龄和民族的人群弓形虫感染状况,为该地区弓形虫病防控提供实验依据。方法 2015?11–2016?05在云南省中老、中越、中缅3个边境地区采集人群血样561份（中越边境222份、中老边境170份、中缅边境169份）,应用酶联免疫吸附试验（ELISA）检测血清中抗弓形虫IgG抗体。结果 云南省边境地区人群抗弓形虫IgG抗体总阳性率为7.84%(44/561) ,其中中越、中老、中缅边境地区人群抗弓形虫IgG抗体阳性率分别为8.56%（19/222）、8.82%（15/170）和5.92%（10/169）。汉族、哈尼族、傣族、苗族、拉祜族、基诺族、瑶族、彝族居民血清抗弓形虫抗体阳性率分别为5.63%（16/284）、10.96%（8/73）、13.70%（10/73）、4.17%（2/48）、11.11%（1/9）、7.69%（1/13）、12.00%（3/25）和11.11%（3/27）;少数民族居民血清抗弓形虫抗体总阳性率（10.11%,28/277）显著高于汉族（[χ2] = 3.884,P < 0.05）,傣族居民血清抗弓形虫抗体阳性率显著高于汉族（[χ2] = 5.594,P < 0.05）。11 ~ 20岁年龄组人群血清抗弓形虫IgG抗体阳性率最高,为23.53%（4/17）,显著高于0 ~ 10岁年龄组[4.23%（3/71）]（[χ2] = 4.593,P < 0.05）和31 ~ 40岁年龄组[4.00%（3/75）]（[χ2] = 4.997,P < 0.05）。结论 云南省边境地区人群存在不同程度弓形虫感染,少数民族居民感染率明显高于汉族,有必要加强对少数民族居民的弓形虫病防控健康宣教。     

深圳市门诊患者和健康人群食源性寄生虫病血清学分析

目的分析深圳市门诊患者和健康人群常见食源性寄生虫病的感染现状,为防治策略的制定提供科学依据。方法 2013年1-12月,收集深圳市疾病预防控制中心寄生虫门诊就诊者的血清,同时按照整群随机抽样原则收集健康人的血清,采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测华支睾吸虫、并殖吸虫、广州管圆线虫、猪囊尾蚴、棘球蚴和裂头蚴等6种常见食源性寄生虫的血清特异性抗体,通过描述性流行病学方法来分析人群血清学特征。结果收集门诊患者312人的血清,6种食源性寄生虫的总阳性率为24.35%(76/312),华支睾吸虫、并殖吸虫、广州管圆线虫、猪囊尾蚴、棘球蚴、裂头蚴血清抗体阳性率依次为12.01%(311258)、6.98%(16/229)、6.19%(13/210)、8.75%(21/240)、5.37%(11/205)、9.20%(23/250)。男性血清抗阳性率为27.33%(44/161)高于的女性的21.19%(32/151),性别间阳性率无统计学意义差异(χ~2=1.593,P0.05);门诊患者中不同年龄组表现了不同的血清阳性率,最高血清阳性率的年龄组分布在21~50岁,高于20岁以下和50岁以上年龄组,但不同年龄组血清阳性率无统计学意义差异(χ~2=4.376,P0.05);同时收集健康人群血清500人份,总阳性率为8.80%(44/500),华支睾吸虫、并殖吸虫、广州管圆线虫、猪囊尾蚴、棘球蚴、裂头蚴血清抗体阳性率依次为2.80%(14/500)、1.60%(8/500)、2.00%(10/500)、2.40%(12/500)、1.80%(9/500)、2.20%(11/500),男性血清阳性率9.67%(25/258)高于女性的7.85%(19/242),性别间阳性率无统计学意义差异(χ~2=0.526,P0.05);健康人群中不同年龄组表现了不同的血清阳性率,最高血清阳性率的年龄组分布在21~50岁,高于20岁以下和50岁以上年龄组,不同年龄组居民血清阳性率有统计学意义差异(χ~2=-8.625,P0.05)。深圳市门诊患者食源性寄生虫的阳性率高于健康人群的平均水平,差异具有统计学意义(χ~2=36.928,P0.05)。结论深圳市门诊患者食源性寄生虫血清阳性率高于健康人群感染的平均水平。食源性寄生虫病防治是深圳市寄生虫病防治工作的重点,应广泛宣传食源性寄生虫病防治知识,继续倡导健康饮食行为。     

2010年秋季新疆甲型H1N1流感病毒抗体水平调查

目的了解2010年秋季新疆普通人群甲型H1N1流感病毒抗体水平。方法根据《全国部分省份甲型H1N1流感病毒感染状况抽样调查方案》,采用多阶段分层随机抽样方法抽取调查对象进行个案调查,同时采集调查对象5 ml血液进行甲型H1N1抗体检测。结果调查对象甲型H1N1抗体阳性率为24.4%(1 270/5 195),省会城市、中小城市及农村抗体阳性率分别为31.5%、24.1%和19.0%,各层间差异有统计学意义(χ2=69.54,P<0.01);0岁～组、6岁～组、16岁～组、25岁～组、60岁～组抗体阳性率分别为26.0%、33.3%、35.2%、18.8%和8.3%,不同年龄组间抗体阳性率差异有统计学意义(χ2=269.68,P<0.01)。结论新疆省会城市人群甲型H1N1流感病毒感染率高于中小城市,而中小城市高于农村;青少年感染率高于其他年龄组,60岁～年龄组人群感染率低于其他年龄组。     

青海省三江源地区人群棘球蚴病血清流行病学分析

目的 了解青海省三江源地区人群棘球蚴病流行现状,为控制棘球蚴病的流行提供依据.方法 对三江源地区6个州的11个县(市)1岁以上常住人口进行现场流行病学调查,采用间接红细胞凝集试验(IHA)检测人群血清中抗棘球蚴IgG抗体,确定感染率.结果 共检查人血清8408份,检出抗棘球蚴IgG抗体阳性者862例,总阳性率为10.25%.其中女性阳性率为12.79%(532/4161),男性阳性率为7.77%(330/4247),女性高于男性(X~2=57.45,P<0.01);棘球蚴病感染率在各年龄组间比较差异有统计学意义(X~2=146.30,P<0.01),其中50岁年龄组[16.77%(105/626)]和≥160岁年龄组[16.00%(52/325)]高于其他年龄组;感染率在各职业人群间分布比较差异有统计学意义(X~2=188.02,P<0.01),其中僧侣[25.60%(31/117)]高于其他职业人群;感染率在各民族间比较差异有统计学意义(X~2=93.42,P<0.01),其中蒙古族、藏族[11.35%(786/6927)、17.43%(38/218)]明显高于其他民族;感染率地区分布比较差异有统计学意义(X~2=2572.33,P<0.01),较高的县依次为南部的久治县[25.97%(287/1113)]、称多县[25.48%(132/518)]、泽库县[16.44%(172/1046)]和河南县[12.84%(52/405)].结论 棘球蚴病在三江源地区均有分布,感染率以南部牧区为主.防治工作重点应针对广大牧区,以牧区的女性、蒙古族、藏族、僧侣、农牧民为主要目标人群.     

2021年驻马店市某县健康人群6种疫苗可预防疾病抗体水平调查

目的 通过2021年河南省驻马店市某县健康人群麻疹、风疹、流行性腮腺炎、百日咳、白喉和破伤风的抗体水平了解常见传染病的免疫状况。方法 以多阶段分层抽样法随机抽取健康人群,现场问卷调查,采用酶联免疫吸附试验检测健康人群血清麻疹、风疹、流行性腮腺炎、百日咳、白喉和破伤风的IgG抗体,比较分析不同性别、年龄组和疫苗接种剂次的人群血清抗体阳性率。结果 共调查550人,男女性别比为0.96∶1;麻疹、风疹、流行性腮腺炎、白喉、破伤风和百日咳血清IgG抗体阳性率分别为99.1%、98.2%、98.4%、44.4%、38.4%和54.5%,破伤风血清IgG抗体阳性率男性(43.0%)高于女性(33.9%),差异有统计学意义(χ²=4.745,P=0.029);百日咳血清IgG抗体阳性率男性(50.0%)低于女性(58.9%),差异有统计学意义(χ²=4.420,P=0.036);血清IgG抗体阳性率麻疹(P=0.030)、流行性腮腺炎(P=0.027)、白喉(χ²=55.962)、破伤风(χ²=202.922)和...     

新疆10岁以下儿童甲型病毒性肝炎感染状况调查

目的了解新疆10岁以下儿童甲型病毒性肝炎感染状况,制定切实可行的甲肝防治策略。方法2004年11月,在全疆对8月龄~10岁儿童进行了一次甲肝血清流行病学调查,共检测有效血清样本4 403份。结果全疆10岁以下儿童抗-HAV IgG流行率为47.76%,低于1992年76.0%的抗体水平。结论地区分布上,南疆地区(65.66%)高于东疆(30.8%)、北疆(28.91%)和乌鲁木齐地区(22.48%);抗-HAV IgG流行率随年龄增长呈上升趋势;维吾尔族抗-HAV IgG流行率为71.1%,远高于回族(36.5%)、哈萨克族(33.3%)和汉族(23.4%);城市儿童抗-HAV IgG流行率为39.3%,农村儿童为51.4%,农村高于城市。与1992年相比,新疆儿童甲肝免疫屏障明显下降。     

2021年河南省驻马店市某镇1～79岁健康人群百日咳、白喉和破伤风抗体水平分析

目的 了解2021年河南省驻马店市某镇健康人群百日咳、白喉和破伤风的抗体水平，为优化免疫接种策略提供参考。方法 采用多阶段分层随机抽样法抽取健康人群，现场问卷调查，采用酶联免疫吸附试验(ELISA)检测健康人群血清百日咳、白喉和破伤风IgG抗体，分析抗体阳性率。结果 共调查550人，百日咳、白喉和破伤风血清IgG抗体阳性率分别为54.55%、44.36%和38.36%，男女性别比0.96∶1，百日咳抗体阳性率女性略高于男性(χ²=4.420,P<0.05)，破伤风抗体阳性率男性略高于女性(χ²=4.745,P<0.05)；白喉(趋势χ²=5.044)和破伤风(趋势χ²=187.071)抗体水平随人群年龄增长而降低(P<0.05)，不同年龄组百日咳(χ²=63.257)、白喉(χ²=55.962)和破伤风(χ²=202.922)抗体阳性率差异均有统计学意义(P<0.05)；“百白破”疫苗(DPT)末剂次接种后白喉...     

Seroepidemiology of hepatitis a in the croatian population

Background

Hepatitis A virus (HAV) has a worldwide distribution, although this distribution tends to be uneven among geographical regions and population groups. The prevalence of anti-HAV antibodies in the general population varies widely among countries. In Europe, the seroprevalence of HAV is reported to range from 32% to 88%.

Objectives

The aim of this study was to determine the seroprevalence of HAV among the general Croatian population.

Materials and Methods

During a 2-year period (2008-2009), a total of 791 serum samples were tested for the presence of anti-HAV total (IgM+IgG) and anti-HAV IgM antibodies using an automated enzyme-linked fluorescent assay (Mini Vidas; bioMérieux, Marcy l''Etoile, France).

Results

The overall anti-HAV seroprevalence was 41.6%. The observed difference in the seroprevalence rates among male and female patients was not statistically significant (44% vs. 39.6%, P = 0.218). A marked increase in anti-HAV seropositivity with age was observed (P < 0.001). The seroprevalence did not differ significantly between participants residing in rural regions (45.3%) and those residing in urban regions (40.6%, P = 0.292).

Conclusions

Our results corroborate those of seroprevalence studies in other developed countries. More than half of the Croatian population (59.4%) is susceptible to HAV infection. Older age is an important predictor for being anti-HAV positive.     

Community-based cross-sectional seroprevalence study of hepatitis A in Bangladesh

AIM: To elucidate the age-distribution of anti-hepatitis A virus (HAV) seroprevalence across different socioeconomic status (SES) categories in Bangladesh which,despite scarce data, is generally deemed to have high endemicity.METHODS: Blood samples of 818 subjects from a strati-fied sample of schools and hospitals, comprising different age categories and SES were collected. They were assayed for total anti-HAV antibodies. Social and medical history data were obtained using a questionnaire.RESULTS: Overall anti-HAV seroprevalence was 69.6%, increasing with age from 1-5 years (40.4%) to > 30 years (98.4%). Seroprevalence was lowest (49.8%) in the high SES group and highest (96.5%) in the rural lower-middle SES group. Among subjects aged 6-20 years, anti-HAV seroprevalence was lowest in urban private school children (43.0%), followed by urban government school children (76.2%) and rural school children (96.5%) ( P < 0.01). Within the high SES group, anti-HAV seroprevalence was 32.3% in subjects < 10 years and 51.7% in those aged 11-20 years. Until now Bangladesh has been deemed to have high endemicity for HAV.CONCLUSION: The transition from high to intermediate HAV endemicity may be underway; high SES adolescents and adults remain particularly at risk of symptomatic illness. Preventive measures need consideration.     

Seroprevalence study of hepatitis A virus in Fars province, southern Iran

Background

There are several studies on seroprevalence of hepatitis A virus (HAV) in adults in the Middle East.

Objectives

To determine seroprevalence of HAV among adult population in Fars province, southern Iran.

Patients and Methods

In a cross-sectional study, we checked anti-HAV antibody (IgG) in subjects refereed to our health care centers to perform laboratory tests before getting married between March 2008 and March 2009. Age-specific seroprevalence was also determined. Some risk factors like level of education, type of residence, job, numbers of family members, and access to treated water were also evaluated in these participants.

Results

From 1050 subjects studied, 927 (88.2%) had ant-HAV antibody; 123 (11.8%) were antibody negative. Among subjects aged < 20 years, the anti-HAV seroprevalence was the lowest (79.3%) followed by subjects aged 20-30 years (91.3%) and those > 30 years (99%) (p = 0.01). 85.1% of studied individuals in urban areas had anti-HAV IgG while 95.9% of subjects in rural regions were anti-HAV positive (p = 0.001). The seroprevalence of HAV antibody was significantly associated with number of family members (p = 0.001).

Conclusion

HAV is highly prevalent in our region especially in rural areas. It is better to vaccinate the children for HAV by the time they receive HBV vaccine or when they are five years.     

Seroprevalence of anti-HAV among patients with chronic viral liver disease

AIM:To investigate the current seroprevalence of hepatitis A virus(HAV) antibodies in patients with chronic viral liver disease in Korea.We also tried to identify the factors affecting the prevalence of HAV antibodies. METHODS:We performed an analysis of the clinical records of 986 patients(mean age:49±9 years,714 males/272 females) with chronic hepatitis B virus(HBV) or hepatitis C virus(HCV) infection who had undergone HAV antibody testing between January 2008 and December 2009.RESULTS:The overall prevale...     

Hepatitis a in Lebanon: a changing epidemiological pattern

In this multicenter study in Lebanon, hepatitis A virus (HAV) seroprevalence rates were surveyed by age, gender, and socioeconomic factors. Blood samples collected from 606 subjects aged 1 to 30 years were analyzed for anti-HAV IgG. Age was the most important factor influencing HAV seroprevalence. HAV seroprevalence rates in the current study were about 78% in the > or = 21 years age group, 28% in the 6-10 years age group, and 11% in the 1-5 years age group as compared with 97.7% in adults, 85% in children aged 6-12 years, and 40% in children aged 1 to 5 years in previous studies, demonstrating a shift in HAV seroprevalence from the younger to the higher age groups. In light of the severity of the disease in adults and availability of safe and effective vaccines against HAV infection, introduction of HAV vaccination into the national immunization schedule of Lebanon should be considered.     

Age-specific seroprevalence of anti-hepatitis a antibody among 1-30 years old population of savadkuh, mazandaran, iran with literature review

Background

To determine age-specific seroprevalence rates of hepatitis A virus (HAV) immunoglobulin G (IgG) antibody in Savadkuh district, Mazandaran province, north of Iran, as well as to compare the collected data with earlier seroprevalence studies in the region and Iran in order to draw a proper epidemiological pattern for HAV infection in the country.

Objectives

This study aimed to assess an age-specific HAV seroprevalence among 1- to 30-yearold people in Savadkuh, a less developed district of Mazandaran province, north of Iran.

Patients and Methods

The study participants were 984 subjects who aged from one to 30 years and were residents of rural and urban areas of Savadkuh. They were selected using cluster sampling method and divided into five age groups: 1-2.9 (316 cases), 3-6.9 (254 cases), 7-10.9 (201 cases), 11-17.9 (115 cases), and 18-30 (98 cases). Anti-HAV antibody was measured by ELISA method. Seroprevalence rates among different age groups and their relationship to residency, educational levels of parents, water supply, and waste water disposal system was analyzed using chi-squared test.

Results

Overall seroprevalence rate was 19.20 % with no significant difference between rural and urban residents. The seroprevalence rates increased significantly with age: from 5.7 % in age group 1-2.9 year to 34.8 % in adolescents, and to 68.4 % among young adults (P < 0.0001); regardless of significant differences in educational levels among parents of residents in two areas it did not affect seroprevalence rates. Findings of this study and reviewing other reports from the region and the country suggest an epidemiological shift towards lower rates of anti-HAV antibody seroprevalence.

Conclusions

It appears that anti-HAV antibody seroprevalence rate has been declining among Iranians and thereby more children would be susceptible to this infection. This would necessitate revising current strategies of preventative measures in Mazandaran and Iran.     

Anti-hepatitis A seroprevalence among chronic viral hepatitis patients in Kelantan, Malaysia

AIM:To determine the seroprevalence of anti-hepatitis A virus (HAV) antibodies in patients with chronic liver disease (CLD) and to justify the need for hepatitis A vaccination.METHODS:Patients (n=119) were enrolled between July and September 2009.The diagnosis of CLD was based on the presence of viral markers for more than 6 mo.The diagnosis of liver cirrhosis was based on clinical,biochemical and radiological profiles.Patient serum was tested for anti-HAV IgG.RESULTS:The overall anti-HAV seroprevalence was...     

Vaccination Rate and Seroepidemiology of Hepatitis A in Chronic-Hepatitis-B-Infected Individuals in the Korean Army

Background/Aims

Vaccination against hepatitis A virus (HAV) is recommended for patients with chronic hepatitis B (CHB), since they are potentially at an increased risk of HAV-related morbidity and mortality. However, little is known about the adherence to these recommendations in the community. This study evaluated the current vaccination status and immunity against HAV among Korean military soldiers with CHB.

Methods

We performed a prospective study of Korean military soldiers from August 2008 to January 2009. We enrolled 96 soldiers with CHB on a consecutive basis. We assessed their vaccination history and the presence of anti-HAV immunoglobulin G (IgG).

Results

The HAV vaccination rate of the soldiers enrolled in our study was 2% (2 of the 96 soldiers). The seroprevalence rates of anti-HAV IgG among military soldiers without a vaccination history were 0%, 50%, and 100% for those aged 19-29 years (n=71), 30-39 years (n=8), and 40 years or older (n=15), respectively (p<0.001).

Conclusions

The HAV vaccination rate is very low among military soldiers. Public health efforts aimed at raising awareness about HAV vaccination in patients with CHB should be strongly encouraged.     

Increasing trend of acute hepatitis A in north India: need for identification of high-risk population for vaccination

BACKGROUND AND AIMS: Hepatitis A (HAV) is endemic in India and most of the population is infected asymptomatically in early childhood with lifelong immunity. Because of altered epidemiology and decreasing endemicity, the pattern of acute HAV infection is changing from asymptomatic childhood infection to an increased incidence of symptomatic disease in the 18-40 age group. The aims of the present study were to assess whether the proportion of adults with acute HAV infection has been increasing over the years and to analyze the seroprevalence of immunoglobulin G (IgG) anti-HAV antibodies in young adults above the age of 15 years as well as in cases of chronic liver disease. METHODS: Sera collected from 3495 patients with acute (1932) and chronic (1563) liver disease attending the Medical Outpatient Department of Lok Nayak Hospital during the previous five years (1999-2003) were tested for various serological markers of acute (HBsAg, HBcIgM, anti-HCV, HEV-IgM, and HAV-IgM) and chronic (HBsAg, HBcIgG, HBeAg, and anti-HCV) hepatitis. In addition, 500 normal healthy attendants of the patients above the age of 15 years were tested for IgG anti-HAV as controls. RESULTS: Of 1932 patients with acute viral hepatitis, 221 (11.4%) were positive for immunoglobulin M (IgM) anti-HAV. The patients who were IgM anti-HAV negative included hepatitis B (321 patients), C (39 patients), E (507 patients) and unclassified (844 patients). Although the frequency of HAV infection among children had increased (10.6% to 22.0%) in the 5-year period, the frequency of HAV infection among adults had also increased (3.4% to 12.3%) during the same period. A total of 300 patients with chronic liver diseases that were etiologically related to hepatitis B (169), C (73) or dual infection (10) and alcoholic liver injury (48) were tested for the presence of IgG anti-HAV antibody; 98% (294/300) were positive for the antibody. CONCLUSIONS: Although universal vaccination against HAV is not currently indicated, selective vaccination of the high-risk population, based on their serological evidence of HAV antibody, would be a rational and cost-effective approach.     

Prevalence of anti-HAV antibodies in multitransfused patients with beta-thalassemia

AIM： To detect the prevalence of anti-HAV IgG antibodies in adult multitransfused beta-thalassemic patients. METHODS： We studied 182 adult beta-thalassemic patients and 209 controls matched for age and sex from the same geographic area, at the same time. Anti-HAV IgG antibodies, viral markers of hepatitis B virus （HBV） and hepatitis C virus （HCV） infection were evaluated. RESULTS： Anti-HAV IgG antibodies were detected more frequently in thalassemic patients （133/182; 73.1%） than in healthy controls （38/209; 18.2%, P 〈 0.0005）. When we retrospectively evaluated the prevalence of anti-HAV IgG antibodies in 176/182 （96.7%） thalassemic patients, whose medical history was available for the previous ten years, it was found that 83 （47.2%） of them were continuously anti-HAV IgG positive, 16 （9.1%） acquired anti-HAV IgG antibody during the previous ten years, 49 （27.8%） presented anti-HAV positivity intermittently and 28 （15.9%） were anti-HAV negative continuously. CONCLUSION： Multitransfused adult beta-thalassemic patients present higher frequency of anti-HAV IgG antibodies than normal population of the same geographic area. This difference is difficult to explain, but it can be attributed to the higher vulnerability of thalassemics to HAV infection and to passive transfer of anti-HAV antibodies by blood transfusions.