Reuters Health Information (2005-08-30): Hepatitis A vaccination rates low among patients with chronic HCV infection
Hepatitis A vaccination rates low among patients with chronic HCV infection
Last Updated: 2005-08-30 10:16:23 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Although guidelines
recommend hepatitis A vaccination for all patients with chronic
hepatitis C virus (HCV) infection, new research indicates that in
practice this seldom occurs. "Public health efforts aimed at raising
awareness about HAV vaccination in patients with chronic liver disease
should be strongly encouraged," the researchers emphasize.
Superinfection with hepatitis A virus (HAV) greatly increases the
risk of liver failure and death in patients with underlying chronic
liver disease, according to the report in the September issue of
Hepatology. As such, HAV vaccination has been recommended for patients
with such disease, including disease arising from HCV infection.
To investigate adherence with HAV vaccination guidelines, Dr. Edmund
J. Bini and colleagues, from VA New York Harbor Healthcare System,
analyzed data from 1193 patients who were diagnosed with chronic HCV
infection over a 1-year period. Nearly 1700 person-years of follow-up
were included in the analysis.
The subjects visited their primary care provider a median of 10
times, the report indicates. HAV antibody testing was performed in 640
subjects (53.6%) and 317 of them (49.5%) tested negative and were
considered susceptible to the pathogen.
Only 94 patients were given the HAV vaccine, including 85 who were
susceptible to HAV, 3 who were immune, and 6 who were not tested for
HAV antibodies. Moreover, 45 of the vaccinated patients received just
During follow-up, three unvaccinated patients developed acute HAV
infection and one of the cases proved to be fatal, the report shows.
"Further studies to evaluate patient and provider barriers to HAV
vaccination are needed to prevent future missed opportunities for
vaccination," Dr. Bini and colleagues conclude.