Patients with chronic liver disease and especially cirrhosis are at increased risk to develop severe liver failure and die if they develop acute viral hepatitis A or B. Viral hepatitis A and B are also more severe with increasing age. It is therefore recommended that all patients with chronic liver disease be vaccinated against viral hepatitis A and B. A combination vaccine for both viral hepatitis A and B is available. Vaccination is effective and results in the production of protective antibodies in about 97% of otherwise healthy patients. Vaccination appears to be less effective in patients with chronic liver disease and cirrhosis.
Patients come in contact with hepatitis B virus (HBV) through intimate sexual contact, by sharing injection drugs and other items of personal hygiene with persons who are unaware they are already infected with HBV. The Center for Disease control currently now recommends that all persons be vaccinated for HBV prior to entering school. Unfortunately, the majority of teenagers and adults did not receive HBV vaccine when they were young and remain at risk for developing HBV if exposed.
HAV is uncommon in the USA but is very common in many counties of the world where Americans vacation. This includes most Carribean Islands, Mexico and may part of Africa and Asia. Americans who travel to these areas of the world should therefore be vaccinated against HAV to prevent them from developing an infection. In addition, all patients with chronic liver disease and especially all patients with cirrhosis should also be vaccinated against HAV. HAV vaccination is highly effective. Over 98% of persons respond to 2 doses of vaccine administered one month apart.
Vaccination for viral hepatitis A and B is available for all patients and their family members at the Liver Institute of Virginia.