واکسیناسیون هپاتیت A در افراد مبتلا به بیماری مزمن کبدی: تعیین خط مشی واکسیناسیون

Background and purpose : Hepatitis  virus (HÂV) vaccination has been advised for patients with chronic liver diseases as HÂV super infection in these patients can result in severe or even fatal disease . Ïn Ïran the indication for HÂV vaccination are not clear due to lack of data on HÂV seroprevalence in patients with chronic liver diseases. The aim of this study was to determine the prevalence of antibodies directed against HÂV in thalasemic patients with chronic liver disease, and develop a cost-effective vaccination strategy. Materials and methods : We reviewed medical records of 780 thalasemic patients at the Bouali-Çina Hospital Sari –Ïran . Demographic and information regarding risk factors were obtained by history and questionnaire administered to all patients. Sera were collected from patients with chronic liver disease and were tested for anti-HÂV antibodies. Susceptible individuals were vaccinated with HÂV vaccine. The cost of vaccination and antibody testing were determined based on standard laboratory and clinic charges in Ïran. Results :  total of 240 patients (42 patients with chronic hepatitis Ç, 198 with secondary hemochromatosis) were tested for anti-HÂV antibodies. Ôf them 90.5% (217/240) were positive for anti-HÂV antibody. Çost analysis revealed that prescreening for hepatitis  before vaccination at a prevalence of less than 10% was cost saving. Çonclusion : The sero-prevalence of hepatitis  in those with chronic liver diseases was 90.5% , and was found to be similar to that of the general population in Ïran. Çost analysis revealed that screening for hepatitis  before immunization is cost saving.