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Patients with HBV, HCV should receive hepatitis A vaccination

Physicians should consider administering hepatitis A vaccines to their patients with hepatitis B and those with hepatitis C, according to a commentary published in Gastroenterology.

“Recent large outbreaks of HAV related to foodborne and person-to-person exposures have resulted in substantial rates of morbidity and mortality; these events underscored the relatively low prevalence of immunity against HAV infection among the U.S.-born adult population,” Anne C. Moorman, MPH, from the CDC, and colleagues wrote.

According to Moorman and colleagues, the Advisory Committee on Immunization Practices approved language clarifying that all patients with HCV infection should receive HBV vaccination and physicians should consider HAV vaccinations for all patients with HBV and HCV infections.

The authors reviewed data from a variety of sources, including national survey and observational cohort data like the Chronic Hepatitis Cohort Study and the National Health and Nutrition Examination Survey. While HAV immunity among U.S. adults varied, the authors found that the rate of HAV protection among U.S. adults is overall poor, particularly for vulnerable populations with underlying chronic liver disease.

Specifically, 32.6% of patients with HBV and 33.6% of patients with HCV were never tested for HAV. Among those who had been tested, 58.9% of patients with HBV and 39.2% of those with HCV were anti-HAV positive. Additionally, 60.4% of patients with HBV and 62% of those with HCV who tested negative for anti-HAV never received follow-up vaccination.

“These findings, from multiple populations, support current guideline efforts to improve rates of screening for immunity to HAV and subsequent vaccination of vulnerable populations of patients with chronic viral hepatitis,” Moorman and colleagues concluded. – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.