Initial evaluation of universal immunization with a single dose against hepatitis A virus in Central Brazil

ABSTRACT Vaccination against the hepatitis A virus (HAV) administered in two doses has been used effectively in universal child immunization programs in several countries. A single-dose vaccination was adopted in some low-income countries in an attempt to reduce costs without losing effectiveness. In 2014, single-dose universal vaccination was introduced in Brazil for children aged two years. Since such strategy is still not universally accepted, its efficacy should be compared to the two-dose strategy. To assess the humoral response after the single-dose HAV vaccination schedule, a cross-sectional study was conducted in Primavera do Leste, in Mato Grosso state, Central Brazil, including 265 children vaccinated through the National Immunization Program. Blood was collected by using a digital puncture and further applied to filter paper cards. Anti-HAV was detected in 218 out of 265 dried blood spots (DBS). Blood venous samples were collected from 34 out of 47 children who were not anti-HAV positive in DBS samples. Eighteen of them tested positive for anti-HAV, giving a final score of 93.6% (236/252) of seropositivity. In conclusion, this study demonstrated a high rate of anti-HAV positivity in the short term after single-dose hepatitis A vaccination in the population investigated. Moreover, the DBS was shown to be a reliable tool for detecting anti-HAV antibodies.

Hepatitis A seroprevalence in public school children in Campos dos Goytacazes, Rio de Janeiro State, Brazil, prior to the introduction of the hepatitis A universal childhood vaccination / Soroprevalência da hepatite A em crianças de escolas públicas em Campos dos Goytacazes, Rio de Janeiro, Brasil, antes da introdução da vacinação infantil universal / Seroprevalencia de la hepatitis A en niños de escuelas públicas en Campos dos Goytacazes, Río de Janeiro, Brasil, antes de la introducción de la vacunación infantil universal

Abstract: This cross-sectional study was carried out between August 2011 and July 2012 in the city of Campos dos Goytacazes in Rio de Janeiro State, Brazil. Dried blood spot samples were collected on filter paper from 919 individuals between the ages of 1 and 19 and were tested for antibodies against the hepatitis A virus (anti-HAV). The total prevalence was 20.7%, while 94.7% of children under the age of 5 were found to be susceptible to HAV infection. The prevalence of anti-HAV increased with age, reaching 33.3% among individuals aged between 15 and 19, thereby indicating that this municipality has a low level of endemicity for hepatitis A. Age, non-white skin color, accustomed to swimming in the river and more than five people living at home were the factors that were associated with an increase in the chance of a positive anti-HAV result. Mother's education level (secondary or tertiary) was considered a protective factor for HAV infection. The data obtained showed that a large proportion of the children from Campos dos Goytacazes were at risk of HAV infection, which should be minimized with the introduction of the vaccination program against hepatitis A that was launched in the municipality in 2011.

Resumo: Estudo do corte transversal, realizado entre agosto de 2011 e julho de 2012 em Campos dos Goytacazes, Rio de Janeiro, Brasil. Amostras de sangue capilar em papel de filtro foram coletadas de 919 indivíduos com idade entre 1 e 19 anos e testadas para anticorpos para o vírus da hepatite A (anti-HAV). A prevalência total foi de 20,7% e 94,7% das crianças abaixo de 5 anos foi suscetível a infecção pelo HAV. A prevalência de anti-HAV aumentou com a idade, alcançando 33,3% entre indivíduos com 15 a 19 anos, caracterizando este município com um nível baixo de endemicidade para hepatite A. Idade, cor da pele não-branca, hábito de nadar no rio e número de moradores na residência acima de 5 foram associados com o aumento de chance de ser positivo para anti-HAV. O nível educacional materno (médio ou superior) foi considerado como fator de proteção para a infecção pelo HAV. Os dados obtidos mostraram que uma grande parte das crianças de Campos dos Goytacazes estava sob risco de infecção pelo HAV, o que deve ser minimizado com o programa de vacinação contra hepatite A implantado em 2011 no município.

Resumen: Estudio de corte transversal, realizado entre agosto de 2011 y julio de 2012 en Campos dos Goytacazes, Río de Janeiro, Brasil. Se recogieron muestras de sangre capilar en papel de filtro de 919 individuos con una edad entre 1 y 19 años y testadas para anticuerpos del virus de la hepatitis A (anti-HAV). La prevalencia total fue de un 20,7% y un 94,7% de los niños por debajo de los 5 años fue susceptible a la infección por el HAV. La prevalencia de anti-HAV aumentó con la edad, alcanzando un 33,3% entre individuos con 15 a 19 años, caracterizando este municipio con un nivel bajo de endemicidad para la hepatitis A. Edad, color de piel no-blanca, hábito de nadar en el río y un número de ocupantes en la residencia de más de 5 se asociaron con el aumento de oportunidad de ser positivo para anti-HAV. El nivel educacional materno (medio o superior) se consideró como un factor de protección para la infección por el HAV. Los datos obtenidos mostraron que una gran parte de los niños de Campos dos Goytacazes estaba bajo riesgo de infección por el HAV, lo que debe ser minimizado con el programa de vacunación contra la hepatitis A implantado en 2011 en el municipio.

The Immunogenicity of a Single Dose of Hepatitis A Virus Vaccines (Havrix(R) and Epaxal(R)) in Korean Young Adults

PURPOSE: Assessing the immunogenicity of a single dose of hepatitis A virus (HAV) vaccines is important because some people receive only a single dose. However, previous studies have shown variable results and have not examined the effects of demographic characteristics other than gender. This study was performed to examine the immunogenicity of a single dose of HAV vaccine according to the vaccine type and demographic characteristics in young adults. MATERIALS AND METHODS: Seronegative medical school students were randomly allocated to receive either Havrix or Epaxal. RESULTS: After approximately 11 months, the seroconversion rate in 451 participants was 80.7%. In men, the Havrix group showed a significantly higher seroconversion rate (81.9%) than the Epaxal group (69.2%), whereas both vaccine groups showed similarly high immunogenicity in women (Havrix: 90.1%, Epaxal: 92.9%; P for interaction=0.062). According to the results of a multivariate analysis, Epaxal showed significantly lower immunogenicity than Havrix only in men. Age, obesity, drinking, smoking, and follow-up time did not significantly affect seroconversion in either gender. CONCLUSION: The seroconversion rate of single-dose HAV vaccines was low in men, particularly in those who received Epaxal. Our results suggest that gender effects should be considered when comparing the immunogenicity of different HAV vaccines.

Declining prevalence of hepatitis A virus antibodies among children from low socioeconomic groups reinforces the need for the implementation of hepatitis A vaccination in Brazil

Age-related seroprevalence studies that have been conducted in Brazil have indicated a transition from a high to a medium endemicity of hepatitis A virus (HAV) infection in the population. However, most of these studies have focused on urban populations that experience lower incidence rates of HAV infection. In the current study, the prevalence of anti-HAV antibodies was investigated in children with a low socioeconomic status (SES) that live on the periphery of three capital cities in Brazil. A total of 1,162 dried blood spot samples were collected from individuals whose ages ranged from one-18 years and tested for anti-HAV antibodies. A large number of children under five years old (74.1-90%) were identified to be susceptible to HAV infection. The anti-HAV antibody prevalence reached ≥ 50% among those that were 10-14 years of age or older. The anti-HAV prevalence rates observed were characteristics of regions with intermediate level of hepatitis A endemicity. These data indicated that a large proportion of children with a low SES that live at the periphery of urban cities might be at risk of contracting an HAV infection. The hepatitis A vaccine that is currently offered in Brazil is only available for high-risk groups or at private clinics and is unaffordable for individuals with a lower SES. The results from this study suggest that the hepatitis A vaccine should be included in the Brazilian National Program for Immunisation.

Epidemiological and serological aspects of hepatitis A among children and teenagers in the city of Santos: a cross-sectional study / Aspectos epidemiológicos e sorológicos da hepatite A em crianças e adolescentes na cidade de Santos: estudo transversal

CONTEXT AND OBJECTIVE: Viral hepatitis A is still a concern at public health level in Brazil and around the world, due both to the number of affected subjects and the possibility of complications in the acute forms. The Brazilian Ministry of Health estimates that at least 70% of this country's population has already had contact with the hepatitis A virus (HAV). The aim here was to discover the prevalence of serological markers for the hepatitis A virus among children and teenagers at daycare facilities, kindergartens and elementary schools in the city of Santos. DESIGN AND SETTING: Cross-sectional study in kindergartens and elementary schools within the municipal education network in several regions of the city of Santos. METHOD: Students' family members were surveyed using a questionnaire and 4,680 finger-prick blood samples were taken and assayed by means of the ELISA technique. RESULTS: The general prevalence of anti-HAV IgG was 9.72% and, of these cases, 74.6% were reactive to anti-HAV IgM. There was higher prevalence of anti-HAV IgG among older children, females, children who played in streams, those whose homes were not connected to the sewage system, those whose parents had low education levels, those with low household income and those who did not live along the seashore. The prevalence of anti-HAV IgM peaked in the early years and subsequently fell, and it was lower on the hills and in the Northwestern Zone. CONCLUSION: The general prevalence of serological markers for hepatitis A was low in Santos.

CONTEXTO E OBJETIVO: A hepatite viral A continua sendo uma preocupação em nível de saúde pública no Brasil e no mundo, tanto pelo número de indivíduos atingidos, como pela possibilidade de complicação das formas agudas. O Ministério da Saúde estima que pelo menos 70% da população do Brasil já tiveram contato com o vírus da hepatite A. O objetivo foi conhecer a prevalência de marcadores sorológicos do vírus da hepatite A em crianças e adolescentes de creches e escolas de ensino infantil e fundamental na cidade de Santos. TIPO DE ESTUDO E LOCAL: Estudo transversal em pré-escolas e de ensino fundamental da rede municipal em diversas regiões da cidade de Santos. MÉTODO: Foi aplicado um questionário aos familiares dos estudantes e coletadas 4.680 amostras de sangue através de punção capilar para realização da sorologia pela técnica ELISA. RESULTADOS: A prevalência geral do anti-HVA IgG foi de 9,72% e, desses, 74,6% foram anti-HVA IgM reagentes. A prevalência de anti-HVA IgG foi maior entre as crianças mais velhas, meninas, aquelas que brincavam em córregos, sem rede de coleta de esgoto em sua moradia, de pais com baixa instrução, de baixa renda familiar e aquelas que não eram moradoras da orla. A prevalência de anti-HVA IgM teve pico nos primeiros anos e posterior queda e, no morro e Zona Noroeste, foi mais baixa. CONCLUSÃO: A prevalência geral dos marcadores sorológicos para hepatite A foi baixa em Santos.

Soroprevalência de hepatite A em crianças e adolescentes / Seroprevalence of hepatitis A in children and adolescents

OBJETIVOS: Avaliar a soroprevalência de hepatite A (VHA) em crianças e adolescentes com idade entre 1 e 14 anos, e identificar fatores associados à infecção prévia. MÉTODO: Estudo epidemiológico transversal, realizado entre fevereiro e agosto de 2006, em Curitiba, Paraná, Brasil, e em sua região metropolitana. A análise laboratorial constituiu-se de pesquisa qualitativa de anticorpos totais para o VHA em amostra de sangue total. RESULTADOS: No estudo, 901 crianças e adolescentes foram incluídos. A distribuição por faixa etária foi: 237 (26,3 por cento) entre 1 e 4 anos; 313 (34,7 por cento) entre 5 e 9 anos; e 351 (39 por cento) entre 10 e 14 anos. A taxa de soroprevalência geral encontrada foi de 19,8 por cento, e por grupo etário foi de 3, 21,1 e 29,9 por cento (p < 0,01), respectivamente. Na análise multivariada, demonstrou-se que os fatores que, em conjunto, mantiveram associação positiva com as prevalências de anticorpos contra o VHA na população estudada foram: faixa etária de 5 a 9 e 10 a 14 anos, morar em casas com um ou mais habitantes por cômodo, frequentar refeitório comunitário e ter baixa renda per capita. CONCLUSÕES: Os resultados demonstraram uma baixa prevalência de anticorpos contra o VHA, o que justifica o uso de medidas profiláticas, que incluem a vacinação precoce.

OBJECTIVES: To determine the seroprevalence of hepatitis A (HAV) in children and adolescents aged 1 to 14 years, and to identify factors associated with a history of infection. METHOD: This was a cross-sectional epidemiological study, conducted form February to August 2006 in the city of Curitiba, Paraná, Brazil, and the surrounding municipalities (Greater Curitiba). Laboratory analysis comprised qualitative assay for total HAV antibodies in whole blood samples. RESULTS: A total of 901 children and adolescents were recruited for the study. Age distribution was as follows: 1 to 4 years, n = 237 (26.3 percent); 5 to 9 years, n = 313 (34.7 percent); and 10 to 14 years, n = 351 (39 percent). The global rate of seroprevalence was 19.8 percent, and seroprevalence rates by age group were 3 percent, 21.1 percent and 29.9 percent respectively (p < 0.01). Multivariate analysis demonstrated that the following factors, in combination, had a positive association with the prevalence rate of antibodies against HAV in the study population: age groups 5 to 9 and 10 to 14 years, living in a household with more than one inhabitant per room, shared eating area and low per capita income. CONCLUSIONS: The results show a low prevalence of antibodies against HAV, which justifies the use of prophylactic measures, including early vaccination.

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.

The Seroprevalence Rate, Vaccination Rate and Seroconversion Rate of Hepatitis A in Central Region of Korea / 대한소화기학회지

BACKGROUND/AIMS: Acute hepatitis A (HAV) is markedly increasing recently on. Some patients with acute hepatitis A show severe clinical course. The seroprevalence rate of IgG anti-HAV has been changing with the regions and the times. Vaccination and seroconversion rate of HAV are not well known. In this study, we aimed to study the difference of seroprevalence rate of IgG anti-HAV according to various clinical factors and to know the vaccination rate and seroconversion rate below 10 years old in the central region of South Korea including Cheonan city. METHODS: Seven hundred seventy two subjects were included in the study from January to September 2009. We analyzed seroprevalence rate of IgG anti-HAV according to sex, age, region, and other viral markers. We interviewed the history of vaccination(1st, 2nd) and analyzed seroconversion rate according to vaccination time below 10 years old. RESULTS: The total seroprevalence rate of IgG anti-HAV was 65.3%. The seroprevalence rate of IgG anti-HAV rate in 2nd, 3rd, and 4th decade was very low (1.9%, 18.8%, 44.8%). The vaccination rate of children was about 50%. The seroconversion rate after 1st, and 2nd vaccination were 85%, 96%. CONCLUSIONS: Catch-up vaccination for teenagers and young adults is needed. Immunizing children with HAV vaccine as a routine schedule should be considered.

Seroprevalence of IgG Anti-HAV in Hospital Employees below 40 Years Old / 대한소화기학회지

BACKGROUND/AIMS: Hepatitis A is an acute infectious disease transmitted by fecal-oral route. As the incidence of hepatitis A has been increased in Gwangju and Chonnam province of Korea recently, the number of hepatitis A patients in hospital employees has also increased. Thus, we investigated the seroprevalence of IgG anti-HAV in hospital employees below 40 years old. METHODS: We analysed the seroprevalence of anti-HAV IgG from 1,002 Chonnam national university hospital empolyees (men: 190, women: 812) who were below 40 years old. The age group was divided by 5 years; 21-25 years old 199 (19.9%), 26-30 years old 426 (42.5%), 31-35 years old 215 (21.5%), 36-40 years old 162 (16.1%). RESULTS: Overall seropositive rate of IgG anti-HAV was 32.8% (329/1,002). The seropositive rate of men was 40.5% (77/190) and that of women was 31.0% (252/812). The seropositive rates of each age group were 1.5% (3/199) in 21-25 years old, 21.6% (92/426) in 26-30 years old, 48.4% (104/215) in 31-35 years old, and 80.2% (130/162) in 36-40 years old. The seropositivity rate of the high risk group (doctors, nurses, technicians) was 28.9% (234/809). CONCLUSIONS: The seropositive rate of IgG anti-HAV was the lowest in early twenties of hospital employees and below 50% in early thirties. Therefore, hepatitis A vaccination may be warranted in the hospital empolyees below the early thirties.

Fulminant hepatitis failure in adults and children from a Public Hospital in Rio de Janeiro, Brazil

Fulminant hepatic failure (FHF) is characterized by massive hepatocellular injury, whose physiopathology is still unclear. Hepatitis B (HBV) is probably the most common viral cause of FHF, while hepatitis A (HAV) virus seem occurs less frequently. However, the host and viral factors that determine the outcome of these infections are poorly understood. In the present study, viral load and genotyping determining regions of HAV and HBV genomes were sequenced. Eight FHF patients and one patient with severe acute hepatitis (SAH) were included. Liver and blood samples were collected during liver transplantation or necropsy procedures. HAV-RNA and HBV-DNA were extracted from serum, biopsy and paraffin liver. Nucleotide sequencing of HAV-RNA was performed from VP1/2A and HBV-DNA from PreS/S region. The amplified samples were quantified by Real-Time PCR. The cases of HAV infection were due to subgenotype IA. The cases of HBV infection were due to genotype A2 and D4. The case of HAV/HBV coinfection was infected by genotype IA and D3. Hepatitis A and B infection were associated with genotypes most prevalent in Brazil. In hepatitis A infection the mean of period evolution was 13 days. In hepatitis B, FHF patients infected by genotype D have a shorter period of evolution than FHF patients infected by genotype A (mean 15 v. 53 days). There was no association with genotype-determining region with the severity of hepatitis, however nucleotide differences and high viral load could be observed among FHF.

Hepatitis A virus subgenotypes dissemination during a community outbreak in a surrounding region of Rio de Janeiro

From December 1999 to December 2001, many cases of hepatitis A were notified in the county of Belford Roxo involving individuals aged 0 to 79 years. Serum samples were collected to evaluate the prevalence of anti-hepatitis A virus (HAV) antibodies, to detect HAV-RNA and to correlate with possible risk factors of HAV infection. Serum samples were screened by commercial IgM and total anti-HAV antibody ELISA and HAV-RNA was isolated and subsequently amplified by reverse transcription-polymerase chain reaction (RT-PCR) at VP1/2A region, sequenced and analyzed. Total anti-HAV prevalence was 87.9 percent (203/231) and IgM anti-HAV prevalence was 38.7 percent (89/231). Multivariate analysis showed that individuals under 20 years old are risks groups to acquire the infection suggesting that hygienic habits of young subjects are the principal factor of transmission and so they could be the target for vaccine programs. HAV-RNA was amplified from 29 (32.5 percent) IgM anti-HAV positive patients and 26 samples were sequenced and classified into subgenotypes IB (8 isolates) and IA (18 isolates). Isolates classified into subgenotype IB were identical representing one distinct strain. We could observe both subgenotypes circulating during the study which suggests different sources of infection. Prophylactic measures as vaccination strategies added to improvements in hygienic and sanitary conditions would be highly effective to reduction of infection.

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

Comparison of Recent IgG Anti-HAV Prevalence between Two Hospitals in Seoul and Gyeonggi area / 대한간학회지

BACKGROUND/AIMS: Recently, the incidence of acute hepatitis A has increased nationwide and is related to the low rate of IgG anti-HAV. This study compared the prevalence of IgG anti-HAV in two university hospitals located in a large city and in a small city including a rural region according to age, gender, and the year of diagnosis. METHODS: IgG anti-HAV was measured in a total of 4299 patients, who visited Seoul or Guri Hanyang University Hospital between January 2002 and December 2006. RESULTS: The positive rates of the antibody in Seoul and Guri hospitals were 52.7% vs 57.1% in under the age of 1, 40.7% vs 42.2% in age of 1 to 4, 31.8% vs 30.3% in age of 5 to 9, 24.8% vs 27.1% in age of 10 to 14, 11.6% vs 18.2% in age of 15 to 19, 23.0% vs 20.3% in age of 20 to 24, 40.5% vs 42.9% in age of 25 to 29, 67.5% vs 75.0% in age of 30 to 34, 86.5% vs 88.1% in age of 35 to 39, 95.3% vs 93.6% in age of 40 to 44, 97.0% vs 98.7% in age of 45 to 49, and 98.5% vs 98.6% in patients who were more than 50, respectively. The positive rates of the antibody were not significantly different between two sites according to each age group and gender. CONCLUSIONS: The results confirmed the low rates of IgG anti-HAV, particularly in the ages of 10-24 that match the age group of recently increased incidence of acute hepatitis A nationwide. Therefore, measurement of the antibody and vaccination should be considered in this age group.

Changes in the Seroprevalence of Hepatitis A Virus Antibody in Korea / 대한간학회지

No abstract available.

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.

Seroepidemiology of hepatitis A virus in Iranin soldiers in 2006: Do they need vaccination?

Since hepatitis A virus is a contagious viral infection, crowded military quarters are a fertile ground for the spread of this disease. This study sought to evaluate immunity against hepatitis A virus among Iranian military draftees so as to determine whether or not universal vaccination for the armed forces is necessary. This cross-sectional study randomly selected 800 army draftees in Tehran, the capital city of Iran in 2006. Demographic data, namely age, occupation before call-up, education, and time of in-service, were collected. Five ml of blood was taken from all the subjects; the blood samples were then centrifuged and their serum was examined by the Elisa test with a broad test of Abbott-hepatitis A virus AB META-AXSYM system for total hepatitis A virus antibody. The data were subsequently analyzed with SPSS software, t-test, and Mann-Whitney's test. P<0.05 was considered significant. All the 800 soldiers were male with a mean age of 19 +/- 1SD years, and 702 [88%] of them were holders of a high school diploma with the rest being school dropouts. 781[97.63%] of the subjects had anti-hepatitis A virus antibody while the other 19 [2.37%] did not. That 97.63% of the army draftees recruited into our study were immune to hepatitis A virus is an indication that vaccination for hepatitis A is not necessary for Iranian military conscripts at this juncture

Serum Hepatitis B Virus DHA Level and Hepatocellulor Carcinoma / 대한간학회지

No abstract available.