Hepatitis A vaccination in patients with chronic liver disease in Taiwan

While hepatitis A infection is rarely fatal, mortality is age-dependent, suggesting that cofactors may play a role in disease expression. The safety and immunogenicity of an inactivated hepatitis A vaccine was evaluated in a study involving 60 patients with chronic liver disease (CLD) (56 patients with chronic hepatitis B, and four patients with chronic hepatitis C). A two-dose schedule, at 0 and 6 months, produced 100% seroconversion. All individuals remained seropositive for 12 months, the majority maintaining high levels of antibody during a 5-year follow-up period. The inactivated hepatitis A vaccine was found to be well tolerated and immunogenic in patients with CLD. However, the immune response generated was inferior to that observed in healthy individuals, indicating the need for a higher dose, and the two-dose schedule to ensure adequate protection.