Korean J Fam Pract. 2018; 8(6): 864-869  https://doi.org/10.21215/kjfp.2018.8.6.864
Seroprevalence Rate of Hepatitis A in Medical Personnel of the National Medical Center of Korea, 2013-2016
Taeho Hwang1, Eunju Shin1, Jaeyoun Kim1,*, Yeonjae Kim2
1Department of Pediatrics and 2Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea
Jaeyoun Kim
Tel: +82-2-2260-7306, Fax: +82-2-2267-8685
E-mail: jaeyoun.kim@nmc.or.kr
ORCID: http://orcid.org/0000-0002-9399-7481
Received: September 20, 2017; Revised: October 31, 2017; Accepted: October 31, 2017; Published online: December 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Korean adults are at high risk for hepatitis A because of a low seroprevalence rate in the population, especially in healthcare and medical professionals, among whom seroprevalence is highly critical for immunity. Thus, this study aimed to investigate the seroprevalence rate of hepatitis A among newly hired medical personnel and healthcare workers at the National Medical Center of Korea from 2013 to 2016.
Methods: Subjects were medical personnel and healthcare workers newly hired at the National Medical Center of Korea from January 1, 2013 to December 31, 2016. Serum samples were tested for immunoglobulin G antibodies against hepatitis A virus using a bead-based immunoserological assay, and nuclear medical testing (Cobra II Gamma Counter). Subjects’ medical records were retrospectively reviewed.
Results: Of the 563 total subjects, 189 (33.6%) were seropositive for hepatitis A, with a higher seroprevalence rate among women (37.3%) than among men (26.9%). By age group, the seroprevalence rates among men were 11.5%, 23.3%, 77.8%, and 100% for patients 20?29, 30?39, 40?49, and ≥50 years old, respectively. Among women, the seroprevalence rates by age group were 18.8%, 35.5%, 85.1%, and 91.7% for patients 20?29, 30?39, 40?49, and ≥50 years old, respectively.
Conclusion: All medical personnel and healthcare workers in their 20s and 30s should be tested for anti-hepatitis A virus immunoglobulin G, and if the results are negative, active immunization should be considered for these individuals.
Keywords: Hepatitis A; Health Personnel; Hepatitis A Antibodies; Hepatitis A Vaccines
  1. Feinstone SM, Kapikian AZ, Purceli RH. Hepatitis A: detection by immune electron microscopy of a viruslike antigen associated with acute illness. Science 1973; 182: 1026-8.
    Pubmed CrossRef
  2. American Academy of Pediatrics. Hepatitis A. In: Kimberlin DW, Brady MT, Jackson MA, Long SS, editors. Red book: 2015 report of the Committee on Infectious Diseases. 30th ed. Elk Grove Village (IL): American Academy of Pediatrics; 2015. p. 391-9.
  3. Fiore AE, Feinstone SM, Bell BP. Hepatitis A vaccine. In: Plotkin SA, Orenstein WA, Offit PA, editors. Vaccines. 6th ed. Philadelphia (PA): Saunders;2013. p. 183-204.
  4. Melnick JL. History and epidemiology of hepatitis A virus. J Infect Dis 1995;171 Suppl 1: S2-8.
    Pubmed CrossRef
  5. Koff RS. Seroepidemiology of hepatitis A in the United States. J Infect Dis 1995; 171 Suppl 1: S19-23.
    Pubmed CrossRef
  6. Kim JH. Recent epidemiological status and vaccination of hepatitis A in Korea. J Korean Med Assoc 2008; 51: 110-8.
  7. Center for Disease Control and Prevention (CDC). Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 1999; 48: 1-37.
  8. Lee BC, Lee DB. Clinical observation of type A hepatitis in children. J Korean Pediatr Soc 1979; 22: 213-22.
  9. Kim NJ, Sung JK, Lee SW, Lee KT, Lee SM, Kim SH, et al. An outbreak of hepatitis A in Taejeon city. Korean J Gastroenterol 1999; 34: 205-12.
  10. Han SH, Lee SH, Roh BJ, Shim SC, Cho SC, Sohn JH, et al. An outbreak of hepatitis A in South Korean military personnel : a clinical and epidemiologic study. Korean J Hepatol 2001; 7: 392-400.
  11. Choi W, Eom HS, Kim IH, Lee DH, Kim PS, Kim HG, et al. Patterns of acute hepatitis A and anti-HAV seroprevalence of Kyungin province. Korean J Gastroenterol 1999; 34: 69-75.
  12. Lee CH, Chung KW, Moon YM, Yoo JY, Sub DJ, Lee SG. An outbreak of hepatitis A in Korean young adults in 1998. Korean J Gastroenterol 1998;32(Suppl 1): 105A.
  13. Noble RC, Kane MA, Reeves SA, Roeckel I. Posttransfusion hepatitis A in a neonatal intensive care unit. JAMA 1984; 252: 2711-5.
    Pubmed CrossRef
  14. Azimi PH, Roberto RR, Guralnik J, Livermore T, Hoag S, Hagens S, et al. Transfusion-acquired hepatitis A in a premature infant with secondary nosocomial spread in an intensive care nursery. Am J Dis Child 1986; 140: 23-7.
  15. Hadler SC. Global impact of hepatitis A virus infection. Changing patterns. In: Hollinger FB, Lemon SM, Margolis HS, editors. Viral hepatitis and liver disease. Baltimore (MA): Williams & Wilkins; 1991. p. 14-20.
  16. Lee H, Cho HK, Kim JH, Kim KH. Seroepidemiology of hepatitis A in Korea:changes over the past 30 years. J Korean Med Sci 2011; 26: 791-6.
    Pubmed KoreaMed CrossRef
  17. Yun SW, Lee WK, Cho SY, Moon SH, Shin HD, Yun SY, et al. The seroprevalence rate, vaccination rate and seroconversion rate of hepatitis A in central region of Korea. Korean J Gastroenterol 2011; 57: 166-72.
    Pubmed CrossRef
  18. Lee SJ. Alert for hepatitis A in Seoul-Capital area. DongA Ilbo. 1998 July 4;Sect. 15. Korean.
  19. Hong WS, Kim CY. Seroepilemiology of type A and type B hepatitis in Seoul area. Korean J Med 1982; 25: 19-26.
  20. Yang NY, Yu PH, Mao ZX, Chen NL, Chai SA, Mao JS. Inapparent infection of hepatitis A virus. Am J Epidemiol 1988; 127: 599-604.
    Pubmed CrossRef
  21. Tassopoulos NC, Papaevangelou GJ, Ticehurst JR, Purcell RH. Fecal excretion of Greek strains of hepatitis A virus in patients with hepatitis A and in experimentally infected chimpanzees. J Infect Dis 1986; 154: 231-7.
    Pubmed CrossRef
  22. Skinhøj P, Mathiesen LR, Kryger P, Møller AM; Copenhagen Hepatitis Acuta Programme. Faecal excretion of hepatitis A virus in patients with symptomatic hepatitis A infection. Scand J Gastroenterol 1981; 16: 1057-9.
  23. Goodman RA, Carder CC, Allen JR, Orenstein WA, Finton RJ. Nosocomial hepatitis A transmission by an adult patient with diarrhea. Am J Med 1982;73: 220-6.
  24. Shimizu H, Takebayashi T, Goto M, Togashi T. [Studies on an outbreak of hepatitis A in an institution for the mentally retarded children]. Hokkaido Igaku Zasshi 1984; 59: 247-53. Japanese.
  25. Klein BS, Michaels JA, Rytel MW, Berg KG, Davis JP. Nosocomial hepatitis A. A multinursery outbreak in Wisconsin. JAMA 1984; 252: 2716-21.
    Pubmed CrossRef
  26. André F, Van Damme P, Safary A, Banatvala J. Inactivated hepatitis A vaccine:immunogenicity, efficacy, safety and review of official recommendations for use. Expert Rev Vaccines 2002; 1: 9-23.
    Pubmed CrossRef
  27. Jilg W, Bittner R, Bock HL, Clemens R, Schätzl H, Schmidt M, et al. Vaccination against hepatitis A: comparison of different short-term immunization schedules. Vaccine 1992; 10 Suppl 1: S126-8.
  28. Van Damme P, Matheï C, Thoelen S, Meheus A, Safary A, André FE. Single dose inactivated hepatitis A vaccine: rationale and clinical assessment of the safety and immunogenicity. J Med Virol 1994; 44: 435-41.
    Pubmed CrossRef
  29. Müller R, Chriske H, Deinhardt F, Jilg J, Theilmann L, Hess G, et al. Hepatitis A vaccination: schedule for accelerated immunization. Vaccine 1992; 10 Suppl 1: S124-5.
  30. KCDC. Epidemiology and management of vaccine preventable disease. 5th ed. Cheongju: Korea Centers for Disease Control and Preventon; 2017.

This Article