Low Prevalence of Vaccination or Documented Immunity to Hepatitis A and Hepatitis B Viruses Among Individuals with Chronic Liver Disease |
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| Authors: | Robert J Wong Robert G Gish Ramsey Cheung Amit S Chitnis |
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| Institution: | 1. Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, CA;2. Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA;3. Hepatitis B Foundation, Doylestown, PA;4. Tuberculosis Section, Division of Communicable Disease Control and Prevention, Alameda County Public Health Department, San Leandro, CA;1. Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn;2. Heart Institute, Hadassah University Medical Center, Jerusalem, Israel;3. Faculty of Medicine, Hebrew University, Jerusalem, Israel;4. Department of Health Sciences Research, Mayo Clinic, Rochester, Minn;1. Center for Medical Training, Ehime Seikyo Hospital, Japan;2. Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, Japan;1. Department of Philosophy, Texas Tech University, Lubbock;2. Texas Tech University Health Sciences Center, School of Medicine, Lubbock;1. Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston;2. Division of Cardiology, Weill Cornell Medicine-Qatar, Doha, Qatar;3. Division of Cardiothoracic Surgery, Baylor School of Medicine, Houston, Tex;4. Division of Cardiovascular Medicine, Mayo Clinic, Rochester, Minn;5. Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston;6. Department of Cardiovascular Medicine, University of Kentucky, Lexington;7. Division of Cardiology, Baylor School of Medicine, Houston, Tex;1. Department of Psychiatry, Yale University School of Medicine, New Haven, Conn;2. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY |
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| Abstract: | BackgroundDespite national guidelines emphasizing the importance of vaccination or documenting immunity to hepatitis A virus and hepatitis B virus for patients with chronic liver disease, the success of adhering to these recommendations is suboptimal. We aim to evaluate the prevalence of vaccination or documented reactivity to hepatitis A antibody and hepatitis B surface antibody among US adults with chronic liver disease.MethodsUsing 2011-2018 National Health and Nutritional Examination Survey data, adults with nonalcoholic fatty liver disease, alcoholic liver disease, hepatitis B, and hepatitis C were evaluated to determine prevalence of vaccination (self-reported completion) and hepatitis A antibody reactivity or hepatitis B surface antibody reactivity.ResultsOverall prevalence of vaccination or hepatitis A antibody reactivity was lowest among individuals with nonalcoholic fatty liver disease (60.8%; 95% confidence interval CI], 57.9-63.6) and alcoholic liver disease (61.8%; 95% CI, 59.0-64.6), and highest among individuals with hepatitis B (82.9%; 95% CI, 76.8-89.0). Prevalence of vaccination or hepatitis B surface antibody reactivity was much lower: 38.6% (95% CI, 35.7-41.4) in nonalcoholic fatty liver disease, 40.7% (95% CI, 34.4-47.0) in chronic hepatitis C virus, and 47.1% (95% CI, 44.3-49.9) in alcoholic liver disease.ConclusionAmong US adults with chronic liver disease, prevalence of vaccination or documented reactivity to hepatitis A antibody and hepatitis B surface antibody was alarmingly low. These observations are particularly concerning given that underlying chronic liver disease increases risks of severe liver injury and decompensation from acute hepatitis A or hepatitis B infections. |
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| Keywords: | Chronic liver disease Hepatitis A Hepatitis B Immunization Vaccination |
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