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Routine testing for IgG antibodies against hepatitis A virus in Israel.

Samuels N - BMC Public Health (2005)

Bottom Line: This study examines the benefits of routine testing for anti-HAV IgG in high-risk population.A retrospective examination of the files of teenage and adult patients (aged 16-99 years; mean 33.9) in two primary care clinics found 1,017 patients who had been tested for anti-HAV IgG antibodies for either general healthcare screening or ongoing follow-up for chronic illness.The relatively high prevalence rate of anti-HAV seropositivity in our study may me due to the fact that the study was conducted in a primary care clinic or that it took place in Jerusalem, a relatively poor and densely populated Israeli city.

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Affiliation: Maccabi Healthcare Services, 130 Rachmilevich Street, Jerusalem 97791, Israel. refplus@netvision.net.il

ABSTRACT

Background: Viral hepatitis is highly endemic in Israel, with the hepatitis A virus (HAV) responsible for most cases. Improved socioeconomic factors, as well as the universal vaccination of infants (introduced in 1999) has resulted in a decline in infection rates in Israel. This study examines the benefits of routine testing for anti-HAV IgG in high-risk population.

Methods: A retrospective examination of the files of teenage and adult patients (aged 16-99 years; mean 33.9) in two primary care clinics found 1,017 patients who had been tested for anti-HAV IgG antibodies for either general healthcare screening or ongoing follow-up for chronic illness. Seropositive patients were then asked regarding recall of past hepatitis (i.e. jaundice, regardless of viral etiology); post-exposure prophylaxis with immune serum immunoglobulin (ISG); and active immunization with inactivated virus. Seronegative patients were subsequently sent for active immunization.

Results: Of the 1,017 patient records studied (503 male, 514 female), a total of 692 were seropositive (354 males, 338 females; P = 0.113). Seropositivity rates increased with age (p < 0.005), and were highest among those born in Middle Eastern countries other than Israel (91.3%) and lowest among immigrants from South America (44.1%; P < 0.005). 456 of the seropositive patients were interviewed, of whom only 91 recalled past illness while 103 remembered receiving post-exposure prophylaxis (ISG) and 8 active vaccination. Those who were unaware of past infection were more likely to have been vaccinated with ISG than those who were aware (26.3% vs. 7.7%; p < 0.005).

Conclusion: The relatively high prevalence rate of anti-HAV seropositivity in our study may me due to the fact that the study was conducted in a primary care clinic or that it took place in Jerusalem, a relatively poor and densely populated Israeli city. Most of the seropostive patients had no recollection of prior infection, which can be explained by the fact that most hepatitis A infections occur during childhood and are asymptomatic. Routine testing for anti-HAV IgG in societies endemic for HAV would help prevent seropositive patients from receiving either post-exposure or preventive immunization and target seronegative patients for preventive vaccination.

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Prevalence of positive HAV serology according to country of birth(%). * Eastern Bloc = former USSR and Eastern European countries** Western Bloc = North America and Western Europe
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Figure 2: Prevalence of positive HAV serology according to country of birth(%). * Eastern Bloc = former USSR and Eastern European countries** Western Bloc = North America and Western Europe

Mentions: Patients who were born in Middle Eastern countries other than Israel had the highest seropositive rate (91.3%), while those born in South America the lowest (44.1%; p < 0.005. See Figure 2). Immigrants from the Eastern Bloc countries (former Soviet Bloc and Eastern Europe) had a significantly higher prevalence of anti-HAV antibodies than native Israelis (70.3% vs. 58.7%; p = 0.016).


Routine testing for IgG antibodies against hepatitis A virus in Israel.

Samuels N - BMC Public Health (2005)

Prevalence of positive HAV serology according to country of birth(%). * Eastern Bloc = former USSR and Eastern European countries** Western Bloc = North America and Western Europe
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1173118&req=5

Figure 2: Prevalence of positive HAV serology according to country of birth(%). * Eastern Bloc = former USSR and Eastern European countries** Western Bloc = North America and Western Europe
Mentions: Patients who were born in Middle Eastern countries other than Israel had the highest seropositive rate (91.3%), while those born in South America the lowest (44.1%; p < 0.005. See Figure 2). Immigrants from the Eastern Bloc countries (former Soviet Bloc and Eastern Europe) had a significantly higher prevalence of anti-HAV antibodies than native Israelis (70.3% vs. 58.7%; p = 0.016).

Bottom Line: This study examines the benefits of routine testing for anti-HAV IgG in high-risk population.A retrospective examination of the files of teenage and adult patients (aged 16-99 years; mean 33.9) in two primary care clinics found 1,017 patients who had been tested for anti-HAV IgG antibodies for either general healthcare screening or ongoing follow-up for chronic illness.The relatively high prevalence rate of anti-HAV seropositivity in our study may me due to the fact that the study was conducted in a primary care clinic or that it took place in Jerusalem, a relatively poor and densely populated Israeli city.

View Article: PubMed Central - HTML - PubMed

Affiliation: Maccabi Healthcare Services, 130 Rachmilevich Street, Jerusalem 97791, Israel. refplus@netvision.net.il

ABSTRACT

Background: Viral hepatitis is highly endemic in Israel, with the hepatitis A virus (HAV) responsible for most cases. Improved socioeconomic factors, as well as the universal vaccination of infants (introduced in 1999) has resulted in a decline in infection rates in Israel. This study examines the benefits of routine testing for anti-HAV IgG in high-risk population.

Methods: A retrospective examination of the files of teenage and adult patients (aged 16-99 years; mean 33.9) in two primary care clinics found 1,017 patients who had been tested for anti-HAV IgG antibodies for either general healthcare screening or ongoing follow-up for chronic illness. Seropositive patients were then asked regarding recall of past hepatitis (i.e. jaundice, regardless of viral etiology); post-exposure prophylaxis with immune serum immunoglobulin (ISG); and active immunization with inactivated virus. Seronegative patients were subsequently sent for active immunization.

Results: Of the 1,017 patient records studied (503 male, 514 female), a total of 692 were seropositive (354 males, 338 females; P = 0.113). Seropositivity rates increased with age (p < 0.005), and were highest among those born in Middle Eastern countries other than Israel (91.3%) and lowest among immigrants from South America (44.1%; P < 0.005). 456 of the seropositive patients were interviewed, of whom only 91 recalled past illness while 103 remembered receiving post-exposure prophylaxis (ISG) and 8 active vaccination. Those who were unaware of past infection were more likely to have been vaccinated with ISG than those who were aware (26.3% vs. 7.7%; p < 0.005).

Conclusion: The relatively high prevalence rate of anti-HAV seropositivity in our study may me due to the fact that the study was conducted in a primary care clinic or that it took place in Jerusalem, a relatively poor and densely populated Israeli city. Most of the seropostive patients had no recollection of prior infection, which can be explained by the fact that most hepatitis A infections occur during childhood and are asymptomatic. Routine testing for anti-HAV IgG in societies endemic for HAV would help prevent seropositive patients from receiving either post-exposure or preventive immunization and target seronegative patients for preventive vaccination.

Show MeSH
Related in: MedlinePlus