Why actively promote vaccination in patients with cirrhosis?

[Guest guest]

http://www.journalofclinicalvirology.com/article/PIIS1386653209001899/abstract?r\

ss=yes

Articles in Press

Why actively promote vaccination in patients with cirrhosis?

Pierre Loulergueabc, Stanislas Polad, Malletad, Philippe Sogniad, Odile

Launayabc, for the GEVACCIM Group1

Received 24 April 2009; accepted 1 May 2009. published online 05 June 2009.

Corrected Proof

Abstract

Patients with cirrhosis are immunocompromised and have an increased risk of

infection, with a worse outcome. Some of those infections may be prevented by

vaccination. Immunization can reduce the morbidity and mortality associated with

cirrhosis. Immunizations against hepatitis A and B viruses, influenza and

pneumococcus are recommended by the French Haute Autorité de Santé since 2007.

Vaccination against hepatitis A is recommended in non-immunized cirrhotic

patients. Vaccination against hepatitis B is recommended in every cirrhotic

patient with no serological markers, and post-vaccinal antibodies titer should

be checked. Annual influenza immunization can be done in cirrhotic patients, and

pneumococcal polysaccharide vaccine should be repeated after 3–5 years. Few data

regarding vaccination coverage are available, but studies suggest that

immunization rates are too low in this population.

Keywords: Cirrhosis, Vaccine, Hepatitis A, Hepatitis B, Pneumococcal, Influenza

a Université Paris Descartes, Faculté de médecine, Paris, France

b INSERM, CIC BT 505, Paris, France

c Assistance Publique – Hôpitaux de Paris (AP-HP), Groupe Hospitalier

Cochin-Saint de , CIC de Vaccinologie Cochin Pasteur, Pôle de

Médecine, Paris, France

d AP-HP, Groupe Hospitalier Cochin-Saint de , Unité d’Hépatologie,

INSERM U 567, Paris, France

Corresponding author at: 27, rue du Faubourg St Jacques, 75679 Paris Cedex 14,

France. Tel.: +33 11 58 41 28 58; fax: +33 11 58 41 29 10.

1 GEVACCIM group: Groupe d’étude sur la vaccination des sujets immunodéprimés

(GEVACCIM); coordination O. Launay (Hôpital Cochin, Paris), members: T. Ancelle

(Hôpital Cochin, Paris), J.B. Armangaud (Hôpital Ambroise Paré, Boulogne), Y.

Calmus (Hôpital Cochin, Paris), P.H. Consigny (Centre Médical, Institut Pasteur,

Paris), C. Couzigou (Hôpital Brousse, Villejuif), P. Duchet Niedziolka

(Hôpital Cochin, Paris), A. Gergely (Centre Médical, Institut Pasteur, Paris),

M. Goudal (Centre Médical, Institut Pasteur, Paris), T. Hanslik (Hôpital

Ambroise Paré, Boulogne), S. Kerneis (Hôpital Cochin, Paris), O. Launay (Hôpital

Cochin, Paris), O. Lortholary (Hôpital Necker, Paris), P. Loulergue (Hôpital

Cochin, Paris), M.F. Mazmer (Hôpital Necker, Paris), D. Salmon Céron (Hôpital

Cochin, Paris), D. Van der Vliet (Hôpital Cochin et Centre Médical, Institut

Pasteur, Paris), D. Vittecoq (Hôpital Brousse, Villejuif), C. Voyer

(Hôpital Brousse, Villejuif), B. Wyplosz (Hôpital Brousse, Villejuif).

PII: S1386-6532(09)00189-9

doi:10.1016/j.jcv.2009.05.006

[Guest guest]

http://www.journalofclinicalvirology.com/article/PIIS1386653209001899/abstract?r\

ss=yes

Articles in Press

Why actively promote vaccination in patients with cirrhosis?

Pierre Loulergueabc, Stanislas Polad, Malletad, Philippe Sogniad, Odile

Launayabc, for the GEVACCIM Group1

Received 24 April 2009; accepted 1 May 2009. published online 05 June 2009.

Corrected Proof

Abstract

Patients with cirrhosis are immunocompromised and have an increased risk of

infection, with a worse outcome. Some of those infections may be prevented by

vaccination. Immunization can reduce the morbidity and mortality associated with

cirrhosis. Immunizations against hepatitis A and B viruses, influenza and

pneumococcus are recommended by the French Haute Autorité de Santé since 2007.

Vaccination against hepatitis A is recommended in non-immunized cirrhotic

patients. Vaccination against hepatitis B is recommended in every cirrhotic

patient with no serological markers, and post-vaccinal antibodies titer should

be checked. Annual influenza immunization can be done in cirrhotic patients, and

pneumococcal polysaccharide vaccine should be repeated after 3–5 years. Few data

regarding vaccination coverage are available, but studies suggest that

immunization rates are too low in this population.

Keywords: Cirrhosis, Vaccine, Hepatitis A, Hepatitis B, Pneumococcal, Influenza

a Université Paris Descartes, Faculté de médecine, Paris, France

b INSERM, CIC BT 505, Paris, France

c Assistance Publique – Hôpitaux de Paris (AP-HP), Groupe Hospitalier

Cochin-Saint de , CIC de Vaccinologie Cochin Pasteur, Pôle de

Médecine, Paris, France

d AP-HP, Groupe Hospitalier Cochin-Saint de , Unité d’Hépatologie,

INSERM U 567, Paris, France

Corresponding author at: 27, rue du Faubourg St Jacques, 75679 Paris Cedex 14,

France. Tel.: +33 11 58 41 28 58; fax: +33 11 58 41 29 10.

1 GEVACCIM group: Groupe d’étude sur la vaccination des sujets immunodéprimés

(GEVACCIM); coordination O. Launay (Hôpital Cochin, Paris), members: T. Ancelle

(Hôpital Cochin, Paris), J.B. Armangaud (Hôpital Ambroise Paré, Boulogne), Y.

Calmus (Hôpital Cochin, Paris), P.H. Consigny (Centre Médical, Institut Pasteur,

Paris), C. Couzigou (Hôpital Brousse, Villejuif), P. Duchet Niedziolka

(Hôpital Cochin, Paris), A. Gergely (Centre Médical, Institut Pasteur, Paris),

M. Goudal (Centre Médical, Institut Pasteur, Paris), T. Hanslik (Hôpital

Ambroise Paré, Boulogne), S. Kerneis (Hôpital Cochin, Paris), O. Launay (Hôpital

Cochin, Paris), O. Lortholary (Hôpital Necker, Paris), P. Loulergue (Hôpital

Cochin, Paris), M.F. Mazmer (Hôpital Necker, Paris), D. Salmon Céron (Hôpital

Cochin, Paris), D. Van der Vliet (Hôpital Cochin et Centre Médical, Institut

Pasteur, Paris), D. Vittecoq (Hôpital Brousse, Villejuif), C. Voyer

(Hôpital Brousse, Villejuif), B. Wyplosz (Hôpital Brousse, Villejuif).

PII: S1386-6532(09)00189-9

doi:10.1016/j.jcv.2009.05.006