Journal Information
Vol. 15. Issue 3.
Pages 268-271 (May - June 2011)
Share
Share
Download PDF
More article options
Vol. 15. Issue 3.
Pages 268-271 (May - June 2011)
Open Access
Seroprevalence of hepatitis A immunity among Brazilian adult patients with liver cirrhosis: is HAV vaccination necessary?
Visits
2470
Luiz Carlos Marques de Oliveira1,
Corresponding author
oliveiralcm@ufu.br

Rua Gonçalves Dias, 455 Tabajaras, Uberlândia MG - 38400-288, Fone/fax: (34) 3218.2246.
, Samantha Martins Comácio2, Júlia de Fátima Gonçalves Santos3
1 Professor, Department of Internal Medicine, Medical School, Universidade Federal de Uberlândia, MG, Brazil
2 Resident Physician (R2) in Internal Medicine, Medical School, Universidade Federal de Uberlândia, MG, Brasil
3 Health Sciences; Physician at Gastroenterology Service, Hospital de Clínicas, Universidade Federal de Uberândia, MG, Brazil
This item has received

Under a Creative Commons license
Article information
Abstract
Background

Patients with chronic liver disease have a higher risk of fulminant hepatitis when infected with hepatitis A virus, and vaccination of these patients against such infection is recommended. In Brazil, mainly in the South and Southeast regions, the epidemiology of hepatitis A (HA) has shifted from high to intermediate endemicity, which would have implication on policy of HA vaccination for these populations.

Objective

To verify the prevalence of HA immunity in adult patients with liver cirrhosis (LC), in Uberlândia MG, a city of Southeastern Brazil.

Methods

Between December 2005 and December 2006, 106 patients with LC were consecutively evaluated. In addition, 75 individuals without LC or alcoholism were evaluated (control group - CG).

Results

Total anti-HAV (ELISA methods) was positive in 104 (98.1%) patients with LC (82 men, 24 women; mean age, 53.3±11.9 years) and in 74 (98.7%) individuals of the CG (55 men, 20 women; mean age, 47±11.6 years), p>0.05.

Conclusions

For patients with chronic liver disease, in the geographic regions and age groups evaluated, routine vaccination against hepatitis A is not recommended. Moreover, the serum determination of total anti-HAV, used to assess immunity, is five times cheaper than vaccination against hepatitis A and, for this reason, should precede vaccination.

Keywords:
hepatitis A vaccines
hepatitis A virus
liver cirrhosis
prevalence
Full text is only aviable in PDF
References
[1.]
Prevention of hepatitis A. through active or passive immunization.
Recommendations of the advisory committee on immunization practices (ACIP).
MMWR Recomm Rep, 48 (1999), pp. 1-37
[2.]
R.S. Koff, A. Hepatitis.
Lancet, 351 (1998), pp. 1643-1649
[3.]
N.G. Barzaga.
Hepatitis A shifting epidemiology in South-East Asia and China.
Vaccine, 18 (2000), pp. S61-S64
[4.]
S.A.C. Clemens, J.C. Fonseca, T. Azevedo, et al.
Soroprevalência para hepatite A e hepatite B em quatro centros no Brasil.
Rev Soc Bras Med Trop, 33 (2000), pp. 1-10
[5.]
C.L. Vitral, C.F.T. Yoshida, E.R.S. Lemos, C.S. Teixeira, A.M.C. Gaspar.
Age-specific prevalence of antibodies to hepatitis A in children and adolescents from Rio de Janeiro, Brazil, 1978 and 1995. Relationship of prevalence to environmental factors.
Mem Inst Oswaldo Cruz, 93 (1998), pp. 1-5
[6.]
M.P. Zago-Gomes, G.C. Stantolin, S. Perazzio, K.H. Aikawa, C.S. Gonçalves, F.E.L. Pereira.
Prevalence of anti-hepatitis A antibodies in children of different socioeconomic conditions in Vila Velha, ES.
Rev Soc Bras Med Trop, 38 (2005), pp. 285-289
[7.]
M.I.S. Dinelli, M. Fisberg, M.I. Moraes-Pinto.
Anti-hepatitis A virus frequency in adolescents at an outpatient clinic in São Paulo, Brazil.
Rev Inst Med Trop S. Paulo, 48 (2006), pp. 43-44
[8.]
E.B. Keeffe.
Is hepatitis A more severe in patients with chronic hepatitis B and other chronic liver diseases?.
Am J Gastroenterol, 90 (1995), pp. 201-205
[9.]
G. Reiss, E.B. Keeffe.
Review article: hepatitis vaccination in patients with chronic liver disease.
Aliment Pharmacol Ther, 19 (2004), pp. 715-727
[10.]
S. Vento, T. Garofano, C. Renzini, et al.
Fulminant hepatitis associated with hepatitis A virus superinfection in patients with chronic hepatitis C.
N Engl J Med, 338 (1998), pp. 286-290
[11.]
E.A. Akriviadis, A.G. Redeker.
Fulminant hepatitis A in intravenous drug users with chronic liver disease.
Ann Intern Med, 110 (1989), pp. 838-839
[12.]
L.C.M. Oliveira, A.G. Buso, A.T. Oliveira, C.A. Arantes, L.V. Borges, S.R.G. Valente.
Prevalence of hepatitis B and hepatitis C markers in alcoholics with and without clinically evident hepatic cirrhosis.
Rev Inst Med Trop. São Paulo, 41 (1999), pp. 69-73
[13.]
J.A. Ewing.
Detecting alcoholism. The CAGE questionnaire.
JAMA, 252 (1984), pp. 1905-1907
[14.]
J.Y. Wang, S.D. Lee, Y.T. Tsai, K.J. Lo, B.N. Chiang.
Fulminant hepatitis A in chronic HBV carrier (letter).
Dig Dis Sci, 31 (1986), pp. 109-111
[15.]
M.R. Arguedas, A. Johnson, M.A. Eloubeidi, M.B. Fallon.
Immunogenicity of hepatitis A vaccination in decompensated cirrhotic patients.
Hepatology, 34 (2001), pp. 28-31
[16.]
S.K. Acharya, Y. Batra, B. Bhatkal, et al.
Seroepidemiology of hepatitis A virus infection among school children in Delhi and north Indian patients with chronic liver disease: implications for HAV vaccination.
J Gastroenterol Hepatol, 18 (2003), pp. 822-827
[17.]
A. Duseja, S. Sharma, K. Das, R.K. Dhiman, Y.K. Chawla.
Is vaccination against hepatitis A virus required in patients with cirrhosis of the liver?.
Trop Gastroenterol, 25 (2004), pp. 162-163
[18.]
L.M. Villar, M.M.M. Melo, I.A. Calado, A.J. Almeida, E. Lampe, A.M.C. Gaspar.
Should Brazilian patients with chronic hepatitis C virus infection be vaccinated against hepatitis A virus?.
J Gastroenterol Hepatol, 24 (2009), pp. 238-242
[19.]
S. Devalle, V.S. Paula, J.M. Oliveira, C. Niel, A.M.C. Gaspar.
Hepatitis A virus infection in hepatitis C Brazilian patients.
J Infect, 47 (2003), pp. 125-128
Copyright © 2011. Elsevier Editora Ltda.. All rights reserved
The Brazilian Journal of Infectious Diseases
Article options
Tools