{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T04:54:34Z","timestamp":1774241674654,"version":"3.50.1"},"reference-count":13,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T00:00:00Z","timestamp":1612742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Korea Disease Control and Prevention Agency, KDCA","award":["Project No. 4837-301 and 4838-303"],"award-info":[{"award-number":["Project No. 4837-301 and 4838-303"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Hepatitis A, an acute type of hepatitis caused by the hepatitis A virus, occurs worldwide. Following the 2009 hepatitis A epidemic in South Korea, patient outbreak reports were collectively converted to an \u201call-patient report\u201d in 2011, and national immunization programs were introduced for children in 2015. In this study, we aimed to analyze the changes and characteristics of hepatitis A antibody titers in South Korea following the epidemic. The results of hepatitis A antibody tests performed at clinical laboratories from 2009 to 2019 were analyzed based on year, age, region, sex, and medical institution. The average 2009\u20132018 positive anti-hepatitis A virus immunoglobulin G rate was 51.8%, but it increased (56.06%) in 2019. Significantly different antibody-positive rates were observed based on age: &lt;10 years, 54.5%; 20\u201329 years, 19.5%; \u226550 years, almost 100%. The positive rate of individuals in their teens and 20s gradually increased, whereas that of those in their 30s and 40s gradually decreased. Males had higher antibody-positive rates than females, and samples from higher-level general hospitals exhibited higher antibody rates. The positive anti-hepatitis A virus immunoglobulin M rates gradually decreased after 2009 and were &lt;1% after 2012. However, a high positive rate of 3.69% was observed in 2019 when there was an epidemic. Anti-hepatitis A virus immunoglobulin G-positive rates were similar throughout the year, but the anti-hepatitis A virus immunoglobulin M-positive rates increased from January, peaked in April, and decreased from July, exhibiting distinct seasonality. This is considered to be related to groundwater pollution during the spring drought season. The introduction of the \u201call-patient report\u201d and national vaccination program for children has had an effective influence on hepatitis A management. However, for hepatitis A prevention, policy considerations for high-risk age groups with low antibody-positive rates will be necessary.<\/jats:p>","DOI":"10.1371\/journal.pone.0245162","type":"journal-article","created":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T01:00:08Z","timestamp":1612832408000},"page":"e0245162","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":20,"title":["Nationwide seroprevalence of hepatitis A in South Korea from 2009 to 2019"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4481-4789","authenticated-orcid":true,"given":"Deog-Yong","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su-Jin","family":"Chae","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung-Rye","family":"Cho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wooyoung","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4729-3114","authenticated-orcid":true,"given":"Chang-Ki","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3543-1826","authenticated-orcid":true,"given":"Myung-Guk","family":"Han","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,2,8]]},"reference":[{"key":"pone.0245162.ref001","first-page":"1027","article-title":"Hepatitis 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Yoon","year":"2017","journal-title":"PLoS One"},{"key":"pone.0245162.ref009","doi-asserted-by":"crossref","first-page":"44","DOI":"10.3350\/kjhep.2011.17.1.44","article-title":"A nationwide seroprevalence of total antibody to hepatitis A virus from 2005 to 2009: age and area-adjusted prevalence rates","volume":"17","author":"D Lee","year":"2011","journal-title":"Korean J Hepatol"},{"key":"pone.0245162.ref010","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1128\/CMR.19.1.63-79.2006","article-title":"Diagnosis of hepatitis A virus infection: a molecular approach","volume":"19","author":"OV Nainan","year":"2006","journal-title":"Clin Microbiol Rev"},{"key":"pone.0245162.ref011","doi-asserted-by":"crossref","first-page":"413","DOI":"10.15585\/mmwr.mm6818a2","article-title":"Increase in hepatitis A virus infections\u2014United States, 2013\u20132018","volume":"68","author":"MA Foster","year":"2019","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"pone.0245162.ref012","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1089\/fpd.2014.1879","article-title":"Three gastroenteritis outbreaks in South Korea caused by the consumption of kimchi tainted by norovirus GI.4","volume":"12","author":"JH Park","year":"2015","journal-title":"Foodborne Pathog Dis"},{"key":"pone.0245162.ref013","doi-asserted-by":"crossref","first-page":"96","DOI":"10.4103\/2249-4863.152263","article-title":"Seasonality of hepatitis: a review update","volume":"4","author":"A Fares","year":"2015","journal-title":"J Family Med Prim Care"}],"container-title":["PLOS 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