واكسيناسيون هپاتيت A در افراد مبتلا به بيماري مزمن كبدي :تعيين خط مشي واكسيناسيون

Seroepidemiology of hepatits A vites infection among Sari thalasemic patients with chronic liver disease :Implication for HA V vaccination

Background and purpose : Hepatitis A virus (HAY) vaccination has been advised for patients with chronic liver diseases as HAV super infection in these patients can result in severe or even fatal disease . In Iran the indication for HAY vaccination are not clear due to lack of data on HAY seroprevalence in patients with chronic liver diseases. The aim of this study was to determine the prevalence of antibodies directed against HAV in thalasemic patients with chronic liver disease, and develop a cost-effective vaccination strategy. Materials and methods : We reviewed medical records of 780 thalasemic patients at the Bouali-Cina Hospital San -Iran . Demographic and information regarding risk factors were obtained by history and questionnaire administered to all patients. sera were collected from patients with chronic liver disease and were tested for anti-HAY antibodies. Susceptible individuals were vaccinated with HAV vaccine. The cost of vaccination and antibody testing were determined based on standard laboratory and clinic charges in Iran. Results : A total of 240 patients (42 patients with chronic hepatitis C, 198 with secondary hemochromatosis) were tested for anti-HAY antibodies. Of them 90.5% (2171240) were positive for anti-HAY antibody. Cost analysis revealed that prescreening for hepatitis A before vaccination at a prevalence of less than 10% was cost saving. Conclusion : The sero-prevalence of hepatitis A in those with chronic liver diseases was 90.5% , and was found to be similar to that of the general population in Iran. Cost analysis revealed that screening for hepatitis A before immunization is cost saving.