VACCINATION STATUS OF PATIENTS WITH CHRONIC LIVER DISEASE FOLLOWED UP AT A REFERENCE CENTER IN BRAZIL

Patients with chronic liver disease (CLD) often experience varying degrees of immune dysfunction, making them vulnerable to multiple preventable infectious diseases through appropriate vaccination.

To evaluate vaccination status and vaccine coverage among patients with chronic liver disease (CLD) receiving care at a tertiary referral center.

This cross-sectional observational study was conducted at the Hepatology Outpatient Clinic of Hospital São Paulo, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, Brazil. A convenience sample of adult patients with different etiologies of CLD was prospectively included. Participants underwent a standardized interview, review of vaccination records, and serological testing for hepatitis A and hepatitis B.

Among 104 patients (61.5% women, median age 51 years), chronic hepatitis C (63.5%) and hepatitis B (10.6%) were the most common causes of CLD. Advanced liver fibrosis was identified in 46.1% of the patients. Vaccination records were available for 82.7% of participants, but only 45.1% showed serological evidence of hepatitis B immunization (anti-HBs positive). Positive anti-HAV IgG serology was detected in 75% of patients, whereas only 14.4% had documented hepatitis A vaccination. Vaccination coverage for other vaccines was as follows: meningococcal conjugate vaccine (8.7%), pneumococcal vaccine PPSV23 (25%), influenza vaccine (53.8%), tetanus-diphtheria vaccine (60.6%), measles-mumps-rubella vaccine (23%), yellow fever vaccine (28.8%), and COVID-19 vaccination coverage was 92.3%.

Vaccination coverage among patients with chronic liver disease remained lower than expected for several recommended vaccines, even in a specialized referral center. These findings highlight the importance of systematic assessment of immunization status and reinforcement of vaccination strategies in patients with chronic liver disease.