Prevalence of Hepatitis A and B Markers and Vaccine Indication in Cirrhotic Patients Evaluated for Liver Transplantation in Spain

Abstract Vaccination against hepatitis A virus (HAV) and hepatitis B virus (HBV) is generally recommended for patients with chronic liver disease and those evaluated for liver transplantation in the absence of immunity. HAV and HBV infections after liver transplantation are frequent and associated w...

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Bibliographic Details
Published in:Transplantation proceedings 2008-11, Vol.40 (9), p.2946-2948
Main Authors: Aoufi, S, Pascasio, J.M, Sousa, J.M, Sayago, M, Ferrer, M.T, Gómez-Delgado, E, De la Cruz, M.D, Álamo, J.M, Gómez-Bravo, M.A, Bernardos, A, Márquez, J.L
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Biological and medical sciences
Biomarkers - analysis
Epidemiology
Female
Fundamental and applied biological sciences. Psychology
Fundamental immunology
General aspects
Hepatitis A - epidemiology
Hepatitis A - immunology
Hepatitis A Vaccines
Hepatitis B - epidemiology
Hepatitis B - immunology
Hepatitis B Surface Antigens - analysis
Hepatitis B Vaccines
Humans
Liver Cirrhosis - surgery
Liver Cirrhosis - virology
Liver Transplantation - statistics & numerical data
Liver, biliary tract, pancreas, portal circulation, spleen
Male
Medical sciences
Middle Aged
Public health. Hygiene
Public health. Hygiene-occupational medicine
Spain
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Tissue, organ and graft immunology
Young Adult
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Summary:Abstract Vaccination against hepatitis A virus (HAV) and hepatitis B virus (HBV) is generally recommended for patients with chronic liver disease and those evaluated for liver transplantation in the absence of immunity. HAV and HBV infections after liver transplantation are frequent and associated with a worse prognosis. The data suggest that the number of patients with chronic liver disease without naturally acquired immunity against HAV and HBV is substantial, and that new vaccination strategies are needed. The aim of this study was to determine the level of immunity from hepatitis A and B infections and the need for HBV and HAV vaccination among cirrhotic patients evaluated for liver transplantation. We studied HBV and HAV serological markers (HbsAg, anti-HBc, anti-HBs, IgG anti-HAV) in 451 cirrhotic patients evaluated for liver transplantation to investigate the association with gender, age, and etiology of cirrhosis. Negative HBV markers were observed in 57% of patients with 43% displaying one positive HBV marker: HBsAg (+), 9.5%; anti-HBc (+)/anti-HBs (−), 11.5%; anti-HBc (−)/anti-HBs(+), 4.2%; anti-HBc(+)/anti-HBs(+), 17.7%. HBV vaccine indication established in 68.5% of patients was greater among women and hepatitis C virus-negative patients. No differences were observed in age or cause of cirrhosis. HAV vaccination indicated in 6.7% of patients (IgG anti-HVA-negative) was greater among patients with negative HBV markers (9.3% vs 3.3%, P = .018) and younger patients (25.3% of patients ≤45 years). In conclusion, there are frequent indication, for HBV vaccine among cirrhotic patients evaluated for liver transplantation, as is time for HAV vaccine, especially among patients younger than 45 years of age.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2008.09.015