Lab Med Online.  2020 Jul;10(3):227-234. 10.3343/lmo.2020.10.3.227.

Recent Seroprevalence of Anti-hepatitis A IgG in the Korean Population: a Large, Population-based Study

• Choi R
• Park MJ
• Lee SG
• Lee EH

• KMID: 2504133
• DOI: http://doi.org/10.3343/lmo.2020.10.3.227

Abstract

Background
Because there is limited recent information on this topic, this study investigated the seroprevalence of anti-hepatitis A virus (HAV) immunoglobulin G (IgG) in the South Korean population in 2015–2017.
Methods
Anti-HAV IgG seroprevalence data were obtained from the laboratory information system of Green Cross Laboratories, one of the largest referral laboratories in South Korea.
Results
During the three-year study period, we obtained test results from 240,840 individuals (124,353 men and 116,487 women) from 1,348 hospitals and local clinics throughout South Korea. The median (range) age of subjects was 38.0 (18.0–97.2) years. The annual seroprevalence of anti-HAV IgG was 53.3%, 53.0%, and 53.1% in 2015, 2016, and 2017, respectively. The median age differed among geographic regions and anti-HAV seroprevalence differed among age groups and geographic regions (P<0.0001). Subjects in their 20’s had a significantly lower rate of anti-HAV IgG-positivity than subjects in their 10’s (odds ratio, [OR] 0.74, 95% CI, 0.69–0.78, P<0.0001), while other age groups had higher rates. Multivariable-adjusted logistic regression analysis showed that women and subjects living in Inchoen, Sejong city, Gangwon province, Gwangju, and North Jeolla province were more likely to be immune to HAV compared to subjects living in Seoul (OR >1.0, P<0.05).
Conclusions
This study provides basic information about the recent seroprevalence of anti-HAV IgG in the Korean population and contributes to identifying groups at high risk of an HAV epidemic.

Keyword

Hepatitis A; Seroepidemiologic studies; Korea; Hepatitis A antibodies

Figure

• 

  Fig. 1 Numbers of positive anti-hepatitis A virus IgG results and age-stratified anti-hepatitis A virus IgG seroprevalence (%) from 2015 to 2017 in Korean adults. (A) Men and (B) women.

Reference

1. Lemon SM, Ott JJ, Van Damme P, Shouval D. 2018; Type A viral hepatitis: A summary and update on the molecular virology, epidemiology, pathogenesis and prevention. J Hepatol. 68:167–84. DOI: 10.1016/j.jhep.2017.08.034. PMID: 28887164.

2. GBD 2013 Mortality and Causes of Death Collaborators. 2015; Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 385:117–71. DOI: 10.1016/S0140-6736(14)61682-2.

3. Yoon JG, Choi MJ, Yoon JW, Noh JY, Song JY, Cheong HJ, et al. 2017; Seroprevalence and disease burden of acute hepatitis A in adult population in South Korea. PLoS One. 12:e0186257. DOI: 10.1371/journal.pone.0186257. PMID: 29065115. PMCID: PMC5655533.

4. Korea Centers for Disease Control and Prevention. 2008. Changing patterns of hepatitis A virus infection in Korea. Public Health Weekly Report. http://www.nih.kr/CDC/cms/cmsFileDownload.jsp?d=496&cid=12809& eldName=attach1&index=1. Updated on Apr 2020.

5. Lee H, Cho HK, Kim JH, Kim KH. 2011; Seroepidemiology of hepatitis A in Korea: Changes over the past 30 years. J Korean Med Sci. 26:791–6. DOI: 10.3346/jkms.2011.26.6.791. PMID: 21655066. PMCID: PMC3102874.

6. Korea Centers for Disease Control and Prevention. 2018. 2017 Infectious Diseases Surveillance Yearbook. http://www.cdc.go.kr/npt/biz/npp/portal/nppPblctDtaView.do?.pblctDtaSeAt=1&pblctDtaSn=631 (Updated on Apr 2020). Updated on Apr 2020.

7. Statistics Korea. KOrean Statistical Information Service. http://kosis.kr/statisticsList/statisticsListIndex.do?.menuId=M_01_01&vwcd=MT_ZTITLE&parmTabId=M_01_01&parentId=A.1;A41.2;#SelectStatsBoxDiv. Updated on Apr 2020.

8. Lee A, Lim HS, Nam CM, Song SM, Yoon HR, Lee KR. 2009; An epidemiological analysis of hepatitis A virus serologic markers during the recent four years in Korea. Korean J Lab Med. 29:563–9. DOI: 10.3343/kjlm.2009.29.6.563. PMID: 20046089.

9. Lee D, Ki M, Lee A, Lee KR, Park HB, Kim CS, et al. 2011; A nationwide seroprevalence of total antibody to hepatitis A virus from 2005 to 2009: age and area-adjusted prevalence rates. Korean J Hepatol. 17:44–50. DOI: 10.3350/kjhep.2011.17.1.44. PMID: 21494077. PMCID: PMC3304627.

10. Cho SE and Kim Y. 2013; Seroepidemiology of hepatitis A in South Korea: a nationwide study by the Eone Reference Laboratory. J Epidemiol. 23:270–4. DOI: 10.2188/jea.JE20120188. PMID: 23629647. PMCID: PMC3709547.

11. Gripenberg M, Aloysia D'Cor N, L'Azou M, Marsh G, Druelles S, Nealon J. 2018; Changing sero-epidemiology of hepatitis A in Asia Pacific countries: a systematic review. Int J Infect Dis. 68:13–7. DOI: 10.1016/j.ijid.2017.12.021. PMID: 29292043.

12. Wang H, Gao P, Chen W, Bai S, Lv M, Ji W, et al. 2019; Changing epidemiological characteristics of hepatitis A and warning of Anti-HAV immunity in Beijing, China: a comparison of prevalence from 1990 to 2017. Hum Vaccin Immunother. 15:420–5. DOI: 10.1080/21645515.2018.1529128. PMID: 30260275. PMCID: PMC6422449.

13. Chen Y, Zhang XJ, Zhao YL, Zhang YH, Wang SM, Hao ZY, et al. 2014; Waning of anti-HAV immunity in Shijiazhuang prefecture, Hebei province, China: a comparison of seroprevalence between 1992 and 2011. Vaccine. 32:6227–32. DOI: 10.1016/j.vaccine.2014.09.022. PMID: 25258099.

14. Centers for Disease Control and Prevention. VPD surveillance manual enhancing surveillance: Chapter 19. https://www.cdc.gov/vaccines/pubs/surv-manual/chpt19-enhancing-surv.html. Updated on Nov 2017.

15. Choe YJ, Choe S-A, Cho S-I. 2018; Trends in infectious disease mortality, South Korea, 1983-2015. Emerg Infect Dis. 24:320–7. DOI: 10.3201/eid2402.170862. PMID: 29350153. PMCID: PMC5782883.