Seroprevalence of hepatitis A immunity among brazilian adult patients with liver cirrhosis: is HAV vaccination necessary?

background: patients with chronic liver disease have a higher risk of fulminant hepatitis when infected with hepatitis a virus, and vaccination of these patients against such infection is recommended. in brazil, mainly in the south and southeast regions, the epidemiology of hepatitis a (ha) has shifted from high to intermediate endemicity, which would have implication on policy of ha vaccination for these populations. objective: to verify the prevalence of ha immunity in adult patients with liver cirrhosis (lc), in uberlandia mg, a city of southeastern brazil. methods: between december 2005 and december 2006, 106 patients with lc were consecutively evaluated. in addition, 75 individuals without lc or alcoholism were evaluated (control group - cg). results: total anti-hav (elisa methods) was positive in 104 (98.1%) patients with lc (82 men, 24 women; mean age, 53.3 ± 11.9 years) and in 74 (98.7%) individuals of the cg (55 men, 20 women; mean age, 47 ± 11.6 years), p > 0.05. conclusions: for patients with chronic liver disease, in the geographic regions and age groups evaluated, routine vaccination against hepatitis a is not recommended. moreover, the serum determination of total anti-hav, used to assess immunity, is five times cheaper than vaccination against hepatitis a and, for this reason, should precede vaccination.