Journal List > Korean J Lab Med > v.29(6) > 1011599

Lee, Lim, Nam, Song, Yoon, and Lee: An Epidemiological Analysis of Hepatitis A Virus Serologic Markers during the Recent Four Years in Korea

Abstract

Background:

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.

Methods:

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.

Results:

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 ≥21 yr.

Conclusion:

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 ≥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.

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Fig. 1.
Age related seroprevalence of anti-HAV total from 2005 to 2008.
P for trends were obtained from Cochran-Armitage trend test for positive rates of anti-HAV total by calendar year from 2005 to 2008 in each age groups.
Abbreviation: HAV, hepatitis A virus.
kjlm-29-563f1.tif
Fig. 2.
Age related seroprevalence of anti-HAV IgM from 2005 to 2008.
P for trends were obtained from Cochran-Armitage trend test for positive rates of anti-HAV IgM by calendar year from 2005 to 2008 in each age groups.
Abbreviation: HAV, hepatitis A virus.
kjlm-29-563f2.tif
Table 1.
Study population according to year, sex and age groups
  2005 2006 2007 2008 Total (%)
M/F Total (%) M/F Total (%) M/F Total (%) M/F Total (%)
Anti-HAV total (Age)
1-10 250 (22.1) 144/106 182 (11.2) 109/73 166 (8.3) 93/73 405 (6.4) 218/187 1,003 (9.1)
11-20 128 (11.3) 80/48 223 (13.7) 133/90 244 (12.2) 145/99 485 (7.7) 263/222 1,080 (9.8)
21-30 181 (16.0) 87/94 316 (19.4) 151/165 348 (17.4) 162/186 1,201 (19.0) 530/671 2,046 (18.5)
31-40 212 (18.7) 119/93 336 (20.6) 192/144 476 (23.8) 306/170 1,549 (24.6) 805/744 2,573 (23.2)
≥41 362 (32.0) 213/419 571 (35.1) 310/261 766 (17.5) 440/326 2,667 (42.3) 1,325/1,342 4,366 (39.4)
Total 1,133 (100.0) 643/490 1,628 (100.0) 895/733 2,000 (100.0) 1,146/854 6,307 (100.0) 3,141/3,166 11,068 (100.0)
Anti-HAV IgM (Age)
1-10 460 (8.3) 277/183 504 (6.7) 298/206 385 (4.8) 236/149 540 (4.8) 317/223 1,889 (5.8)
11-20 461 (8.3) 308/153 611 (8.2) 436/175 634 (7.9) 440/194 1,000 (8.9) 650/350 2,706 (8.4)
21-30 1,106 (19.9) 632/474 1,493 (19.9) 801/692 1,519 (18.9) 815/704 2,347 (20.8) 1,132/1,015 6,465 (20.0)
31-40 1,093 (19.7) 643/450 1,587 (21.2) 908/679 1,662 (20/7) 946/716 2,617 (23.2) 1,569/1,048 6,959 (21.5)
≥41 2,422 (43.8) 1,265/1,168 3,301 (44.0) 1,743/1,558 3,816 (47.6) 1,973/1,843 4,791 (42.4) 2,531/2,260 14,341 (44.3)
Total 5,553 (100.0) 3,125/2,428 7,496 (100.0) 4,186/3,310 8,016 (100.0) 4,410/3,606 11,295 (100.0) 6,399/4,896 32,360 (100.0)

Abbreviations: M, male; F, female; HAV, hepatitis A virus.

Table 2.
Positive rates of anti-HAV total according to sex from 2005 to 2008
Year Male Female Total P
2005 59.4% (382/643) 58.0% (284/490) 58.8% (666/1,133) 0.6233
2006 63.4% (567/895) 61.9% (454/773) 62.7% (1,022/1,628) 0.5570
2007 63.6% (729/1,146) 59.7% (510/854) 62.0% (1,239/2,000) 0.0761
2008 63.9% (2,007/3,141) 63.4% (2,018/3,166) 63.8% (4,025/6,307) 0.8967
2005-2008 63.3% (3,685/5,825) 62.3% (3,266/5,243) 62.8% (6,951/11,068) 0.2922
P for trend 0.0761 0.0111 0.0030 -

P values were obtained by Chi square test;

P for trends were obtained from Cochran-Armitage trend test.

Abbreviations: HAV, hepatitis A virus.

Table 3.
Positive rates of anti-HAV IgM according to sex from 2005 to 2008
Year Male Female Total P
2005 7.6% (237/3,125) 7.8% (189/2,428) 7.7% (426/5,553) 0.7810
2006 11.1% (465/4,186) 10.5% (349/3,310) 10.9% (814/7,496) 0.4352
2007 9.8% (430/4,410) 7.9% (283/3,606) 8.9% (713/8,016) 0.0029
2008 15.8% (1,011/6,399) 12.3% (602/4,896) 14.3% (1,613/11,295) <0.0001
2005-2008 11.8% (2,143/18,120) 10.0% (1,423/14,240) 11.0% (3,566/32,360) <0.0001
P for trend <0.0001 <0.0001 <0.0001 -

P values were obtained by Chi square test;

P for trends were obtained from Cochran-Armitage trend test.

Abbreviations: HAV, hepatitis A virus.

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