Seroprevalence of hepatitis Antibodies in patients with cirrhosis of liver

Abstract

Background and Aim: Patients with cirrhosis have a compromised immune system and are at increased risk of infections, including Hepatitis A virus (HAV). Acute HAV infection in patients with chronic liver disease/ cirrhosis can result in acute-on-chronic liver failure, which is associated with high mortality. Several Indian studies in the past have noted that 93.2%-99% patients with chronic liver disease or cirrhosis had evidence of past infection with HAV. We aimed to determine the seroprevalence of antibodies against HAV in adult patients with cirrhosis of liver. Methods: The study cohort included all patients (>18 years) with cirrhosis of liver seen by the author between May 2019 to December 2021. Diagnosis of cirrhosis was based on clinical, endoscopic, biochemical and radiological parameters. Patients with age <18 years and those who did not provide consent for testing were excluded. IgG anti HAV antibodies were tested using chemiluminescent magnetic microparticle immunoassay (CMIA) test. A value equal or greater than 1 was taken as reactive /positive. Results: A total of 548 adult patients with cirrhosis were seen during the study period. Three huned forty-nine consented to participate in the study. The median age of the study cohort was 43 (18-68 years) and 66.7 % (233) were males. The etiology for cirrhosis of liver included alcohol (210, 60.2%), hepatitis B (58, 16.7%), hepatitis C (11, 3.15%), non alcoholic steatophepatitis (51,14.6%) and others (10, 2.9%). Ig G anti HAV antibodies were detected in 238 (68.2%) cases. Conclusions: The results highlight that seroprevalence of anti HAV antibodies in cirrhotic patients is 68.2% which is much lower than previously reported in Indian studies.