Changes in hepatitis A and B vaccination rates in adult patients with chronic liver diseases and diabetes in the united states population.

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Hepatology. 2011 Jul 2. doi: 10.1002/hep.24510. [Epub ahead of print]

Changes in hepatitis A and B vaccination rates in adult patients with chronic

liver diseases and diabetes in the united states population.

Younossi ZM, Stepanova M.

Source

Center for Liver Diseases at Inova Fairfax Hospital; Betty and Guy Beatty Center

for Integrated Research, Inova Health System Falls Church, VA, USA.

zobair.younossi@....

Abstract

BACKGROUND:

Professional societies recommend hepatitis A and hepatitis B immunization for

individuals with chronic liver disease (CLD), but the degree of implementation

is unknown.

METHODS:

Data were obtained from the National Health and Nutrition Examination Surveys

conducted in 1999-2008. For the entire study population and for those with CLD

and diabetes, we determined the rates and independent predictors of history of

hepatitis A and hepatitis B (HepA and HepB) vaccinations, of their

effectiveness, and of sero-prevalence of anti-hepatitis A antibody and

anti-HBsurface antibody.

RESULTS:

24,871 participants from NHANES were included: 14,886 (1999-2004), and 9,985

(2005-2008). Of these individuals, 14.0% had CLD and 8.6% had diabetes. During

the study period, HepA vaccination in CLD increased from 13.3±1.0% to 20.0±1.5%,

HepB vaccination increased from 23.4±1.2% to 32.1±1.5%. Of subtypes of CLD, HepA

vaccination rates increased only in NAFLD, whereas HepB vaccination increased

for hepatitis C and non-alcoholic fatty liver disease. In diabetic cohort, HepA

vaccination rates increased from 9.3±1.1% to 15.4±1.7% and HepB rates increased

from 15.2±1.5% to 22.4±1.7%. All changes were similar to those observed in the

general population. The QM for HepA in the general population decreased from

44.4±1.2% in 1999-2004 to 41.7±1.9% in 2005-2008, and similar changes were noted

for all sub-cohorts. On the other hand, QM for HepB increased from 31.7±0.9% to

40.7±1.0% in the population while no changes in QM were noted in any diagnostic

cohort except for NAFLD.

CONCLUSIONS:

Although vaccination rates in CLD and diabetic cohorts are increasing, they

remain low. Given the public health implications of acute hepatitis A and

hepatitis B in patients with CLD, better implementation of the vaccination

recommendations for these populations is warranted. (HEPATOLOGY 2011.).

Copyright © 2011 American Association for the Study of Liver Diseases.

PMID: 21725988 [PubMed - as supplied by publisher]