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Incidence of HAV and HBV infections and vaccination rates in patients with autoimmune liver diseases.
Am J Gastroenterol. 2008 Jan; 103(1):138-46.AJ

Abstract

OBJECTIVES

Hepatitis A virus (HAV) or hepatitis B virus (HBV) superinfection is associated with an increased mortality in patients with chronic liver diseases (CLD). Despite official recommendations, it was reported that the vaccination rate against HAV is low in patients with chronic hepatitis C infection. To evaluate the situation in patients with autoimmune liver diseases, we conducted a retrospective cohort study.

METHODS

Susceptibility to HAV and HBV infections, course of HAV and HBV infections, vaccination rates against HAV and HBV, and efficacy of hepatitis A/B vaccines were evaluated by antibody testing in 225 patients with autoimmune liver diseases during 1,677 person-years.

RESULTS

Susceptibility to HAV/HBV infection was 51/86%. Incidence of HAV/HBV infection was 1.3/1.4 per 1,000 person-years. One HAV infection occurred, but the patient recovered spontaneously. Two patients were HBV-infected after receiving an anti-HBc-positive (antibody to hepatitis B core antigen) donor graft during orthotopic liver transplantation, and one of them developed chronic HBV infection. Vaccination rates were 11% (HBV) and 13% (HAV), respectively. Seventy-six percent of the vaccinated patients (HBV vaccine) developed anti-HBs (antibody to hepatitis surface antigen) >or=10 UI/L. Ten out of 13 vaccinated patients, showing a low or nonresponse to hepatitis B vaccine, had concomitant immunosuppressive therapy. Anti-HAV was detectable in all patients after administration of HAV vaccine.

CONCLUSIONS

Patients with autoimmune liver diseases have a high susceptibility to HAV and HBV infections. Vaccination rates are low in this patient cohort and efficacy of hepatitis B vaccine is reduced due to immunosuppressive therapy. Improving adherence to vaccine recommendations is essential to prevent HAV and HBV infections in patients with autoimmune liver diseases.

Authors+Show Affiliations

Department of Internal Medicine I, Johannes Gutenberg-University, Mainz, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17970833

Citation

Wörns, Marcus A., et al. "Incidence of HAV and HBV Infections and Vaccination Rates in Patients With Autoimmune Liver Diseases." The American Journal of Gastroenterology, vol. 103, no. 1, 2008, pp. 138-46.
Wörns MA, Teufel A, Kanzler S, et al. Incidence of HAV and HBV infections and vaccination rates in patients with autoimmune liver diseases. Am J Gastroenterol. 2008;103(1):138-46.
Wörns, M. A., Teufel, A., Kanzler, S., Shrestha, A., Victor, A., Otto, G., Lohse, A. W., Galle, P. R., & Höhler, T. (2008). Incidence of HAV and HBV infections and vaccination rates in patients with autoimmune liver diseases. The American Journal of Gastroenterology, 103(1), 138-46.
Wörns MA, et al. Incidence of HAV and HBV Infections and Vaccination Rates in Patients With Autoimmune Liver Diseases. Am J Gastroenterol. 2008;103(1):138-46. PubMed PMID: 17970833.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence of HAV and HBV infections and vaccination rates in patients with autoimmune liver diseases. AU - Wörns,Marcus A, AU - Teufel,Andreas, AU - Kanzler,Stephan, AU - Shrestha,Annette, AU - Victor,Anja, AU - Otto,Gerd, AU - Lohse,Ansgar W, AU - Galle,Peter R, AU - Höhler,Thomas, Y1 - 2007/10/26/ PY - 2007/11/1/pubmed PY - 2008/3/14/medline PY - 2007/11/1/entrez SP - 138 EP - 46 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 103 IS - 1 N2 - OBJECTIVES: Hepatitis A virus (HAV) or hepatitis B virus (HBV) superinfection is associated with an increased mortality in patients with chronic liver diseases (CLD). Despite official recommendations, it was reported that the vaccination rate against HAV is low in patients with chronic hepatitis C infection. To evaluate the situation in patients with autoimmune liver diseases, we conducted a retrospective cohort study. METHODS: Susceptibility to HAV and HBV infections, course of HAV and HBV infections, vaccination rates against HAV and HBV, and efficacy of hepatitis A/B vaccines were evaluated by antibody testing in 225 patients with autoimmune liver diseases during 1,677 person-years. RESULTS: Susceptibility to HAV/HBV infection was 51/86%. Incidence of HAV/HBV infection was 1.3/1.4 per 1,000 person-years. One HAV infection occurred, but the patient recovered spontaneously. Two patients were HBV-infected after receiving an anti-HBc-positive (antibody to hepatitis B core antigen) donor graft during orthotopic liver transplantation, and one of them developed chronic HBV infection. Vaccination rates were 11% (HBV) and 13% (HAV), respectively. Seventy-six percent of the vaccinated patients (HBV vaccine) developed anti-HBs (antibody to hepatitis surface antigen) >or=10 UI/L. Ten out of 13 vaccinated patients, showing a low or nonresponse to hepatitis B vaccine, had concomitant immunosuppressive therapy. Anti-HAV was detectable in all patients after administration of HAV vaccine. CONCLUSIONS: Patients with autoimmune liver diseases have a high susceptibility to HAV and HBV infections. Vaccination rates are low in this patient cohort and efficacy of hepatitis B vaccine is reduced due to immunosuppressive therapy. Improving adherence to vaccine recommendations is essential to prevent HAV and HBV infections in patients with autoimmune liver diseases. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/17970833/Incidence_of_HAV_and_HBV_infections_and_vaccination_rates_in_patients_with_autoimmune_liver_diseases_ L2 - https://Insights.ovid.com/pubmed?pmid=17970833 DB - PRIME DP - Unbound Medicine ER -