Laboratory characteristics of recent hepatitis A in Korea: ongoing epidemiological shift.
OBJECTIVE
To evaluate seroprevalence of hepatitis A virus (HAV) antibody and investigate demographic, clinical, and laboratory features of recent cases in Korea.


METHODS
For the evaluation of hepatitis A seroprevalence, we analyzed the data from 3127 subjects including, healthcare workers and patients who visited Konkuk University Hospital, a secondary referral center, from January to October 2009. The sera with positive IgM were excluded from seroprevalence data for total HAV antibody. We retrospectively reviewed the electronic medical records of 419 patients with HAV, who were diagnosed by the presence of serum IgM antibodies against HAV. All patients presented at Konkuk University Hospital between August 2005 and September 2008.


RESULTS
Among 3127 sera tested, 1428 (45.7%) were positive for anti-HAV antibody. The seroprevalence was very low in teenagers or those in their twenties, increased in those in their thirties, and was > 90% in older patients. In children younger than 10 years, seroprevalence was increased again. Most patients with HAV hepatitis were in their twenties and thirties. The gamma-glutamyl transpeptidase increased with age and was significantly higher in patients older than 30 years. Indicators of severity, such as decreased albumin and increased bilirubin, were also more prominent in the older age group; however, the leukocyte count was higher and the frequency of leukopenia was lower in younger patients than in older adults.


CONCLUSIONS
There has been an apparent epidemiological shift in HAV seroprevalence and a change in the peak age of HAV hepatitis. This study could provide baseline data of recent hepatitis A in Asia.
Moon
Hee Won
HW
Department of Laboratory Medicine, Konkuk University School of Medicine, Konkuk University Medical Center, 4-12, Hwayang-dong, Gwangjin-gu, Seoul 143-729, South Korea.
Cho
Jin Hee
JH
Hur
Mina
M
Yun
Yeo-Min
YM
Choe
Won Hyeok
WH
Kwon
So Young
SY
Lee
Chang Hong
CH
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006506:Hepatitis A / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology; D035922:Hepatitis A Antibodies / Q000097:blood*; D030041:Hepatitis A virus / Q000276:immunology*; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D007223:Infant; D007231:Infant, Newborn; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult
D015415:Biomarkers; D035922:Hepatitis A Antibodies; D007075:Immunoglobulin M