ABSTRACT
Background: Superadded infection with hepatitis B virus [HBV] or hepatitis A virus [HAV] may cause serious consequences for patients with chronic liver disease [CLD]. Therefore, immunization of these patients can reduce the morbidity and mortality associated with cirrhosis. Vaccines against HBV and HAV are available; these vaccines are safe and immunogenic in healthy individuals [and in patients with CLD]
Aim: The aim of the present study was to assess long-term efficacy of HAV and HBV vaccinations in children with CLDs
Patients and methods: Our study included 200 children with CLDs. They were studied both prospectively and retrospectively to evaluate the immunogenicity and longevity of HAV and HBV vaccination during a follow-up period of 5 years. They were divided into two groups according to presence [n=77] or absence [n=123] of cirrhosis
Results: All patients did not lose their immunity against HAV through 5-year follow-up. During the first check up, 65.8% of children were immune against HBV. After 1 year, 14% of cases required booster dose and 7.8% were vaccinated by three doses. At 5 years after vaccination, 66.7% were immune, 18.3% required booster dose, and 12.5% were vaccinated by three doses. Three cases received a course of three double doses because of repeatedly low hepatitis B surface antibody [HBsAb] titer during our follow-up
Conclusion: HAV and HBV vaccines are safe and well tolerated in children with CLD, whether cirrhotic or not. HAV vaccine induces a satisfactory immune response. More frequent doses of HBV vaccine may achieve better results especially with long-term follow-up. There was no statistical difference between cirrhotic and noncirrhotic patients as regards vaccination response
Recommendation: Immunizations against HAV and HBV are recommended in CLD. Postvaccinal HBsAb titer should be checked