Prevalence of hepatitis B and A virus markers and vaccination indication in cirrhotic patients evaluated for liver transplantation in Spain

Transplant Proc. 2012 Jul-Aug;44(6):1502-4. doi: 10.1016/j.transproceed.2012.05.020.

Abstract

In the absence of immunity, vaccination against hepatitis A virus (HAV) and hepatitis B virus (HBV) is recommended for patients with chronic liver disease and those evaluated for liver transplantation (OLT) HAV and HBV infections after OLT which are frequent in this setting, are associated with a worse prognosis. The aim of this study was to estimate the need for vaccination against HBV and HAV among cirrhotic patients who were candidates for OLT and associations with gender, age, and etiologic factors. HBV and HAV serological markers HBsAg, anti-HBc, antiHBs, immunoglobulin G (IgG)-anti-HAV were investigated among 568 patients, including 75% men. The overall mean age was 53.6 ± 8.9 years range 17-69, and 20% were diabetic. This etiologies were alcohol (68%), hepatitis C virus (35%) or other causes (10.4%). Child-Pugh classes were: A (26%), B (44%), and C (30%). In contrast with 359 patients (63.2%) who had negative HBV markers, 209 (36.8%) were positive: HBsAg (+), 43 (7.6%), isolated anti-HBc (+), 57 (10%), isolated anti-HBs (+), 19 (3.3%), anti-HBc (+)/anti-HBs (+), 90 (15.8%). HBV vaccine indication was performed in 416 patients (73.2%) who either had negative HBV markers or isolated anti-HBc (+). It was more frequently performed in women (82.3% versus 70.3%, P = .005), albeit with no differences according to age or etiology. There were only 8.2% (44/538) IgG-anti-HAV-negative, an indication for vaccination against HAV, which was more frequent affecting patients who were younger [≤ 45 years (27.6%), 46-55 (7.2%), >55 (2.6%); P < .0001)]; nondiabetic (9.5% versus 2.8%, P = .023); nonalcoholic (11.4% versus 6.6%, P = .056); and displayed negative HBV markers (10.2% versus 4.6%, P = .023). Only three patients with IgG-anti- HAV (-) were over 60 years. In conclusion, there is a frequent indication for HBV vaccination among cirrhotic and especially HAV vaccine for under 45 year old patients undergoing evaluation for OLT.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Biomarkers / blood
  • Female
  • Hepatitis A / diagnosis
  • Hepatitis A / epidemiology
  • Hepatitis A / immunology
  • Hepatitis A / prevention & control*
  • Hepatitis A Antibodies / blood
  • Hepatitis A Vaccines / administration & dosage*
  • Hepatitis B / diagnosis
  • Hepatitis B / epidemiology
  • Hepatitis B / immunology
  • Hepatitis B / prevention & control*
  • Hepatitis B Antibodies / blood
  • Hepatitis B Surface Antigens / blood
  • Hepatitis B Vaccines / administration & dosage*
  • Humans
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / epidemiology
  • Liver Cirrhosis / immunology
  • Liver Cirrhosis / surgery*
  • Liver Transplantation* / adverse effects
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Spain / epidemiology
  • Treatment Outcome
  • Vaccination*
  • Young Adult

Substances

  • Biomarkers
  • Hepatitis A Antibodies
  • Hepatitis A Vaccines
  • Hepatitis B Antibodies
  • Hepatitis B Surface Antigens
  • Hepatitis B Vaccines