Changes in hepatitis A and B vaccination rates in adult patients with chronic liver diseases and diabetes in the United States population

July 6, 2011

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

liver diseases and diabetes in the united states population

Hepatology, 07/05/2011

Younossi ZM et al. - Although vaccination rates in chronic liver disease (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.

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, authors

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.

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