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Hepatitis A > Prevention Author: Catherine M. Dentinger, FNP, MS; Brian J. McMahon, MD, MACP
Editorial changes - 2009-11-04
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Rationale:

  • Persons with chronic liver disease are at increased risk for severe outcomes from hepatitis A.

Evidence:

  • Persons with chronic liver disease are at increased risk for serious outcomes from hepatitis A (72; 73).
  • 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 (74).
  • 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 (33).
  • 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 (75).

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.
  • Chronic liver disease remains an important and preventable contributing cause of death due to hepatitis A.
FAQs
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.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott.

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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