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Rationale:
- Persons with chronic liver disease are at increased risk for severe outcomes from hepatitis A.
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Evidence:
- Persons with chronic liver disease are at increased risk for serious outcomes from hepatitis A (64; 65).
- In a multicenter trial of 475 persons, including healthy subjects and subjects with chronic liver disease, hepatitis A vaccine
was found to be safe and immunogenic (66).
- In a study of 34 pediatric patients with chronic liver disease and 55 pediatric control subjects, hepatitis A vaccine was
found to be safe and immunogenic (67).
- Forty-nine children with HCV or HBV infection responded well to two doses of hepatitis A vaccine. Long-term protection among
these children is not known (68).
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Comments:
- The ACIP does not recommend routine vaccination of persons with chronic hepatitis B or C in the absence of chronic liver disease.
- The National Institutes of Health Consensus Development Conference Statement Management of Hepatitis C: 2002 recommends immunizing all persons with hepatitis C with hepatitis A vaccine.
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Brian J. McMahon, MD, MACP has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Catherine M. Dentinger, FNP, MS has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
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The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
or PDFs may rapidly become obsolete. Therefore, PIER users should
compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
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PIER is copyrighted (c) 2008 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
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Hepatitis A
> Prevention
