Anti-hepatitis A virus seroprevalence among patients with chronic viral liver disease in Korea

BACKGROUND/OBJECTIVE: It is generally recommended that patients with chronic viral hepatitis should be vaccinated against hepatitis A virus (HAV) infection. We intended to evaluate the prevalence of IgG anti-HAV according to age in patients chronically infected with hepatitis B virus or hepatitis C virus in Korea. METHODS: From June to October 2006, 303 patients (226 male, 77 female) with chronic hepatitis, liver cirrhosis, or hepatocellular carcinoma were recruited (mean age 50.8±14.4 years; range 16-84). The sera were tested for antibodies to HAV, and overall and age-specific seroprevalence of anti-HAV was assessed. RESULTS: Hepatitis B virus infection was the etiology of liver diseases in 267 patients (88.1%), with hepatitis C virus infection in 36 (11.9%). The distribution of clinical diagnosis was chronic hepatitis in 86 patients (28.4%), liver cirrhosis in 36 (11.9%), and hepatocellular carcinoma in 181 (57.9%). The patients were categorized by decade of age and the distribution was as follows: nine patients (2.5%) in their teens, 23 (6.2%) in their 20s, 36 (12.4%) in their 30s, 78 (25.7%) in their 40s, 72 (24.1%) in their 50s, and 85 (29%) ≥61 years. The overall seroprevalence of anti-HAV was 87.8% (266/303), and no difference was observed in sex (86.7 vs. 90.9%, P=0.42). The seroprevalence in each age group was 22.2, 26.1, 72.2, 97.4, 100 and 98.8%, respectively, showing marked increase in those over 40 years of age (P<0.001). CONCLUSION: Our study demonstrates that most Korean patients over 40 years of age with chronic liver disease have already been exposed to HAV.