Hepatitis A vaccination of patients with hepatitis C is insufficient

Few patients with chronic hepatitis C are vaccinated against hepatitis A, despite the recommendations made in this direction, U.S. researchers have found through a study to be published in "Hepatology" magazine.

The vaccine against hepatitis A is available since 1995, but the infection is still one of the most common preventable diseases in the United States. Far from being harmless, it can cause severe hepatitis, liver failure or death in patients who are already suffering from chronic liver disease.

Since 1996, U.S. health authorities also recommend vaccination against hepatitis A for these patients, but it is unclear to what extent this advice is applied.

To find out, Edmund J. Bini and colleagues at the School of Medicine in New York looked at the number of screened and vaccinated against HAV among 1193 patients with chronic HCV infection identified in 2000 individuals and that they were followed for two years. They also examined the number of vaccine doses received, the proportion of patients sensitive to HAV (indicated by the absence of anti-HAV), the incidence of HAV infection during follow-up and the number of medical consultations.

Just over half (53%) of patients had anti-HAV assay, and nearly half of them were susceptible to the virus, the authors report. However, only 94 patients were vaccinated, and among these, 45 received a single dose. Always among the 94 vaccinated patients, 88 had an antibody assay.

A total of 3 patients with HCV infection developed HAV infection, but none had been vaccinated even though they were all known to be susceptible to HAV.

"The low levels of HAV testing and vaccination are striking given that there since 1996 vaccination recommendations of these individuals against HAV that followed was long and the number of visits to a health professional was high , "the authors write for that this reflects missed opportunities for prevention.

As reasons, they evoke a refusal of patients (they believe themselves to be immune to HAV infection, they have doubts about the effectiveness of the vaccine or fear the side effects), a lack of knowledge from health professionals, lack of resources or a lack of time during medical consultations, doctors have more heart to treat the most urgent and obvious health problems of their patients.

They call health authorities to further encourage vaccination against hepatitis A in patients with chronic liver disease..