Prevalence of hepatitis A antibody among population covered by different hepatitis A immunization strategies in Shandong Province, 2015, China / 中华预防医学杂志

Objective@#To evaluate prevalence of hepatitis A antibody (anti-HAV IgG) among population covered by different hepatitis A vaccine immunization strategies in Shandong Province in 2015.@*Methods@#In October 2015, according to the geographical location of Shandong Province, the stratified random sampling method was used to stratify the 17 municipal distrcts, and the random number table method was used for sampling, First, two eastern cites (Qingdao, Rizhao), two western cities (Liaocheng, Zaozhuang) and three central cities (Jinan, Zibo and Laiwu) were selected; secondly, one county was drawn from each city. Finally, the participants were divided into five age groups including ≤7 years (age group covered by free hepatitis A vaccination strategy), 8-11 years (age group who receive hepatitis A vaccination at their own charge), 12-24 years (age group covered by catch-up vaccination of hepatitis A), 25-34 years (age group born before hepatitis A vaccine was used) and ≥35 years (age group born before hepatitis A vaccine was used). After all the paticipants or their guardians asked and registered basic information such as age, gender, home address, blood samples were collected from them and anti-HAV IgG was detected by ELISA method. The positive rate of anti-HAV IgG and 95%CI were calculated.@*Results@#A total of 1 654 participants were involved in the final analysis, including 856 males (51.75%) and 798 females (48.25%) whose mean age was (13.44±13.06) years. The crude positive rate of anti-HAV IgG was 91.41% (1 512/1 654, 95%CI: 89.96%-92.72%) and the age-adjusted rate was 90.93% (95%CI: 90.92%-90.94%). The positive rates of anti-HAV IgG was at the highest level in the age group of ≤7 years (95.90%, 95%CI: 95.88%-95.91%) and was at the lowest level in the age group of 25-34 years (83.23%, 95%CI: 83.21%-83.25%). The age-specific positive rates of anti-HAV IgG in eastern areas (96.79%, 95%CI: 96.78%-96.80%) were higher than those in both middle areas (86.66%, 95%CI: 86.65%-86.67%) and western areas (91.96%, 95%CI: 91.95%-91.97%).@*Conclusion@#The positive rate of anti-HAV IgG was high among the general population in Shandong Province, but relatively low among young and middle-aged adults. Besides the routine immunization of hepatitis A among the children, more efforts should be taken for the prevention and control of hepatitis A among young and middle-aged adults in Shandong Province, especially in central and western areas.

Seroprevalence of Anti-hepatitis B Virus, Anti-hepatitis A Virus, and Anti-varicella Zoster Virus Antibodies in Nursing Students from 2009 to 2013 / 병원감염관리

BACKGROUND: Nursing students may be exposed to patients with infectious diseases such as hepatitis B and hepatitis A through needle stick injuries or close contact during their clinical practice. This study surveyed the presence of antihepatitis B virus (anti-HBV), anti-hepatitis A virus (anti-HAV), and anti-varicella zoster virus antibodies in nursing students before the initiation of their clinical practice to help prevent subsequent infections. METHODS: From 2009 to 2013, the junior students of a nursing college in Jeollabuk-do were tested for antibodies against the hepatitis B, hepatitis A, and varicella zoster viruses before the initiation of their clinical practice. RESULTS: The students tested positive for anti-HBV (46.2-57.1%), anti-HAV (0-10.5%), and anti-varicella zoster antibodies (80.2-90.2%). No significant differences in the positivity rates were observed with respect to the year of their enrollment. CONCLUSION: This study was a survey of the seroprevalence of anti-HBV, anti-HAV, and anti-varicella zoster antibodies in nursing students before they started their clinical practice. The positivity rate of anti-HAV was lower than 10%. In order to prevent infection, it is necessary to test nursing students for the presence of antibodies against hepatitis B, hepatitis A, varicella, measles, mumps, and rubella, and check their vaccination history as recommended in the adult immunization schedule. Vaccination must be recommended for students who test negative for the respective antibodies.

Avaliação da utilização de ensaio imunocromatográfico para o diagnóstico e estudo de prevalência da hepatite A / Evaluation of an immunochromatographic assay for diagnosis and prevalence study of hepatitis A

O diagnóstico da infecção pelo vírus da hepatite A (HAV) através de testes de alta sensibilidade e especificidade pode levar um diagnóstico mais precoce e mais preciso,melhorando o prognóstico da doença. Deve também ser mencionado que um diagnóstico mais preciso pode tornar estudos epidemiológicos mais confiáveis e servir de base para a produção de programas de controle e erradicação mais efetivos. O objetivo deste estudo foi avaliar a utilização de um teste imunocromatográfico em surtos e estudos epidemiológicos de prevalência, triagem de candidatos para programas de vacinação e detecção de resposta imunológica pós-vacinação. Para este fim, 342 amostras provenientes de quatro grupos diferentes foram analisadas: (I) amostras de doadores de sangue (n= 96), (II) amostras de indivíduos vacinados contra a hepatite A (n= 46), amostras de surtos de hepatite A (III) (n=103) e (IV) amostras de casos esporádicos de hepatite A (n= 97). Estas amostras foram submetidas ao teste rápido SD BIOLINE HAV IgG/IgM e todos os resultados do teste rápido foram comparados com os resultados do ensaio imunoenzimático para HAV (EIA), que é o padrão ouro para detectar anticorpos contra o HAV...

The diagnosis of infection by the hepatitis A virus (HAV) through high sensitivity andspecificity tests can lead an earlier and more accurate diagnosis, improving the prognosis ofthe disease. It should also be mentioned that a more precise diagnosis can become morereliable epidemiological studies and as a basis for the production of more effective controland eradication programs. The aim of this study was to evaluate an immunochromatographictest in outbreaks and epidemiological studies of prevalence, screening candidates forvaccination and post-vaccination surveillance programs. For this purpose, 342 samples frompatients of four different groups were analyzed: (I) samples from blood donors (n=96), (II)samples from individuals vaccinated for hepatitis A (n=46), (III) samples from hepatitis Aoutbreaks (n=103) and (IV) samples from sporadic cases of hepatitis A (n=97). These sampleswere submitted to the rapid test SD BIOLINE HAV IgG/IgM and all results of the rapid testwere compared to the results of HAV enzyme immunoassay (EIA) that is the gold standard todetect antibodies against HAV. The results obtained for the group I showed that, 33.3%(32/96) were positive for anti-HAV IgG using the rapid test and 67.7% (65/96) were positivefor IgG anti-HAV by EIA. At group II, 71.7% (33/46) of the samples were positive for antiHAVIgG by EIA and none of them (0/33) was reactive by rapid test. Groups III and IV weretested for the presence of anti-HAV IgG and anti-HAV IgM antibodies...

Seroprevalence of total hepatitis A virus antibody in children and adolescents in Shanghai and its risk factors / 中华传染病杂志

ObjectiveTo investigate the immunity and seroprevalence of hepatitis A and to identify the risk factors of hepatitis A infection in 0-18 year-old children and adolescents in Shanghai.MethodsSubjects were enrolled by stratifying and clustering random sampling method.Questionnaire interview was applied to investigate the socio-demographic and behavioral factors related to hepatitis A virus (HAV),and information on HAV immunization was abstracted from the immunization registration book of each subject.The enzyme-linked immunosorbent assay (ELISA) was used to qualitatively detect HAV IgM and quantitatively measure total HAV antibody in all subjects.Risk factors associated with HAV among the subjects without HAV vaccination were analyzed.ResultsA total of 2431 subjects were enrolled in the present study with negative HAV IgM antibody and total HAV antibody in 1483 subjects were sero-positive with positivity rate of 61％.Total HAV antibody positivity rates were declined with age increasing and were significantly higher in subjects with HAV vaccination than those without HAV vaccination records.Salad food,eating together without food separation in school and endoscopy inspection were risk factors for HAV infection.ConclusionsHAV vaccination strategies remarkably improve the total HAV antibody seropositive rate in children and adolescents in Shanghai.The risk of HAV infection exists if HAV vaccination is not administrated comprehensively.Therefore,strengthening HAV vaccination and health education are important for children and adolescents to prevent and control of hepatitis A in Shanghai.

Multiplex polymerase chain reaction test for the diagnosis of acute viral hepatitis A

BACKGROUND/AIMS: The early diagnosis of acute hepatitis A (AHA) is hindered because serum IgM against hepatitis A virus (HAV) can yield false-negative results during the window period. This study evaluated the diagnostic accuracy of a polymerase chain reaction (PCR) kit for HAV RNA for the diagnosis of AHA. METHODS: Samples were collected from 136 patients with acute severe hepatitis at their admission to Asan Medical Center between June 2010 and July 2010. Samples were analyzed for serum IgM anti-HAV using an immunoassay test and for qualitative HAV RNA using the Magicplex HepaTrio PCR test kit. The diagnostic accuracies of these methods were tested on the basis of clinical and laboratory diagnoses of AHA. RESULTS: The concordance rate and kappa value between IgM anti-HAV and HAV RNA PCR were 88.2% and 0.707, respectively. For the diagnosis of AHA, the sensitivity and specificity of IgM anti-HAV were 90.7% and 100%, respectively, when an "equivocal" result was regarded as positive; and 79.1% and 100%, respectively, when an "equivocal" result was regarded as negative. The sensitivity and specificity of HAV RNA PCR were 81.4% and 100%, respectively. All four patients with negative IgM anti-HAV and positive HAV RNA PCR results and all four patients with equivocal IgM anti-HAV RNA and positive HAV RNA PCR results were eventually diagnosed with AHA. CONCLUSIONS: The qualitative HAV RNA PCR test has an equivalent diagnostic accuracy for AHA compared to IgM anti-HAV and may be more sensitive during the window period.

A nationwide seroprevalence of total antibody to hepatitis A virus from 2005 to 2009: age and area-adjusted prevalence rates / 대한간학회지

BACKGROUND/AIMS: Recent outbreak of hepatitis A in Korea is clearly related to the epidemiological shift of hepatitis A virus (HAV). However, nationwide seroprevalence data have been limited. This study estimated the nationwide, age- and area-adjusted anti-HAV prevalence from 2005 to 2009. METHODS: Retrospective analysis of the results of total anti-HAV test in 25,140 cases which were requested by 1,699 medical institutions throughout the nation to Seoul Clinical Laboratory from Jan. 1 2005 to Dec. 31 2009 was performed. The estimated seroprevalence was adjusted by area and age of the standard population based on the 2005 Census data from Korea National Statistical Office. RESULTS: The area-adjusted anti-HAV prevalence in the children younger than 10 years were 33.4% in 2005 and 69.9% in 2009. The most susceptible age groups to HAV infection during the last 5 years were teenagers and the young adults in their age of twenties. The area-adjusted seroprevalence in 2009 were 11.9% in the age group of 20-29 years, 23.4% in the age group of 10-19 years, 48.4% in the age group of 30-39 years. The population in 40-49 years showed geographically different seroprevalence with the lowest rate in Seoul (80%). CONCLUSIONS: The most susceptible age group to HAV infection is 10-29 years, while the young children less than 10 years showed about 70% seropositivity. The changing seroepidemiology should be monitored continuously for the proper vaccination and patient care.

Seroprevalence of Hepatitis A in a Manufacture Workplace / 대한산업의학회지

OBJECTIVES: The prevalence of hepatitis A decreases with improved hygiene and changing lifestyle. However, hepatitis A remains a global problem causing sporadic food-borne infections. Over the past 5 years, hepatitis A incidence has increased, and 15 deaths were reported in 2009 in Korea. Concerns about hepatitis A infection have increased. We checked hepatitis A virus antibody (HAV anti-IgG) in a large manufacturing company, so that the results could be a guideline for workplace preventive plan and health policy for hepatitis A. METHODS: We investigated the seroprevalence of HAV anti-IgG and the demographic characteristics of employee volunteer, in a company in Ulsan. In addition, we estimated those factors that affected seroprevalence of HAV anti-IgG. RESULTS: A total of 2,719 employee volunteers were enrolled into the study. The seropositive rate of HAV anti-IgG was 69.8% (n=1,899) and, the seronegative rate was 30.2% (n=820). There were no enrolled employees under age 24 years who tested positive for HAV anti-IgG; in this group, the seropositive rate was 0.0% (n=0); in 25~29 years the rate was 3.9% (n=12) and 26.5% (n=118) in 30~34 years olds. In the 35-39 ears, 61.1% (n=203) tested HAV anti-IgG positive and 86.8% (n=256) of 40~44 years tested positive. Other group tested as follows: 96.5% (n=335) in 45~49 year olds, 98.7% (n=593) in 50~54 year olds, and 100% (n=382) in over 55 years. There was a significantly increasing tendency to test HAV anti-IgG positive according to age group. In the 34-35 year olds, the seropositive rate exceeded the seronegative rate. CONCLUSIONS: HAV anti-IgG seropositive rate increased according to age. The result can used for guideline recommendationsand establishing hepatitis A policies.

Seroprevalence of Hepatitis A Virus Antibody and Vaccination among Healthcare Workers in a Teaching Hospital / 병원감염관리

BACKGROUND: Recently, the incidence of hepatitis A virus (HAV) infection has been increasing in Korea, and an outbreak among healthcare workers (HCWs) has also been reported. This study aims to evaluate the seroepidemiology of hepatitis A among HCWs at an 820-bed teaching hospital in Korea, thereby facilitating HAV vaccination for these HCWs. METHODS: In June 2009, we assessed the total immunoglobulins against the HAV in the serum samples of 907 HCWs by using VIDAS Anti-HAV Total (bioMerieux, France). RESULTS: Seropositivity for HAV significantly increased with age (P or =61 years. CONCLUSION: Since HCWs aged 20-40 years show low seropositivity for HAV vaccination against hepatitis A should be considered in all these HCWs.

Clinical Features of Acute Hepatitis A in Recent Two YearsClinical Features of Acute Hepatitis A in Recent Two Years / 대한소화기학회지

BACKGROUND/AIMS: The purpose of this study was to characterize the clinical features of acute hepatitis A in Seoul and Gyeonggi province during the recent 2 years. METHODS: We reviewed the medical records of 222 patients who were diagnosed as acute hepatitis A between August 2005 and March 2007 at the Konkuk University Hospital and Korea University, Ansan Hospital. The clinical manifestation, serological tests, and image findings were analyzed. RESULTS: Median age of the patients was 28.1 years and the age groups of highest incidence were the second and third decade. The frequent symptoms were anorexia (66.4%), fatigue (49.2%), fever (47.7%), and abdominal discomfort (42.5%). Fourteen cases (6.3%) showed renal insufficiency, and hemodialysis was performed in one. Cholestatic hepatitis in 2 cases, relapsing hepatitis in 4 cases and prolonged hepatitis in 13 cases were observed. However, there was no case of fulminant hepatitis or death. The underlying diseases including chronic hepatitis B, diabetes mellitus and thyroid disorder did not affect the disease severity of hepatitis A. IgM anti-HAV was not detected initially in 6.7% of the patients. Anti-HEV (IgM) was detected simultaneously in 3 of 150 patients. CONCULSIONS: The age of patients with acute hepatitis A has been increased in the recent years. Most patients recovered uneventfully. However, unusual patterns of severe hepatitis and renal insufficiency occurred in considerable number of cases. Follow-up serologic test for IgM anti-HAV is needed in seronegative cases with hepatitis A

The Age-specific Seroprevalence of Hepatitis A Virus Antibody in Korea / 대한간학회지

BACKGROUNDS/AIMS: The epidemiology of hepatitis A is associated with socioeconomic and hygiene status. Recently, the prevalence of hepatitis A in young adults has been steadily increasing in Korea. This study is to investigate the age-specific seroprevalence of hepatitis A virus in Korea. METHODS: Stored sera from 250 healthy adult subjects who visited the health promotion center in Samsung Medical Center between July and August 2006 were tested for IgG hepatitis A virus antibody (anti-HAV). RESULTS: The prevalence of anti-HAV was 2%, 72%, 92%, 94%, 100% in 20's, 30's, 40's, 50's, and 60's, respectively. The prevalence of anti-HAV was significantly lower in subjects below age 40 compared to those above 40 (37.0% vs. 95.3%, p<0.001). The seroprevalence was higher in area outside of Seoul compared to those living in Seoul in age group below 40 (25.6% vs. 55.6%, p=0.01). In Seoul area, the prevalence was significantly lower in Kangnam-Gu, Seocho-Gu, and Songpa-Gu district compared to the other areas of Seoul in the age group below 40 (20.0% vs. 42.1%, p<0.05). CONCLUSION: The seroprevalence of hepatitis A virus antibody in Korean population below 40 is quite low and immunity to hepatitis A virus in those subjects can be a public health issue. In view of changing seroepidemiology, a policy for hepatitis A vaccination in population below 40 might be warranted.