Anti-hepatitis A virus seroprevalence and seroconversion in a cohort of patients with chronic viral hepatitis.
BACKGROUND
Patients with chronic hepatitis C infected by hepatitis A virus have a substantial risk of fulminant hepatitis or death, while the course of hepatitis A virus is uncomplicated in most subjects with chronic hepatitis B.


OBJECTIVE
To evaluate the prevalence of anti-hepatitis A virus antibodies and the incidence of hepatitis A virus seroconversion in a nationwide sample of 530 patients with chronic hepatitis B and/or hepatitis C infection initially susceptible to this infection after a follow-up of some years.


RESULTS
The overall anti-hepatitis A virus prevalence was 85.7%, with no difference between males and females. By the age of 50 years, almost all patients were found to have been exposed to hepatitis A virus. After a mean follow-up period of 76 months the overall anti-hepatitis A virus seroconversion rate in the 76 initially susceptible individuals was 1.2 per 100 person/years. However, it was 0.3 per 100 person/years in those hepatitis B surface antigen positive but 3.36 per 100 person/years in those anti-hepatitis C virus positive. None of the seroconverters was affected by a clinically evident disease or showed deterioration of underlying chronic liver disease.


CONCLUSIONS
The present study shows that Italian patients >50 years of age with chronic liver disease have already been exposed to hepatitis A virus suggesting that anti-hepatitis A virus screening is not advisable in these subjects.
Stroffolini
T
T
Epidemiology Laboratory, Istituto Superiore di Sanità, Rome, S Giacomo Hospital, Italy.
Almasio
P L
PL
Di Stefano
R
R
Andreone
P
P
Di Gaetano
G
G
Fattovich
G
G
Gaeta
G B
GB
Morisco
F
F
Smedile
A
A
Tripi
S
S
Zignego
A L
AL
Ferraro
D
D
Mele
A
A
Craxi
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006506:Hepatitis A / Q000150:complications / Q000453:epidemiology* / Q000276:immunology; D035922:Hepatitis A Antibodies / Q000097:blood*; D017957:Hepatitis A Virus, Human / Q000276:immunology*; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000276:immunology; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016036:Seroepidemiologic Studies
D035922:Hepatitis A Antibodies