Connective tissue growth factor reacts as an IL - World Journal of ...

Cho HC et al . The seroprevalence of anti-HAV in chronic viral liver disease
Female patients had a relatively higher rate of HAV seropositivity.
This finding might be explained by the fact that
female subjects in Korea have a larger number of social
and household contacts and so probably have more exposure
to HAV. We also observed significant differences
among the places of residence. The lowest seroprevalence
was observed in Seoul, the largest and most urbanized
city in Korea, and the highest was in the provinces, with a
more rural way of life. Such differences in seroprevalence
might well be attributed to the vast variations in living
conditions.
The current study has a couple of limitations. First, this
is a retrospective study and the available epidemiological
data on HAV infection is limited. Socioeconomic characteristics,
including the educational level, salary, the number of
siblings, the type of residence, the water supply, etc., were
not included in this study. Although multivariable analysis
of the seropositivity of anti-HAV was carried out with
relatively limited variables, the results in the present study
may not be applicable to all patients with CLD. Second,
although the current study included a large number of
CLD patients, it was performed at a single medical center.
Therefore, the patients may not be representative of
the whole population of Korea. We also used data from
the Center for Health Promotion and these patients may
not be representative of the general Korean population
without CLD when considering the fact that patients with
a relatively higher level of socioecomonic status visit the
Center for Health Promotion.
In conclusion, the overall prevalence of IgG anti-HAV
in Korean patients with chronic viral liver disease was
86.61%, and most patients who are above 40 years of age
have already been exposed to HAV. Therefore, vaccination
against HAV should be considered, particularly for young
anti-HAV-negative patients with chronic liver disease.
COMMENTS
Background
An improved socioeconomic status, more sanitary conditions and better hygiene
practices have reduced the incidence of hepatitis A virus (HAV) infection.
In Korea, symptomatic hepatitis A has been gradually increasing since the mid-
1990s, with a tendency toward an increase in the mean age and disease severity.
Acute HAV superinfection causes severe liver disease, acute liver failure
and even higher mortality rates in patients with underlying chronic liver disease.
Research frontiers
Identifying the current seroprevalence of HAV antibodies in patients with chronic
viral liver disease would be valuable for establishing appropriate vaccination
guidelines for patients with chronic liver disease.
Innovations and breakthroughs
Recent studies reported a rapid epidemiological shift in HAV infection. In this
study, the authors evaluated seroprevalence of IgG anti-HAV in patients with
chronic liver disease using large population based data, and investigated the agespecific
seroprevalence and the factors that affect IgG anti-HAV seropositivity.
Applications
There has been an apparent epidemiological shift in HAV seroprevalence in
patients with chronic liver disease. Most patients who are above 40 years of age
have already been exposed to HAV. Therefore, vaccination against HAV should
be considered, particularly for young anti-HAV-negative patients with chronic liver
disease.
Peer review
This manuscript is of interest.
WJG|www.wjgnet.com
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