As mentioned above, considering the marked increase in the incidence of apparent hepatitis A due to the epidemiologic shift and a poor prognosis in patients with HBV-related CLD who have HAV superinfection, it is imperative that the vaccination policy for hepatitis A be established in patients with HBV-related CLD
As mentioned above, considering the marked increase in the incidence of apparent hepatitis A due to the epidemiologic shift and a poor prognosis in patients with HBV-related CLD who have HAV superinfection, it is imperative that the vaccination policy for hepatitis A be established in patients with HBV-related CLD. and 0%, 9.8%, 46.3%, 91.1%, 97.7%, and 100% in the HBV-CLD group. In multivariate analysis, age (<30 vs. 30-59 years: OR=19.339, 95% CI=12.504-29.911,P<0.001; <30 vs. 60 years: OR=1060.5, 95% CI=142.233-7907.964,P<0.001) and advanced status of HBV-CLD (OR=19.180, 95% CI=4.550-80.856,P<0.001) were independent predictors of HAV prior exposure. == Conclusions == The seroprevalence of IgG anti-HAV did not differ significantly between the general-healthy-population and HBV-CLD groups. An HAV vaccination strategy might be warranted in people younger than 35 years, especially in patients with HBV-CLD. Keywords:Hepatitis A, Seroprevalence, Chronic hepatitis B, Korea == INTRODUCTION == Hepatitis A is usually self-limited and has a benign clinical course. It is usually asymptomatic in children, whereas it causes clinically apparent disease in the majority of adults, rarely progressing to fulminant hepatic failure.1In particular, the old age and chronic liver disease (CLD) HDAC3 have been known to be risk factors for fulminant hepatic failure.2Therefore, hepatitis A virus (HAV) vaccination is recommended for patients with CLD. Improvements in the socioeconomic status and general public health of Korea have led to a shift in the seroprevalence of hepatitis A from hyperendemic region to lower one.3Paradoxically, the number of children SGI-110 (Guadecitabine) and young adults who are SGI-110 (Guadecitabine) susceptible to HAV infection has been gradually increased, resulting in the recent rapid rise of symptomatic hepatitis A. Currently, hepatitis A has become one of the most common causes of acute viral infection in Korean adults.3,4Although the prevalence of chronic hepatitis B virus (HBV) infection has been declined after the introduction of universal vaccination, it is still the most important cause of CLD in Korea.5Accordingly, the seroprevalence of hepatitis A in patients with HBV-related CLD has been of interest. However, there are few studies about HAV seroepidemiology in Korean population with CLD,6,7and no studies have compared the seroprevalence of IgG anti-HAV between general healthy population and patients with HBV-related CLD. This study was aimed to evaluate the seroprevalence of IgG anti-HAV in Korean patients with HBV-related SGI-110 (Guadecitabine) CLD and analyzed it as compared with general healthy population. Thus, we attempted to provide the objective data about the HAV vaccination strategy in patients with HBV-related CLD and to identify the predictors of prior HAV exposure. == PATIENTS AND METHODS == == Patients and study design == We retrospectively analyzed the medical records of 1 1,319 patients aged 15 years or older who underwent tests for hepatitis B surface antigen (HBsAg), anti-hepatitis C virus antibody (anti-HCV) and IgG anti-HAV, between June 2008 and April 2010. Of them, 622 patients who were negative to both HBsAg and anti-HCV and had no past history of other liver diseases such as alcoholic hepatitis and autoimmune hepatitis were classified as general healthy population. Remaining 697 patients who were positive to SGI-110 (Guadecitabine) HBsAg regardless of the presence of anti-HCV were classified as those with HBV-related CLD. The seroprevalence of IgG anti-HAV was evaluated according to age and sex at the time of laboratory tests and compared between the general healthy population and the patients with HBV-related CLD. The severity of liver disease was classified as follows: 1) inactive HBsAg carrier was defined as those who were positive to HBsAg for more than six months, were negative to hepatitis B e antigen, had a serum level of HBV DNA<104copies/mL and persistently had normal levels of serum ALT for more.