Duseja Ajay, Sharma Sanjeev, Das Kshaunish, Dhiman R K, Chawla Y K
Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh.
Trop Gastroenterol. 2004 Oct-Dec;25(4):162-3.
Hepatitis A virus (HAV) superinfection can cause decompensation in patients with chronic liver disease. The risk of HAV superinfection depends on the endemicity of HAV in that particular population. Recommendations of vaccination against HAV in patients with cirrhosis of the liver in India are lacking. Our aim was to assess the seroprevalence of anti-HAV antibodies in our population of patients with cirrhosis of the liver. In a retrospective analysis, the serum of 55 patients with cirrhosis of the liver was tested for total anti-HAV antibodies by ELISA. In the 35 patients who presented with acute decompensation, the serum was also analysed for IgM anti-HAV antibodies. Fifty-four of the 55 cirrhotics (99%) were positive for total anti-HAV antibodies. All 35 patients with decompensated liver disease were also positive for total anti-HAV antibodies, and none of them tested positive for IgM anti-HAV antibodies. Most of the patients with cirrhosis of the liver in the population studied were already exposed to HAV. Routine vaccination against HAV cannot be recommended in these patients.
甲型肝炎病毒（HAV）重叠感染可导致慢性肝病患者病情失代偿。HAV重叠感染的风险取决于该特定人群中HAV的流行情况。印度缺乏针对肝硬化患者接种HAV疫苗的建议。我们的目的是评估我们研究的肝硬化患者群体中抗-HAV抗体的血清流行率。在一项回顾性分析中，通过酶联免疫吸附测定（ELISA）检测了55例肝硬化患者血清中的抗-HAV总抗体。在35例出现急性失代偿的患者中，还分析了血清中的抗-HAV IgM抗体。55例肝硬化患者中有54例（99%）抗-HAV总抗体呈阳性。所有35例失代偿性肝病患者抗-HAV总抗体也呈阳性，且无一例抗-HAV IgM抗体检测呈阳性。在研究的人群中，大多数肝硬化患者已经接触过HAV。不建议对这些患者常规接种HAV疫苗。
