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.
Subject(s)
Middle Aged , Male , Infant, Newborn , Infant , Humans , Female , Child, Preschool , Child , Aged, 80 and over , Aged , Adult , Adolescent , Risk Factors , Risk Assessment/methods , Liver Diseases/epidemiology , Korea/epidemiology , Incidence , Hepatitis A Vaccines/therapeutic use , Hepatitis A/epidemiology , Disease Outbreaks/prevention & control , Comorbidity , Communicable Diseases, Emerging/epidemiology , Chronic DiseaseABSTRACT
OBJETIVO: Apresentar uma revisão atualizada e crítica da prevenção das hepatites virais A e B, através de imunização. FONTE DOS DADOS: Revisão de artigos médicos obtidos através do banco de dados MEDLINE, sendo selecionados os mais atuais e representativos do tema (2000-2006). Foram também pesquisados os sites do Centers for Disease Control and Prevention (CDC) e American Academy of Pediatrics (AAP), da Sociedade Brasileira de Pediatria (SBP) e do Ministério da Saúde do Brasil. SíNTESE DOS DADOS: A prevenção das hepatites virais é um enorme desafio para o sistema de saúde pública dos países e das comunidades médica e científica. Os vírus das hepatites ocasionam importante morbimortalidade no mundo, causando doença hepática aguda e crônica. Vacinas altamente eficazes estão disponíveis no mercado para prevenir novas infecções pelos vírus A e B. Entretanto, as hepatites virais A e B continuam a estar entre as doenças preveníveis por vacinas mais comumente notificadas. Neste artigo, revisamos as vacinas usadas para prevenir essas infecções com o objetivo de expandir o conhecimento e o uso da prevenção dessas doenças infecciosas. CONCLUSÃO: Embora as vacinas contra as hepatites A e B sejam recomendadas para vários grupos de risco, a cobertura vacinal estimada ainda é modesta e existem muitas oportunidades perdidas de vacinação. Para que haja diminuição na incidência das hepatites A e B, duas doenças preveníveis por vacinas, é necessário que os médicos incentivem seus pacientes a receber as vacinas.
Subject(s)
Child, Preschool , Female , Humans , Pregnancy , Hepatitis A Vaccines/therapeutic use , Hepatitis A/prevention & control , Hepatitis B Vaccines/therapeutic use , Hepatitis B/prevention & control , Vaccination/standards , Hepatitis A/immunology , Hepatitis B/immunology , Immunization Schedule , Mass Vaccination/standardsABSTRACT
Hepatitis A is a vaccine-preventable disease with 1.5 million people infected world-wide annually. Improvement in the socio-economic status and general public health measures of Asian countries over the last 20 years has led to a shift in the seroprevalence of hepatitis A in many of these countries. In Korea, like in many other developed countries, this lowered endemicity has caused an upward shift in the average age of infection, resulting in larger numbers of individuals at risk of clinically significant hepatitis A infection. Sporadic outbreaks increase the public health burden of the disease. Inactivated hepatitis A vaccines are an effective prevention measure and have been shown to be safe, efficacious and well-tolerated in Korean children. Given this changing epidemiology of the disease and the associated increase in morbidity, vaccination of young children who are not immune, as well as other high risk groups, should be recommended.
Subject(s)
Developing Countries , Disease Outbreaks/prevention & control , Hepatitis A/epidemiology , Hepatitis A Vaccines/therapeutic use , Humans , Immunization Programs/standards , Korea/epidemiology , Mass Vaccination/standardsABSTRACT
La vacuna anti hepatitis A inactivada es una valiosa herramienta preventiva por su alta inmunogenicidad, inducción de memoria, eficacia y perfil de seguridad. Puede ser utilizada a partir de los 12 meses de vida con excelente seroconversión. Las diferentes vacunas son intercambiables entre sí facilitando su uso en salud pública. La mayor utilidad en países con endemia mediana como Chile está en su uso programático en cohortes y en el control de brotes epidémicos circunscritos. Además representa una estrategia alternativa a la inmunoglobulina normal en el manejo de contactos estrechos en el hogar y en instituciones cerradas. En este artículo se revisan in extenso las experiencias publicadas que fundamentan estas aseveraciones.