anti-HAV IgG Research Articles

Brief Report: Response to Hepatitis A Virus Vaccine in HIV-Infected Patients Within a Retrospective, Multicentric Cohort: Facing Hepatitis A Outbreaks in the Clinical Practice.

Various recent outbreaks of hepatitis A virus (HAV) have been described in men who have sex with men despite the availability of an effective vaccine. This study aimed to determine the current rates of seroconversion after receiving HAV vaccine (HAV-V) in HIV-infected patients under real-life conditions. Patients were selected from a Southern Spanish multicentric cohort of HIV-infected subjects. Retrospective analysis of all patients who received 2 doses (standard scheme) from April 2008 to May 2016 or from June 2016 to February 2018 facing an HAV outbreak with shortage of HAV-V, 1 single dose of HAV-V. Response to HAV-V was defined as positive anti-HAV IgG between 1 and 12 months after the last vaccination dose. A total of 522 patients were included, mainly men who have sex with men (86.2%). In the standard-dose group, 303/343 [88.3%; 95% confidence interval (CI): 84.5 to 91.5] patients showed seroconversion as compared with 149/179 (83.2%; 95% CI: 76.9 to 88.4) of the single-dose group (P = 0.107). Undetectable baseline HIV-RNA (adjusted odds ratio: 4.86; 95% CI: 1.86 to 12.75; P = 0.001) and a CD4 T-cell count ≥350/μL (adjusted odds ratio, 3.96; 95% CI: 1.26 to 12.49; P = 0.019) were independently associated with response to both regimens. A higher CD4/CD8 ratio was also associated with response after a single dose. HIV-infected patients should be encouraged to undergo HAV-V with 2 standard doses 6 months apart; a single dose achieves a high rate of seroconversion in those patients with favorable response factors and may be enough to limit future outbreaks in case of HAV-V shortage until supply is reestablished.

Serological Evidence and Risk Factors of Hepatitis A Virus among Blood Donors in 3 Tertiary Hospitals in Sokoto, Nigeria

Background and study aim: Globally, Hepatitis-A Virus (HAV) is a major etiology of acute hepatitis. Though, enterically transmitted, there is evidence HAV being transmitted through of blood transfusion. The presence of HAV antibodies may indicate infectious threat to blood transfusion safety. In view of these, the present study was aimed to determine the seroprevalence and associated risk factors of HAV among blood donors in three tertiary Hospitals in Sokoto State, Nigeria. Materials and Methods: Blood samples were collected from one hundred and sixty eight (168) blood donors >20 years. Sera from these samples were investigated for anti-HAV specific IgG and IgM antibodies using a commercial enzyme immunosorbent assay (ELISA) Kits. Structured question-naires were used to access socio-demographic variables of subjects. Results: Seroprevalence of HAV- specific IgG and IgM were 86.3.1% and 0.0%, respectively. Of 168 blood donors, 145 had previous exposure to HAV [IgG (+) IgM (-), and none had recent infection [IgG (-) IgM (+)], 23 were susceptible to HAV [IgG (-) IgM (-). There was no significant association between sero-prevalence and any of the risk factors and sociodemographic variables studied (p>0.05). Findings from this study revealed that larger proportion of blood donors are already immune to HAV infection, while none of them had active HAV infection. Conclusion: The high prevalence of Hepatitis A antibodies among the studied subject reflects a high HAV transmission rate in this area. Hence, determination of HAV should be taken into consideration before blood transfusion.

Comparison of the immunogenicity and safety of 3 inactivated hepatitis A vaccines in Korean children aged 12 to 18 months: An open-label, randomized, prospective, multicenter study.

Several approved inactivated hepatitis A (HA) vaccines are available in Korea. These have been shown to be immunogenic and safe in European children; however, their immunogenicity and safety have not been investigated among Korean children. We aimed to compare the immunogenicity and safety of the most commonly used HA vaccines in ethnic Korean children aged 12 to 18 months.In this open-label, randomized, prospective, multicenter study, 108 children were enrolled and randomized to receive a pediatric form of Avaxim, Epaxal, or Havrix. The 2nd dose was administered after an interval of 6 months. Anti-HA virus (HAV) immunoglobulin (Ig) G was measured to assess geometric mean concentrations (GMCs) and seropositvity rates (≥20 mIU/mL anti-HAV IgG). To assess safety, local solicited adverse events (AEs), systemic solicited AEs, unsolicited AEs, and serious AEs (SAEs) were graded.Among the 108 participants enrolled, 37, 34, and 37 received Avaxim, Epaxal, and Havrix, respectively. After administration of 2 doses, the seropositivity rates in the Avaxim, Epaxal, and Havrix groups were all 100% (95% confidence intervals [CIs]: 99.0–100, 98.9–100, and 99.0–100, respectively; P < .001). The anti-HAV GMCs in the Avaxim, Epaxal, and Havrix groups were 5868.4 (95% CI: 4237.2–8126.6), 1962.1 (95% CI: 1298.0–2965.9), and 2232.9 mIU/mL (95% CI: 1428.4–3490.4), respectively, after administration of 2 doses (P < .001). There were no significant differences in the proportions of participants reporting local solicited AEs, systemic solicited AEs, unsolicited AEs, and SAEs among the 3 vaccine groups after the 1st and 2nd doses. All local solicited and unsolicited AEs were grade 1 or 2. Grade 3 systemic solicited AE occurred in 5.4% and 2.9% of the participants in the Havrix group after the 1st and 2nd doses, respectively. SAEs after the 1st and 2nd doses were reported in 2 participants and 1 participant, respectively, but none was assessed as being related to vaccination.The results indicate that these vaccines were safe and immunogenic in ethnic Korean children. The results have contributed to the establishing of an HA vaccination policy in Korea and will be informative to countries that plan to initiate vaccination programs against HAV.

Epidemiologic profile of Hepatitis A in Meknès, Morocco, 2013-2016.

Hepatitis A virus (HAV) is responsible for 1.5million cases of infection annually worldwide. This disease occurs in areas where hygiene is precarious and affects mainly developing countries. In Morocco, 222cases were reported in 2015, 34of them from the city of Meknes. The objective of this study is to describe the trends in HAV incidence in Meknes to improve preventive measures. For this cross-sectional descriptive study, we investigated each case reported to the HAV surveillance system between 2013 and 2016. The following data were collected: socio-demographic information, season of infection, mode of water supply, food consumed, food purchasing environment, and laboratory confirmation of cases (by an ELISA test to detect anti-HAV IgG). Data were analyzed by Epi info version 7.2.0.1, with mapping by QGIS version 2.18.1. In all, 192cases were reported with a sex ratio (m/f) of 1.3 and an average age of 13± 10years. Incidence fell from 10per 100000 inhabitants in 2013 to 1.6per 100000 in 2016. Most cases (n= 160, 83%) came from the urban environment, and 63 (32%) occurred in springtime. Two people died. The incidence of HAV in the Meknes area has fallen, but public awareness campaigns by health education in the field of personal hygiene remain necessary. It is also essential to improve implementation of regulations banning food handling by virus carriers. Sanitary control of informal markets must be improved.

Administration Frequencies of Hepatitis A and Hepatitis B Vaccines at Two Schools with Different Socioeconomic Status Before Admission to National Immunization Program

Amac: Hepatit A ve hepatit B asilarinin ulkemiz Genisletilmis Bagisiklama Programi’na girmeden once, sosyoekonomik duzeyleri farkli iki okulda, 7-15 yas arasi cocuklarda her iki etkene yonelik asilama oranlarinin ve seroprevelanslarin karsilastirilmasi amaclanmistir. Yontem: Calismamiz, 2003 yilinda, Istanbul Bakirkoy ilcesinde, sosyoekonomik duzeyi farkli iki okulda ogrenim goren 546 cocuk arasinda yapilmistir. Ebeveynlere calisma oncesi bilgilendirme toplantisi yapilmis, calismaya gonullu ebeveynlerin cocuklari calismaya dâhil edilmistir. Cocuklarin hepatit A ve hepatit B asilari uygulanma durumu, cocukta sarilik gecirme oykusu sorgulandi. Cocuklardan alinan venoz kanlardan Anti HAV IgG, HbsAg, Anti Hbs belirtecleri calisilmistir. Bulgular: Sosyoekonomik duzeyin daha yuksek oldugu okulda hepatit A ve hepatit B asisi ile asilanma oranlari ve bu etkenlerin seroprevalanslari istatistiksel anlamli olarak yuksek saptanmistir. Sonuc: Ulusal Asilama Programi’nda yer almayan asilarin uygulanmasi, sosyoekonomik duzeye gore farklilik gosterebilmektedir. Gunumuzde hepatit A ve hepatit B asilarinin Ulusal Bagisiklama Programi’nda yer almasi, cocuk sagliginda var olan bir sosyal esitsizligin kaldirilmasi acisindan onemli bir halk sagligi girisimidir.

Can we differentiate malignant peripheral nerve sheath tumor from benign neurofibroma without invasive sampling

One of the most important benign tumors in neurofibromatosis type 1 (NF1) is plexiform neurofibroma, and there is a risk of developing malignant peripheral nerve sheath tumor (MPNST) throughout life approximately 10%. However lesion characterization by anatomical imaging methods are not possible. Because of that most of cases goes to biopsy. Using of fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) for lesion characterization can be helpful in NF1 patients. We aimed to present an example of the efficacy of FDG-PET/CT in distinguishing benign neurofibroma from MPNST. A 6-year-old male patient who had NF1 admitted to emergency service due to high fever. Acute upper respiratory tract infection was diagnosed; antipyretic and abundant fluid intake was suggested. When high fever continued, the patient referred to our hospital on detection of axillary lymphadenopathy. Leukocytosis was detected in patient's blood count. Sedimentation was 54 mm/h, C-reactive protein 166 g/L, and lactate dehydrogenase 276U/L. Blood and throat cultures did not show pathogenic bacteria. In serological tests, VZV-IgG, EBV-VCA-IgG, and CMV-IgG were avidite positive; Hepatitis B Ag, Anti-HIV, Anti-HAV IgG and IgM, Anti-HCV, EBV-VCA IgM, and VZV-IgM were negative. Based on these results, cervical and thoracic contrast-enhanced computed tomography was performed on preliminary diagnosis of MPNST. Solid lesions with rounded margins, large one being 49 mm in size, that extend from superior mediastinum to posterior mediastinum, left axillary region, and left part of neck were detected, and they were surrounding the vascular structures. Since neurofibroma, MPNST, and lymphoma could not be distinguished, patient referred to FDG-PET/CT scanning. In FDG-PET/CT, highest lesion maximum standardized uptake value (SUVmax) was 1.5; SUVmax lesion/SUVmax liver 1.0, and SUVmax/ SUV mean liver 1.5. Biopsy from mediastinal and axillary region did not have LN structure and was positive for S-100 immunostaining, and patient was diagnosed as benign neurofibroma. We believe that there is no need for biopsy in lesions considered benign based on FDG-PET/CT parameters.

Viral antigen nanoparticles for discriminated and quantitative detection of different subtypes of anti-virus immunoglobulins.

The aim of this study is to develop a novel method for the accurate diagnosis of the infection status of viral diseases, which requires discriminated and quantitative detection of different anti-virus immunoglubulin subtypes. Considering hepatitis A as a representative model disease, viral antigen nanoparticles (vAgNPs) were designed and synthesized by genetically presenting hepatitis A virus (HAV) antigens on the surface of human heavy chain ferritin (hFTH) nanoparticles to detect anti-HAV antibodies with discriminating immunoglobulin subtypes M and G (IgM and IgG, respectively). The vAgNPs also display multi-copies of hexa-histidine peptide (H6) on their surface to chemisorb gold ions (Au3+), which is vital for the autonomous generation of quantitatively meaningful detection signals. The quantitative level of anti-HAV IgM or IgG in 30 patient sera was successfully analyzed using the vAgNPs of HAV, which was performed through label-free one-step-immunoassay based on the self-enhancement of optical signals from gold nanoparticles clustered on the viral antigen nanoparticles. The diagnostic performance was compared with that of enzyme-linked immunosorbent assay (ELISA), which did not enable accurate quantitative assay due to the poor linearity between the antibody concentration and detection signal. Furthermore, these vAgNP-based immunoassays did not produce any false negative/positive signals, indicating 100% sensitivity and 100% specificity.

The frequency of occurrence anti-HAV antibodies to health employees – own observations

In the years 1997-2016, Poland was counted among the countries with a low and very low endemicity of hepatitis A. Based on the epidemiological data from NIZP–PZH (National Institute of Public Health - National Institute of Hygiene), since 2017, an increase in the incidence of hepatitis A has been observed in Poland. Considering the low number of cases by 2016 and a high percentage of seronegative persons, an increased risk of HAV infections should be expected. The aim of the project was to assess the presence of anti-HAV IgG antibodies in the employees of the Provincial Hospital for Infectious Diseases and Observation in Bydgoszcz. The study was conducted on 123 people who are employees of the hospital. The presence of anti-HAV antibodies was detected using HAV IgG Elisa FORTRESS DIAGNOSTICS kits. The presence of anti-HAV IgG antibodies was found in 28/123 (22.8%) subjects. Anti-HAV IgG antibodies were almost exclusively found in people over 40 years of age. Only one case involved a younger person. The low incidence of anti-HAV antibodies in the IgG class among medical personnel confirms the reasonableness of vaccinations against hepatitis A in this group.

Hepatitis A virus vaccination in childhood-onset systemic lupus erythematosus.

Vaccination of systemic lupus erythematosus patients with non-live vaccines may decrease vaccine-preventable infections and mortalities. In the present study, we aimed to compare the immunogenicity and safety of inactivated hepatitis A vaccination in childhood-onset systemic lupus erythematosus and healthy subjects. A total of 30 childhood-onset systemic lupus erythematosus and 39 healthy participants who were seronegative for hepatitis A received two doses of the hepatitis A vaccine in a 0- and 6-month schedule. Hepatitis A virus (HAV) IgG antibodies were measured before vaccination and 7 months after the vaccination. Although anti-HAV IgG antibody titers after vaccination were found to be somewhat lower in children with systemic lupus erythematosus than that of the healthy subjects ( p < 0.05), the difference in seroconversion rate was insignificant between childhood-onset systemic lupus erythematosus patients ( n = 24/30, 80%) and healthy controls ( n = 33/39, 84.6%). There was no increase in median Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2K scores and anti-ds DNA levels after the vaccination procedure. Seroconversion rates in childhood-onset systemic lupus erythematosus patients were not affected by medication, high disease activity (SLEDAI-2K >6) and anti-ds DNA positivity. None of the patients experienced any flare or adverse reaction throughout the study. According to these results, we conclude that inactivated hepatitis A vaccine is safe and well tolerated in childhood-onset systemic lupus erythematosus patients, with no adverse events or increase in activity. Immunogenicity to the hepatitis A vaccine was adequate, with a seropositivity rate of 80%.

Evaluation of hepatitis A, B and C serology in a second-stage state hospital employees

Aim: The most common occupational risks that health workers are exposed to infectious diseases. It is aimed to determine the seroprevalence of Hepatitis A, Hepatitis B and Hepatitis C from the healthcare personnel working at Yozgat City Hospital, which constitutes a high occupational risk for healthcare workers. Differences between age groups, gender, occupation, and working services were evaluated against these diseases. Material and Method: The results of the health screening of the employees of our hospital were examined retrospectively. 628 health workers’ data have been reached through the hospital information system and the results were recorded for the age, gender, occupation, working unit, and anti HAV IgG, HBsAg, anti HBs, anti HCV. Results: 628 health workers were included in the study, 378 (60.1%) participants were female and 250 of them (39.9%) were male. The average age of the participants is 35.8 ± 9.6. Anti HAV IgG positivity rates were determined to be 79.3% and 80.7% in females and 77.2% in males. Anti HAV IgG positivity in the group was evaluated as assistant health personnel and administrative staff was found statistically significantly higher than the doctors and nurses (p: 0.00). HBs Ag positivity was determined 1.3%, and anti HBs positivity was determined to 86%. Anti HBs positivity was found to increase with age (p: 0.00), in the physician and nurse group, immunizations were higher than assisted health personnel and administrative staff (p<0.05). Anti HCV positivity was detected in 0.5%. Conclusion: The screening examinations of the staff at the hospital should be performed regularly and hepatitis A, which is usually neglected, should be included. It is required to the completion of hepatitis A and B vaccinations according to the screening results of all personnel, including healthcare personnel who do not contact with the patient, and for hepatitis C, universal precautions should be followed.

Seroprevalence of Hepatitis A Virus in Children and Adults

Hepatitis A is the most common form of acute viral hepatitis in the world. Major geographical differences in endemicity of hepatitis A are closely related to hygienic and sanitary conditions and other indicators of the level of socioeconomic development. In this study we aimed to investigate the seroprevalence of hepatitis A for adults and pediatric in university hospital- Gaziantep, and to demonstrate the relationship between various socio-demographic data and seropositivity. Serum samples were investigated by ELISA method for Anti HAV IgG and Anti HAV IgM. A total of 102 individuals, 55 male and 47 female, were included in the study. Anti HAV IgG positivity was detected in 87(85.3%), anti HAV IgM positivity was detected in 2 (2.0%). There weren't any significant gender differences in HAV IgG. By analysis according to the age, Anti-HAV IgG seropositivity increased with age. Although there was no significant difference in HAV IgG seropositivity according to the types of drinking water supply, HAV IgG seropositivity was detected in a less percentage in individuals who drink the commercial water. In Turkey HAV infection has been shifted to older ages than younger age. The disease is more complicated in advanced age than younger people. We recommend the importance of applying the vaccine.

Assessment of the national response to acute viral hepatitis A in Tunisia, 2016–2017

Introduction In Tunisia, the epidemiology of hepatitis A has considerably changed in recent years, and the country has moved from high endemicity level to a low endemicity level with an overall national prevalence of IgG anti HAV antibodies estimated at 79% and a low level of immunity in young people. During 2016 year, the national notifiable diseases surveillance system detected the occurrence of a national outbreak of HVA affecting more than 12 governorates. In this context, we have strengthened the national response to the VHA outbreak by establishment of new guidelines. Our aim was to establish a summary report of the national response to HAV epidemic from 2016 to 2017. Methods The national response is based on: early notification of any probable or confirmed HAV case from the regional level to the national level, the immediate epidemiological investigation around cases and active case finding (school or community-based survey), school eviction or work stoppage of any probable or confirmed case for a period of 14 days from the date of onset of symptoms and post-exposure emergency vaccination. Results Until October 2017, 2046 confirmed cases of HVA were recorded, including 1555 in schools and 491 in community settings. The most affected governorate was Gabes (831cases). The number of schools affected was about 458, mostly in rural areas, with poor hygienic conditions and drinking water supply problems. The average age was 10.15 ± 8 years, and 82% of the subjects were enrolled in school. The icteric form was the most common in 68% of cases. Eleven cases of death were noted. Conclusion The epidemic is still expanding in the country, especially schools in rural areas, which requires strengthening the response, awareness and involvement of the various structures concerned like the Ministry of Education, environment and civil society.

A Comparative Evaluation of Serum and Salivary Total Proteins and Immunoglobulins in Patients with Hepatitis A and Healthy Subjects

Assessment of changes in total proteins level, serum and saliva IgG and IgA levels, serum IgM level, serum and saliva IgA/IgG ratio. The study was conducted on a group of 40 subjects, divided into 2 lots: the first lot consisting of 20 healthy individuals and the second consisting of 20 patients with hepatitis with hepatitis A virus (HAV). The levels of total proteins, serum and saliva IgG and IgA, serum IgM and serum and saliva IgA/IgG ratio have higher values in patients with hepatitis A, in comparison to healthy subjects, without necessarily exceeding the maximum admitted value. The results are significant from a statistical point of view. Due to the sensitivity and specificity of salivary anti-HAV IgM and IgG in patients with acute hepatitis A, compared with healthy subjects, there is a possibility of using salivary immunological tests instead of serum tests for the diagnosis and epidemiological study of HAV infection.

High prevalence of anti-hepatitis A IgG in a cohort of UK HIV-negative men who have sex with men: implications for local hepatitis A vaccine policy.

BASHH guidelines recommend that 'the hepatitis A virus total antibody test can be offered to at-risk patients whose immune status is unknown … depending on local funding arrangements'. We sought to measure the local prevalence of anti-hepatitis A (HAV) IgG in HIV-negative men who have sex with men (MSM), to inform the utility of pre-vaccination screening. We assessed the prevalence of anti-HAV IgG in HIV-negative MSM who attended sexual health services in County Durham and Darlington, UK, from March to August 2017. Data were extracted from electronic patient records and analysed in Excel. Our study was granted local Caldicott approval. Seventy four per cent of 244 HIV-negative MSM who attended for review were screened. Anti-HAV IgG was detected in 42% who did not report definite previous infection or vaccination; not detected in 57.4%; and was equivocal in 0.6%. Vaccine was administered to 48% of eligible patients. The estimated financial costs of universal vaccination of MSM (£4235.40) and pre-vaccination screening with vaccination of susceptible patients (£4188.13) are similar. Pre-vaccination screening and vaccination of susceptible patients does not save resources compared to a policy of universal vaccination of MSM in our setting. Universal vaccination of MSM attending genitourinary medicine clinics may improve vaccine uptake.

Exposure to hepatitis E virus, hepatitis A virus and Borrelia spp. infections in forest rangers from a single forest district in western Poland.

Hepatitis E virus (HEV) infection is an emerging problem in developed countries. At least 2 zoonotic genotypes of the virus (HEV-3 and HEV-4) infect human beings. There are some data suggesting that forest rangers (FRs) can be at a higher risk of contact with HEV. The aim of this study was to assess the prevalence of HEV exposure markers in FRs from a single forest district in Greater Poland in relation to anti-HAV (hepatitis A virus) IgG, and anti-Borrelia spp. IgM and IgG antibodies. In total, 138 participants (48 FRs and 90 blood donors - BDs) were tested for anti-HEV IgM and IgG (EUROIMMUN Medizinische Labordiagnostika AG, Luebeck, Germany) and 96 individuals (48 FRs and 48 BDs) were tested for anti-HAV IgG (ARCHITECT immunoassays, Abbott Laboratories, Wiesbaden, Germany); anti-Borrelia IgM and IgG (EUROIMMUN kits) were assessed in FRs only. Anti-HEV markers were detected in 3 participants (2.2%; IgM in 1 FR, IgG in 2 BDs), less frequently than anti-HAV (16 out of 96 individuals, about 17%; FRs 19% vs BDs 15%) or anti-Borrelia antibodies (18 out of 48 individuals, 37.5%) (p < 0.0001 for both). Older study participants (≥45 years of age) were more frequently HAV-seropositive (29% vs 4% of the younger individuals; p = 0.0012). We failed to unequivocally prove HEV exposure in FRs. The HAV seroprevalence in this study paralleled the situation in the general population. Exposure to Borrelia spp. in FRs was common.

Evaluation of candidate genes associated with hepatitis A and E virus infection in Chinese Han population

BackgroundRecent GWAS-associated studies reported that single nucleotide polymorphisms (SNPs) in ABCB1, TGFβ1, XRCC1 genes were associated with hepatitis A virus (HAV) infection, and variants of APOA4 and APOE genes were associated with and hepatitis E virus (HEV) infection in US population. However, the associations of these loci with HAV or HEV infection in Chinese Han population remain unclear.MethodsA total of 3082 Chinese Han persons were included in this study. Anti-HAV IgG and anti-HEV IgG were detected by enzyme-linked immunosorbent assay (ELISA). Genotypes in ABCB1, TGFβ1, XRCC1, APOA4 and APOE SNPs were determined by TaqMan MGB technology.ResultsIn Chinese Han population, rs1045642 C to T variation in ABCB1 was significantly associated with the decreased risk of HAV infection (P < 0.05). However, the effect direction was different with the previous US study. Rs1001581 A to G variation in XRCC1, which was not identified in US population, was significantly associated with the protection against HAV infection in our samples (P < 0.05). In addition, our results suggested that rs7412 C to T variation in APOE was significantly associated with lower risk of HEV infection in males (adjusted OR < 1.0, P < 0.05) but not in females.ConclusionsABCB1 and XRCC1 genes variants are significantly associated with the protection against HAV infection. Additionally, Chinese Han males with rs7412 C to T variation in APOE gene are less prone to be infected by HEV.

Evaluation of Hepatitis A and Isolated Anti-Hbc IgG Prevalences in A City of Eastern Anatolia

Background: Hepatitis A and hepatitis B are virological diseases which cause serious health problems worldwide and are closely related with social, economic, and cultural status of countries. Their seroprevalences change with varying social conditions. The purpose of our study was to evaluate hepatitis A and B encounter rates and anti-HAV IgG and Hbc IgG serological parameters in patients admitted to our clinic. Method: Biochemical tests of the patients included in our study were studied using Mindray BS2000M autoanalyzer and Mindray kits in accordance with the instruction manual of the producer company. ELISA tests (HbsAg, anti- Hbs, anti Hbc IgG, and anti HAV IgG) were studied using Cobas 6000 e601 autoanalyzer and Roche kits with the chemiluminescence method in accordance with the instruction manual of the producer company. Results: This study included 897 subjects (475 females and 422 males) who admitted to a gastroenterology clinic of our hospital for various reasons and had hepatitis viral parameters testing. In 874 study participants (97.4%) anti HAV IgG was positive. HAV IgG was positive in 465 of the 475 females (97.9%) and 409 of the 422 males (96.9%). There was not a statistically significant difference in anti HAV IgG positivity according to sex (p=0.402). Isolated anti Hbc IgG positivity rate was 3.7%. Isolated anti HbcIgG positivity rate was 3.2% in females (s=15) and 4.3% in males (s=18). Conclusion: Anti-HAV IgG positivity rate in our study was 97.4%. Isolated anti Hbc IgG positivity rate was 3.7%. Both hepatitis A and hepatitis B encounter rates were detected to increase with age. High anti-HAVIgG positivity in our society warrants careful reviewing of our food and water resources. Moreover, informing public about contagiousness of hepatitis and implementing vaccination programs in a controlled fashion are among precautions that should be practiced.

Evaluation of hepatitis A, B, and C serology in patients with cirrhosis and intensive alcohol consumption.

OBJECTIVE:The objective of this study was to evaluate the serology of hepatitis A, B, and C in patients with cirrhosis and intensive alcohol consumption.METHODS:We retrospectively reviewed the viral serology results of 817 patients with cirrhosis and intensive alcohol consumption who presented to the Gastroenterology Clinic of Atatürk Training and Research Hospital of Izmir Katip Çelebi University between April 2008 and December 2017. The diagnosis of cirrhosis was based on clinical and biochemical evaluations and imaging results. Patients consuming absolute alcohol 40 g/day for >10 years were included and those who quit drinking ≥15 years ago were excluded.RESULTS:Of all the patients, 806 (98.7%) were positive for anti-HAV IgG, 159 (19.5%) for HBsAg, and 32 (3.9%) for anti-HCV. Genotyping was performed in 13 patients. Genotype 1 was detected in 10 patients (1a, one patient; 1b, nine patients) and genotype 3 in three patients. Of the patients with HBV, 10.0% had HBeAg and 7.6% had anti-delta. One-hundred and two (12.5%) patients had HCC, and of these, six (5.9%) were HCV-positive and 53 (52.0%) were HBsAg-positive.CONCLUSION:Patients with cirrhosis and intensive alcohol consumption have an increased hepatitis B and C prevalence. Patients with chronic viral hepatitis with alcohol habit are at a higher risk for HCC. Therefore, patients with cirrhosis and intensive alcohol consumption should be screened for hepatitis B and C.

Seroprevalence and disease burden of acute hepatitis A in adult population in South Korea.

BackgroundAdult seroprevalence of HAV is decreasing in developed countries including South Korea, due to general sanitation improvement. Although hepatitis A vaccination was introduced in South Korea more than 20 years ago, recent infection rates have not decreased. In this study, we investigate the seroprevalence of anti-HAV IgG, and estimate the national disease burden of acute hepatitis A in adult population.MethodsSeroprevalence data were collected from health promotion center of Korea University Guro Hospital, in Seoul, Korea from 2010 to 2014. Data from adults (≥20-years) being tested for anti-HAV IgG were included. In addition, epidemiological and clinical data of patients diagnosed with acute hepatitis A from 2009 to 2013, were collected from Korean Statistical Information Service (KOSIS) and the National Health Insurance Service (NHIS) database. Data were stratified and compared by age groups.ResultsA total of 11,177 subjects were tested for anti-HAV IgG from 2010 to 2014. Age-related seroprevalence showed relatively low seropositivity in young adults. Incidence of acute hepatitis A was highest in 2009 and lowest in 2013. When categorized by age group, adults in their 20s and 30s had more HAV infections and related-admissions than older adults. However, ICU admission rate and average insurance-covered cost was high in older adults.ConclusionThe anti-HAV IgG seropositivity in Korean younger adult population was low while the incidence of acute hepatitis A was high, especially in the 20–39 aged. However, a substantial number of older adults were infected, and required more intensive procedures and incurred higher insurance-covered medical costs.

Updated Dosing Instructions for Immune Globulin (Human) GamaSTAN S/D for Hepatitis A Virus Prophylaxis.

GamaSTAN S/D (Grifols Therapeutics, Inc., Research Triangle Park, North Carolina) is a sterile, preservative-free solution of immune globulin (IG) for intramuscular administration and is used for prophylaxis against disease caused by infection with hepatitis A, measles, varicella, and rubella viruses (1). GamaSTAN S/D is the only IG product approved by the Food and Drug Administration for hepatitis A virus (HAV) prophylaxis. In July 2017, GamaSTAN S/D prescribing information was updated with changes to the dosing instructions for hepatitis A preexposure and postexposure prophylaxis indications. These changes were made because of concerns about decreased HAV immunoglobulin G antibody (anti-HAV IgG) potency, likely resulting from decreasing prevalence of previous HAV infection among plasma donors, leading to declining anti-HAV antibody levels in donor plasma (2). No changes in dosing instructions were made for measles, varicella, or rubella preexposure or postexposure prophylaxis.