Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016:2016:5795712.
doi: 10.1155/2016/5795712. Epub 2016 Apr 30.

Vaccinating Adult Patients with Cirrhosis: Trends over a Decade in the United States

Abhijeet Waghray  1 , Nisheet Waghray  2 , Hicham Khallafi  2 , K V Narayanan Menon  3
Affiliations

Vaccinating Adult Patients with Cirrhosis: Trends over a Decade in the United States

Abhijeet Waghray et al. Gastroenterol Res Pract. 2016.

Abstract

Introduction. The progression of chronic liver disease to cirrhosis involves both innate and adaptive immune system dysfunction resulting in increased risk of infectious complications. Vaccinations against pneumococcus, hepatitis A virus (HAV), and hepatitis B virus (HBV) are well tolerated and effective in disease prevention and reduction in morbidity and mortality. Prior studies assessing vaccination rates in patients with cirrhosis have specific limitations and to date no study has provided a comprehensive evaluation of vaccination rates in patients with cirrhosis in the United States. Aim. This study assessed vaccination rates for pneumococcus, HAV, and HBV in patients with cirrhosis. Results. Overall 59.7% of patients with cirrhosis received at least 1 vaccination during the study period. Vaccination rates within the same or following year of cirrhosis diagnosis were 19.9%, 7.7%, and 11.0% against pneumococcus, HAV, and HBV, respectively. Trend analysis revealed significant increases in vaccination rates for pneumococcus in all patients with cirrhosis and within subgroups based on age, gender, and presence of concomitant diabetes. Conclusion. The study demonstrated that vaccination rates in patients with cirrhosis remain suboptimal. Ultimately, the use of electronic medical record (EMR) reminders improved communication between healthcare professionals and public health programs to increase awareness are fundamental to reducing morbidity, mortality, and health-care related costs of vaccine preventable diseases in patients with cirrhosis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Vaccinations assessed in patients with cirrhosis.
Figure 2
Figure 2
Percentage of total cirrhotics vaccinated between 2004 and 2013. Time represented as years of vaccination (same or following year of cirrhosis diagnosis).
Figure 3
Figure 3
Percentage of cirrhotics with concurrent diabetes vaccinated between 2004 and 2013. Time represented as years of vaccination (same or following year of cirrhosis diagnosis).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Arvaniti V., D'Amico G., Fede G., et al. Infections in patients with cirrhosis increase mortality four-fold and should be used in determining prognosis. Gastroenterology. 2010;139(4):1246–1256.e5. doi: 10.1053/j.gastro.2010.06.019. - DOI - PubMed
    1. Liaw Y.-F., Yeh C.-T., Tsai S.-L. Impact of acute hepatitis B virus superinfection on chronic hepatitis C virus infection. The American Journal of Gastroenterology. 2000;95(10):2978–2980. doi: 10.1016/s0002-9270(00)01129-1. - DOI - PubMed
    1. Bonnel A. R., Bunchorntavakul C., Reddy K. R. Immune dysfunction and infections in patients with cirrhosis. Clinical Gastroenterology and Hepatology. 2011;9(9):727–738. doi: 10.1016/j.cgh.2011.02.031. - DOI - PubMed
    1. Wiest R., Lawson M., Geuking M. Pathological bacterial translocation in liver cirrhosis. Journal of Hepatology. 2014;60(1):197–209. doi: 10.1016/j.jhep.2013.07.044. - DOI - PubMed
    1. Ghassemi S., Garcia-Tsao G. Prevention and treatment of infections in patients with cirrhosis. Best Practice and Research: Clinical Gastroenterology. 2007;21(1):77–93. doi: 10.1016/j.bpg.2006.07.004. - DOI - PubMed

LinkOut - more resources