SCREENING AND VACCINATION AGAINST HEPATITIS A IN PEDIATRIC CHRONIC LIVER DISEASE PATIENTS

Abstract

Background: Superadded HAV infection in patients with chronic liver disease (CLD) or cirrhosis may result in further deterioration of liver functions causing acute on chronic liver failure. The Center for disease control (CDC) strongly recommends to vaccinate all CLD patients against HAV. Methods: All pediatric patients with chronic liver disease for >6 months, after informed consent from their parents were enrolled. HAV immunity was defined as the qualitative presence of HAV IgG antibody (?1.00 reactive) in the serum blood test. All patients with negative HAV IgG were subjected to HAV vaccination and adverse events were also noted. Results: A total of 30 pediatric CLD patients with a mean age of 9.3 ± 3.9 years were enrolled. Majority of participants were males n=19 (63.3%). The overall prevalence of positive HAV serology (IgG) was 86.7 %. Three participants with negative HAV serology received a series of two vaccines, 6 months apart and HAV IgG titers were checked at 4 weeks after the first and second dose of vaccination. Despite two doses of vaccine satisfactory titer levels could not be achieved. Conclusion: This is the first study from Pakistan in which pediatric CLD patients were evaluated for HAV exposure. Early vaccination is advisable in such patients as advanced liver disease patients may not achieve adequate titers.