title: Seroprevalence of hepatitis A immunity among brazilian adult patients with liver cirrhosis: is HAV vaccination necessary?
abstract: BACKGROUND
  Patients with chronic liver disease have a higher risk of fulminant hepatitis when infected with hepatitis A virus, and vaccination of these patients against such infection is recommended. In Brazil, mainly in the South and Southeast regions, the epidemiology of hepatitis A (HA) has shifted from high to intermediate endemicity, which would have implication on policy of HA vaccination for these populations.
  
  
  OBJECTIVE
  To verify the prevalence of HA immunity in adult patients with liver cirrhosis (LC), in Uberlândia MG, a city of Southeastern Brazil.
  
  
  METHODS
  Between December 2005 and December 2006, 106 patients with LC were consecutively evaluated. In addition, 75 individuals without LC or alcoholism were evaluated (control group - CG).
  
  
  RESULTS
  Total anti-HAV (ELISA methods) was positive in 104 (98.1%) patients with LC (82 men, 24 women; mean age, 53.3 ± 11.9 years) and in 74 (98.7%) individuals of the CG (55 men, 20 women; mean age, 47 ± 11.6 years), p > 0.05.
  
  
  CONCLUSIONS
  For patients with chronic liver disease, in the geographic regions and age groups evaluated, routine vaccination against hepatitis A is not recommended. Moreover, the serum determination of total anti-HAV, used to assess immunity, is five times cheaper than vaccination against hepatitis A and, for this reason, should precede vaccination.
authors.affiliation: Department of Internal Medicine, Medical School, Universidade Federal de Uberlândia, MG, Brazil. oliveiralcm@ufu.br
authors.forename: Luiz Carlos Marques de
authors.initials: LC
authors.lastname: Oliveira
authors.forename: Samantha Martins
authors.initials: SM
authors.lastname: Comácio
authors.forename: Júlia de Fátima Gonçalves
authors.initials: Jde F
authors.lastname: Santos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D022362:Hepatitis A Vaccines / Q000008:administration & dosage / Q000276:immunology; D030041:Hepatitis A virus / Q000276:immunology*; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000276:immunology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D015995:Prevalence; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D022362:Hepatitis A Vaccines