Lee Anna, Lim Hyun-Sun, Nam Chung-Mo, Song Sean-Mi, Yoon Hye-Ryoung, Lee Kyoung-Ryul
Department of Laboratory Medicine, Seoul Medical Science Institute, Seoul, Korea.
Korean J Lab Med. 2009 Dec;29(6):563-9. doi: 10.3343/kjlm.2009.29.6.563.
To establish effective preventive measures for hepatitis A virus (HAV) infection, a nationwide epidemiologic study on seroprevalence of anti-HAV and the disease prevalence is needed. The aim of this study was to analyze the recent sero-epidemiological changes of hepatitis A markers in Korea.
The results of 11,068 anti-HAV total and 32,360 anti-HAV IgM tests by electro-chemiluminescence immunoassay (ECLIA) that had been requested in recent four years (2005-2008) to a reference medical laboratory from 1,699 institutions nationwide were retrospectively analyzed according to the distribution of year, sex, and age groups.
The overall positive rate of anti-HAV total was 62.8%. The overall positive rate of anti-HAV IgM was 11.0%, showing a significantly increasing trend by year: 7.7%, 10.9%, 8.9%, and 14.3% in 2005, 2006, 2007, and 2008, respectively (P<0.0001). The positive rate of anti-HAV IgM was higher in male than in female subjects (11.8% vs 10.0%, P<0.0001), and 81.8% (2,916/3,566) of the anti-HAV IgM positive results were observed in the age groups of 21-40 yr. The annual positive rates of anti-HAV total and anti-HAV IgM showed significantly decreasing and increasing trends, respectively, in the age groups of > or = 21 yr.
In accordance with a decreasing sero-positivity of anti-HAV total, the prevalence of acute hepatitis A virus infection has been considerably increased during the recent four years in the age groups of > or = 21 yr. The results of this study could be used effectively as a basic data for establishing effective preventive measures for hepatitis A including vaccination in these susceptible age groups.
为制定甲型肝炎病毒（HAV）感染的有效预防措施，需要开展一项关于抗-HAV血清流行率和疾病患病率的全国性流行病学研究。本研究的目的是分析韩国近期甲型肝炎标志物的血清流行病学变化。
回顾性分析了近四年（2005 - 2008年）全国1699家机构向一家参考医学实验室送检的11068份抗-HAV总抗体检测结果和32360份抗-HAV IgM检测结果，这些检测采用电化学发光免疫分析（ECLIA）法，并根据年份、性别和年龄组分布进行分析。
抗-HAV总抗体的总体阳性率为62.8%。抗-HAV IgM的总体阳性率为11.0%，呈逐年显著上升趋势：2005年、2006年、2007年和2008年分别为7.7%、10.9%、8.9%和14.3%（P<0.0001）。抗-HAV IgM的阳性率男性高于女性（11.8%对10.0%，P<0.0001），81.8%（2916/3566）的抗-HAV IgM阳性结果出现在21 - 40岁年龄组。在≥21岁年龄组中，抗-HAV总抗体和抗-HAV IgM的年阳性率分别呈显著下降和上升趋势。
随着抗-HAV总抗体血清阳性率的下降，在≥21岁年龄组中，近期四年甲型肝炎病毒急性感染的患病率显著增加。本研究结果可有效用作在这些易感年龄组中制定包括疫苗接种在内的甲型肝炎有效预防措施的基础数据。
