Department of Internal Medicine, Medical School, Universidade Federal de Uberlândia, MG, Brazil.
Braz J Infect Dis. 2011 May-Jun;15(3):268-71. doi: 10.1016/s1413-8670(11)70187-8.
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.
To verify the prevalence of HA immunity in adult patients with liver cirrhosis (LC), in Uberlândia MG, a city of Southeastern Brazil.
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).
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.
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.
慢性肝病患者感染甲型肝炎病毒后发生暴发性肝炎的风险较高，因此建议对这些患者进行此类感染的疫苗接种。在巴西，主要在南部和东南部地区，甲型肝炎（HA）的流行病学已从高流行转变为中流行，这将对这些人群的 HA 疫苗接种政策产生影响。
在巴西东南部城市 Uberlândia MG，验证肝硬化（LC）成年患者中 HA 免疫的流行率。
在 2005 年 12 月至 2006 年 12 月期间，连续评估了 106 例 LC 患者。此外，还评估了 75 名无 LC 或酗酒的个体（对照组-CG）。
104 例（82 名男性，24 名女性；平均年龄 53.3 ± 11.9 岁）LC 患者和 74 例（55 名男性，20 名女性；平均年龄 47 ± 11.6 岁）CG 个体的总抗-HAV（ELISA 法）均为阳性，p＞0.05。
对于慢性肝病患者，在评估的地理区域和年龄组中，不建议常规接种甲型肝炎疫苗。此外，用于评估免疫的总抗-HAV 血清测定比甲型肝炎疫苗接种便宜五倍，因此应在接种疫苗之前进行。
