Immunity to hepatitis A virus in liver transplant recipients: A population-based study in Iran

Ahamd Rashidi; Fatemeh Sedaghat; Amirali Nejat; Negar Azarpira; Alireza Shamsaeefar; Koroush Kazemi; Maryam Moini

doi:10.1016/j.gastrohep.2021.03.008

Immunity to hepatitis A virus in liver transplant recipients: A population-based study in Iran

Gastroenterol Hepatol. 2022 Feb;45(2):99-105. doi: 10.1016/j.gastrohep.2021.03.008. Epub 2021 May 21.

[Article in English, Spanish]

Authors

Ahamd Rashidi¹, Fatemeh Sedaghat¹, Amirali Nejat¹, Negar Azarpira², Alireza Shamsaeefar³, Koroush Kazemi³, Maryam Moini⁴

Affiliations

¹ Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
² Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: azarpiran@sums.ac.ir.
³ Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
⁴ Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Division of Gastroenterology, Toronto General Hospital, University of Toronto, Canada.

PMID: 34023475
DOI: 10.1016/j.gastrohep.2021.03.008

Abstract

Background: Acute hepatitis A is usually a self-limited viral disease but can be severe and even fatal in special groups of patients including those with chronic liver disease and recipients of liver transplantation. To take appropriate preventive measures, it is important to determine the immune status against the hepatitis A virus in patients at risk of grave clinical outcomes following infection. To assess the need for immunization against hepatitis A, we aimed to determine the immune status against hepatitis A in a population of liver transplant recipients. We also investigated the association between hepatitis A immune status and demographic factors such as age and sex, underlying liver disease, source of drinking water, geographical area of residence and socioeconomic status.

Methods: This cross-sectional study was performed on 242 recipients of allogenic liver transplants at Abu Ali Sina Organ Transplant Hospital in Shiraz, Iran, between January 2017 and April 2017. The level of immunity was assessed using hepatitis A antibody detection kits.

Results: The rate of immunity against hepatitis A was detected as 88.8% in our study population. In the multivariable logistic regression model, younger age (OR=1.175, P<0.001) and higher education level (OR=2.142, P=0.040) were the main determinants of non-immune status. However, hepatitis A immunity was independent of gender, monthly family income, water supply source, residential area and underlying liver disorder.

Conclusion: Although a significant proportion of liver transplant recipients in this study showed evidence of natural immunity to hepatitis A, a considerable proportion of younger patients and those with a higher level of education were non-immune. The results of this study signify the importance of screening for hepatitis A immunity in this at-risk population of patients and the need for vaccinating non-immune patients.

Keywords: Hepatitis A; Immunity; Inmunidad; Liver transplantation; Trasplante de hígado.

MeSH terms

Acute Disease
Adolescent
Adult
Age Factors
Aged
Child
Cross-Sectional Studies
Educational Status
Female
Hepatitis A / immunology*
Hepatitis A Antibodies / analysis
Hepatitis A virus / immunology*
Humans
Iran
Liver Transplantation* / statistics & numerical data
Logistic Models
Male
Middle Aged
Residence Characteristics
Sex Factors
Social Class
Transplant Recipients*
Water Supply
Young Adult

Substances

Hepatitis A Antibodies