The prevalence of cirrhosis in adults with evidence of immunity against Hepatitis A

Abstract

INTRODUCTION: Hepatitis A is a common and often asymptomatic infection in childhood in the developing world. With improving living standards in some developing countries, its incidence in childhood has decreased leading to a significant proportion of non-immune adults. The infection is a potentially serious illness in adults and can even be fatal in patients with cirrhosis. Vaccination against Hepatitis A is therefore recommended for non-immune cirrhotic. OBJECTIVES: To assess the prevalence of cirrhosis in adults with evidence of immunity against hepatitis A. METHOD: As part of their routine investigations, Hepatitis A Ig G antibodies (anti-HAV IgG) were checked using an ELISA technique in 108 cirrhotic patients presenting to a tertiary referral centre for the first time from 2011 to 2014. Patients’ demographic data were collected and the possible aetiology of cirrhosis investigated. RESULTS: The median age at presentation was 55 years (range 28-78) and the Male: Female ratio was 5:1. Most (62.5%) patients had cryptogenic cirrhosis and 27.7% patients had alcoholic cirrhosis. 48/110 patients (44.4%) were positive and 60 (56.6%) were negative for anti-HAV IgG. None of the patients had received vaccination against hepatitis A. CONCLUSIONS: Most of our patients presenting with cirrhosis did not have evidence of immunity against hepatitis A. In our setting, cirrhotic patients should be investigated for evidence of past infection with Hepatitis A, and vaccination offered to those found to be non-immune.