Seroprevalence of hepatitis A virus in patients with chronic liver disease from Kerala: impact on vaccination policy.

Hepatitis A virus (HAV) vaccination is recommended worldwide for patients with chronic liver disease to prevent decompensation due to superinfection with HAV. There are recent reports of decline in HAV seroprevalence in developing countries, where hepatitis A was considered hyperendemic. This phenomenon would have implication on policy of hepatitis A vaccination in chronic liver disease in our region. The aim of the study was to evaluate the seroprevalence of HAV antibodies in patients with chronic liver disease and to assess the relevance of hepatitis A vaccination in these patients. Three hundred patients (268 males and 32 females) with chronic liver disease, seen at the department of gastroenterology at Amrita institute of Medical Sciences and Research Centre, Cochin, were tested for the presence of IgG anti-HAV antibodies in their sera using a commercially available ELISA kit. The mean age of the patients was 53.7 years. Of these 280 patients (93.33%) tested positive for IgG anti-HAV. Routine vaccination without testing for HAV antibodies is not recommended in chronic liver disease, as there is a high prevalence of pre-existing antibodies in these patients in our region.