ABSTRACT
OBJECTIVE: The age of persons with hepatitis A virus (HAV) infection in the general population has risen; these persons are at increased risk of clinically severe disease, especially patients with chronic liver disease. The aim of the present study was to analyze the prevalence of total antibodies against HAV in patients with chronic liver disease. METHODS: In a prospective study carried out between September 1998 and June 1999, 180 patients seen in the chronic liver disease outpatient department were studied. The prevalence of total anti-HAV antibodies was determined by age group, etiology and degree of histological damage, and according to the antecedents of risk for parenteral infection. A nonconditional logistic regression model was fitted with anti-HAV positivity as the dependent variable. RESULTS: Mean age was 44.1 years, with an anti-HAV prevalence of 77.2% (varying from 42.9% in the 21-25-year-old group to more than 83% in patients > 56-years old). Differences across groups regarding other categories (histological damage, etiology and history of parenteral or drug use) were not statistically significant, but the probability of anti-HAV positivity increased with age and a history of drug addiction. CONCLUSIONS: The prevalence of total anti-HAV antibodies is high among patients with chronic liver disease. We therefore recommend this test before vaccination against HAV, until current recommendations on universal childhood vaccination are implemented, in order to prevent hepatitis A epidemics in the general population.
Subject(s)
Hepatitis A/epidemiology , Hepatitis A/immunology , Hepatitis Antibodies/blood , Adult , Aged , Aged, 80 and over , Chronic Disease , Female , Humans , Male , Middle Aged , Prevalence , Prospective Studies , Seroepidemiologic StudiesABSTRACT
OBJETIVO: la edad de infección por el virus de la hepatitis A (VHA) ha aumentado en la población, con un mayor riesgo de gravedad clínica, sobre todo en pacientes con hepatopatía crónica. Se pretende conocer la prevalencia de anticuerpos totales frente al VHA en pacientes con hepatopatía crónica. PACIENTES Y MÉTODOS: se estudió de forma prospectiva a 180 pacientes atendidos consecutivamente en nuestra consulta de Hepatopatías Crónicas desde septiembre de 1998 hasta junio de 1999. Se determinó la prevalencia de anticuerpos totales anti-VHA por grupos de edad, etiologías, grado de afectación histológica y antecedentes de riesgo de infección por vía parenteral. Finalmente se ajustó un modelo de regresión logística no condicional con variable dependiente la presencia de anti-VHA. RESULTADOS: la edad media fue de 44,1 años, con una prevalencia de anti-VHA del 77,2 por ciento (desde el 42,9 por ciento entre 21-25 años hasta más del 83 por ciento a partir de 56 años). No existieron diferencias estadísticamente significativas según la afectación histológica, etiología o antecedentes de riesgo parenteral o de drogadicción, pero la probabilidad de tener anti-VHA aumentaba con la edad y con el antecedente UDVP. CONCLUSIONES: los pacientes con hepatopatía crónica presentan una alta prevalencia de anticuerpos totales anti-VHA, En consecuencia, en estos pacientes recomendamos su determinación previamente a la vacunación frente al VHA hasta que se introduzcan las recomendaciones actuales de vacunación generalizada de la población infantil para evitar epidemias de hepatitis A en la población general (AU)
Subject(s)
Middle Aged , Adult , Aged, 80 and over , Aged , Male , Female , Humans , Prevalence , Seroepidemiologic Studies , Prospective Studies , Chronic Disease , Hepatitis Antibodies , Hepatitis AABSTRACT
The Sweet syndrome or acute febrile neutrophilic dermatosis is a well characterized cutaneous disease from a clinical and histological point of view and is frequently associated with systemic diseases. Prognosis is favorable with good response to corticoid therapy. A well documented case of Sweet syndrome associated with an outbreak of Crohn's disease with peculiar good therapeutic response is reported.
