Hepatitis A Virus Seropositivity among Healthcare Workers at a University Hospital in Korea

Jun Seong Son; Mi Suk Lee; So Young Kang; Woo In Lee

doi:10.3343/kjlm.2009.29.6.551

Journal List > Korean J Lab Med > v.29(6) > 1011597

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Son, Lee, Kang, and Lee: Hepatitis A Virus Seropositivity among Healthcare Workers at a University Hospital in Korea

Original Article

Korean J Leg Med 2009;29(6):551-556.

Published online: 14 January 2009

DOI: https://doi.org/10.3343/kjlm.2009.29.6.551

Hepatitis A Virus Seropositivity among Healthcare Workers at a University Hospital in Korea

Jun Seong Son, M.D.¹, Mi Suk Lee, M.D.¹, So Young Kang, M.D.², Woo In Lee, M.D.²

¹Departments of Internal Medicine and Laboratory Medicine, Seoul, Korea

²Kyunghee University College of Medicine, Seoul, Korea

Corresponding author: Jun Seong Son, M.D. Department of Internal Medicine, Kyunghee University College of Medicine, East-West Neo Medical Center, 149 Sangil-dong, Gangdong-gu, Seoul 134-727, Korea Tel: +82-2-440-6129, Fax: +82-2-440-7073 E-mail: sonjs@korea.com

Revised 16 October 200815 July 2009 Accepted 22 July 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background:

Healthcare workers (HCW) are known as a risk group of hepatitis A virus (HAV) infection and vaccination of this group against HAV has been suggested. However, the seroprevalence of HAV antibody among HCW in Korea has not been reported. We investigated the seropositivity of HAV antibody in HCW, to obtain a baseline data.

Methods:

We measured serum total HAV antibody using chemiluminescent immunoassay (ADVIA Centaur, Germany) in 174 HCW at one university hospital in Seoul, Korea.

Results:

Serum HAV antibody was positive in 48 (27.6%) of 174 subjects tested. The seropositivity of HAV antibody was significantly increased with increasing age: 21.1% (26/123), 55% (22/40), and 100% (11/11) in the age groups of 20's, 30's, and 40's, respectively (P<0.001). However it was not significantly different among different occupations (physicians 38%, nurses 24.6%, other workers 31.4%, P=0.376) and work places (medical ward 29.1%, pediatric ward 25.9%, emergency room 34.4%, laboratory 0%, P=0.140). The seroprevalence rate of HAV antibody in the age groups of 20's and 30's in this study was not higher than that of previous studies on non-HCW populations in Korea since 2006.

Conclusions:

The seroprevalence of HAV antibody among HCW in the age groups of 20's and 30's in a Korean hospital was not higher than that of non-HCW populations, and the seropositivity increased with increasing age. Further studies are needed for the age-specific strategy for vaccination, considering the increased risk of exposure in HCW to HAV infection in hospital environment with the increase of symptomatic patients with HAV.

Keywords: Hepatitis A virus, HAV antibody, Healthcare workers, Korea

REFERENCES

1.Hadler SC., Webster HM., Erben JJ., Swanson JE., Maynard JE. Hepatitis A in day-care centers. A community-wide assessment. N Engl J Med. 1980. 302:1222–7.

2.Hong WS., Kim CY. Seroepidemiology of type A and type B hepatitis in Seoul area. Korean J Intern Med. 1982. 25:19–26. (홍원선 및김정용. 서울지역에 있어서의A형간염및B형 간염 바이러스 간염에 관한혈청역학적조사. 대한내과학회지 1982;25:19-26.).

3.Lee D., Cho YA., Park Y., Hwang JH., Kim JW., Kim NY, et al. Hepatitis A in Korea: epidemiological shift and call for vaccine strategy. Intervirology. 2008. 51:70–4.

4.Lee G., Kim KH., Kwon JA., Yoon SY., Cho Y., Lee CK, et al. Serologic markers of viral hepatitis of Korea university medical center patients. Korean J Lab Med. 2005. 25:61–5. (이고은, 김경희, 권정아, 윤수영, 이창규, 조윤정등. 3개대학병원환자의바이러스성간염검사에대한혈청학적표지자의역학조사. 대한진단검사의학회지 2005;25:61-5.).

5.Kang CI., Choi CM., Park TS., Lee DJ., Oh MD., Choe KW. Incidence and seroprevalence of hepatitis A virus infection among young Korean soldiers. J Korean Med Sci. 2007. 22:546–8.

6.Song HJ., Kim TH., Song JH., Oh HJ., Ryu KH., Yeom HJ, et al. Emerging need for vaccination against hepatitis A virus in patients with chronic liver disease in Korea. J Korean Med Sci. 2007. 22:218–22.

7.Kim JH., Kang JH., Lee SY., Choi HA., Kim HM., Seo K, et al. A study for seroprevalence of antibody to hepatitis A in Korea. Korean J Hepatol. 2007. 13(S):S27. (김종현, 강진한, 이수영, 최현아, 김행미, 서경등. 국내A형간염항체양성률에대한연구. 대한간학회지 2007;13(S): S27.).

8.Song YB., Lee JH., Choi MS., Koh KC., Paik SW., Yoo BC, et al. The age-specific seroprevalence of hepatitis A virus in Korea. Korean J Hepatol. 2007. 13:27–33. (송영봉, 이준혁, 최문석, 고광철, 백승운, 유병철 등. 한국인 건강검진자에서 연령 특이적 A형간염바이러스 항체 혈청 양성 률. 대한간학회지 2007;13:27-33.).

9.Kim DY., Ahn SH., Lee HW., Kim SU., Kim JK., Paik YH, et al. Anti-hepatitis A virus seroprevalence among patients with chronic viral liver disease in Korea. Eur J Gastroenterol Hepatol. 2007. 19:923–6.

10.Kim TY., Sohn JH., Ahn SB., Son BK., Lee HL., Eun CS, et al. Comparison of recent IgG anti-HAV prevalence between two hospitals in Seoul and Gyeonggi area. Korean J Hepatol. 2007. 13:363–9. (김태엽,손주현, 안상봉, 손병관, 이항락, 은창수등. 서울과경기지역두병원의최 근A형간염항체양성률에대한비교조사. 대한간학회지 2007;13:363-9.).

11.Lee JM., Park HK., Choi KY., Kim HK., Jung JO., Suh SO, et al. Incidence and seroprevalence of hepatitis A virus among Korean auxiliary police officers. Infect Chemother. 2007. 39:292–5. (이정민, 박형기, 최규영, 김현근, 정준오, 서승오등. 전투경찰에서A형간염발생률과 항체양성률. 감염과화학요법 2007;39:292-5.).

12.Kwon YO., Choi IJ., Jung JW., Park JH. An epidemiologic study on the seropositive rate of hepatitis A virus among a selected group of children and adults in Busan. Korean J Pediatr. 2007. 50:262–7. (권영옥, 최임정, 정진화, 박지현. 부산지역 소아 및 성인의A형 간염 바이러스항체양성률에대한역학적조사. 대한소아과학회지 2007;50: 262-7.).

13.Korea Centers for Disease Control and Prevention. Changing patterns of hepatitis A virus infection in Korea. http://www.cdc.go.kr. (Updated on may. 2009.

14.Kim JS., Kim SH. Molecular epidemiology of an outbreak of hepatitis A in Korea. Korean J Clin Pathol. 2001. 21:114–8. (김재석및김상훈. 집단발병한A형 간염 바이러스의 분자생물학적 역학연구. 대한임상병리학회지 2001;21:114-8.).

15.Jeong SH., Hwang SG., Park SJ., Kang SK., Jee Y. Current status of acute viral hepatitis in Korea- epidemiology, clinical, virological characteristics, and the effects of antiviral treatment in severe acute hepatitis B and C-intrim report. Korean J Hepatol. 2007. 13(S):S101–7. (정숙향, 황성규, 박상종, 강숙경, 지영미. 우리나라 급성바이러스 간염의실태: 역학, 임상특성및바이러스학특성과심한급성B형간염및C형간염환자에서항바이러스치료의효과. 대한간학회지 2007;13(S):S101-7.).

16.Korean Society of Infectious Diseases. Vaccination for adult. 1st ed.Seoul: Koonja Publishing;2007. :46-53. (대한감염학회. 성인예방접종. 1 판. 서울: 군자출판사,. 2007:p. 46–53.

17.Jeong SH. Current status and vaccine indication for hepatitis A virus infection in Korea. Korean J Gastroenterol. 2008. 51:331–7. (정숙향. 국내A형간염의현황과백신적응증. 대한소화기학회지 2008;51:331-7.).

18.Chodick G., Ashkenazi S., Lerman Y. The risk of hepatitis A infection among healthcare workers: a review of reported outbreaks and seroepidemiologic studies. J Hosp Infect. 2006. 62:414–20.

19.Chodick G., Ashkenazi S., Aloni H., Peled T., Lerman Y. Hepatitis A virus seropositivity among hospital and community healthcare workers in Israel-the role of occupation, demography and socioeconomic background. J Hosp Infect. 2003. 54:135–40.

20.Szmuness W., Dienstag JL., Purcell RH., Prince AM., Stevens CE., Levine RW. Hepatitis type A and hemodialysis: a seroepidemiologic study in 15 U.S. centers. Ann Intern Med. 1977. 87:8–12.

21.de Juanes Jr., Gonzalez A., Arrazola MP., San-Martin M. Cost analysis of two strategies for hepatitis A vaccination of hospital healthcare personnel in an intermediate endemicity area. Vaccine. 2001. 19:4130–4.

22.Saback FL., Palmer TE., Sabino RR., Carvalho SM., Amorim LM., Gaspar AM, et al. Infection with hepatitis A and TT viruses and socioeconomic status in Rio de Janeiro, Brazil. Scand J Infect Dis. 2001. 33:121–5.

23.Domart M., Mlika-Cabanne N., Henzel D., Pouliquen A., Florentin A., Marande JL, et al. Hepatitis A among health workers in Paris hospitals. Occupational health physicians of Paris hospital (AP-HP). J Med Virol. 1999. 58:321–4.

24.Rudi J., Töppe H., Marx N., Zuna I., Theilmann L., Stremmel W, et al. Risk of infection with Helicobacter pylori and hepatitis A virus in different groups of hospital workers. Am J Gastroenterol. 1997. 92:258–62.

25.Djeriri K., Fontana L., Laurichesse H., Peigue-Lafeuille H., Henquell C., Chamoux A, et al. Seroprevalence of markers of viral hepatitis A, B and C in hospital personnel at the Clermont-Ferrand University Hospital Center. Presse Med. 1996. 25:145–50.

26.Hofmann F., Wehrle G., Berthold H., Köster D. Hepatitis A as an occupational hazard. Vaccine. 1992. 10(S):82–4.

27.Van Damme P., Cramm M., van der Auwera JC., Meheus A. Hepatitis A vaccination for health care workers. BMJ. 1993. 306:1615.

28.Nubling M., Hofmann F., Tiller FW. Occupational risk for hepatitis A and hepatitis E among health care professionals? Infection. 2002. 30:94–7.

29.Poole CJ., Shakespeare AT. Immunity to hepatitis A in paediatric and nursery nurses. Occup Med (Lond). 1996. 46:361–3.

30.Park JY., Lee JB., Jeong SY., Lee SH., Lee MA., Choi HJ. Molecular characterization of an acute hepatitis A outbreak among healthcare workers at a Korean hospital. J Hosp Infect. 2007. 67:175–81.

Table 1.

The seroprevalence of total HAV antibody in healthcare workers by age, occupation and work place

	No. (%) (N=174)	Prevalence of HAV antibody		P value
	No. (%) (N=174)	No.	%	P value
Age
21-30	123 (70.7)	26	21.1	<0.001
31-40	40 (23.0)	22	55
41-50	11 (6.3)	11	100
Occupation
Physicians	21 (12.1)	8	38.1	0.376
Nurses	118 (67.8)	29	24.6
Paramedical and assistant workers	35 (20.1)	11	31.4
Work place
Medical ward workers	103 (59.2)	30	29.1	0.140
Pediatric ward workers	27 (15.5)	7	25.9
Emergency room workers	32 (18.4)	11	34.4
Laboratory workers	12 (6.9)	0	0

Abbreviations: HAV, hepatitis A virus.

Table 2.

The comparison of seroprevalence of HAV antibody between healthcare worker and non-healthcare worker population

	Author [reference]	Study period	Subjects	HAV antibody	Prevalence of HAV antibody according to age group
	Author [reference]	Study period	Subjects	HAV antibody	21-30 % (No.)	31-40 % (No.)	41-50 % (No.)
Non-healthcare worker	Kim et al. [7]	2006	Healthy subjects	Total	15.8% (23/146)	73.2% (109/149)	96% (119/124)
	Song et al. [8]	2006	Healthy subjects	IgG	2% (1/50)	72% (36/50)	92% (46/50)
	Lee et al. [3]	2003-2006	Hospital patients	IgG	8.9% (5/56)	46.5% (33/71)	90.6% (58/64)
	Kim et al. [10]	2002-2006	Hospital patients	IgG	32.8% (110/335)	79.7% (371/465)	-
	Kwon et al. [12]	2004-2005	Hospital patients	IgG	40.5% (15/37)	82.1% (23/28)	94.7% (18/19)
	Total				24.6% (154/624)	74.9% (572/763)	93.7% (241/257)
Healthcare worker	This study	2008	Healthcare workers	Total	21.1% (26/123)	55% (22/40)	100% (11/11)
P value					0.401	0.005	0.393

^∗ P value was calculated by two sample proportion test.

Abbreviations: HAV, hepatitis A virus.

TOOLS

Similar articles