Pneumococcal Vaccination: The Response of Patients with Alcoholic Liver Cirrhosis

Pirovino, M; Lydick, Eva; Grob, Peter J.; Arrenbrecht, Stephan; Altorfer, J; Schmid, Martin

doi:10.1002/hep.1840040527

Cited by 35 publications

(12 citation statements)

References 19 publications

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“…Adequate response to pneumococcal vaccine has been established in patients with alcoholic liver disease (19), although similar data are lacking for influenza vaccination. Anti-HAV seroconversion rates are 94 to 98% among patients with compensated liver disease (20,21) and 66% among those with decompensated disease (21).…”

Section: Discussionmentioning

confidence: 99%

Immunization Needs of Chronic Liver Disease Patients Seen in Primary Care Versus Specialist Settings

Jacobs¹,

Meyerhoff²,

Saab³

2005

Dig Dis Sci

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Chronic liver disease patients may benefit from certain vaccines, but their immunization coverage levels have not been widely studied. We examined the serologic and vaccination status of 693 chronic liver disease patients from 37 primary care and specialist centers. Patients in primary care had more often received influenza (47 versus 32%; P < .001) and pneumococcal (39 versus 19%; P < .001) vaccines. Among patients without documented prior exposure, those seeing specialists had more often completed hepatitis A (28 versus 5%; P < .001) and hepatitis B (29 versus 14%; P < .001) vaccination. Coverage was higher in centers with a policy of vaccinating on-site, among non-Hispanic whites, and among patients with hepatitis C and cirrhosis. In summary, most patients were unprotected against one or more vaccine preventable diseases. The higher coverage rates evident in centers vaccinating on-site suggests a breakdown may occur when patients are referred to alternative vaccination venues.

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Section: Discussionmentioning

confidence: 99%

Immunization Needs of Chronic Liver Disease Patients Seen in Primary Care Versus Specialist Settings

Jacobs¹,

Meyerhoff²,

Saab³

2005

Dig Dis Sci

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“…Chronic active hepatitis and primary biliary cirrhosis also predispose to pneumococcal infections, although they are not associated with alcoholism. The antibody response and opsonic titres of cirrhotic patients after inoculation shows an adequate response to the pneumococcal vaccine (Pirovino et al 1984), but its clinical efficacy remains to be proven (Simberkoff et al 1983). …”

Section: Hepatic Diseasementioning

confidence: 98%

Immunogenicity and immunochemistry ofStreptococcus pneumoniae capsular polysaccharides

Dam

Fleer

Snippe

1990

Antonie van Leeuwenhoek

139

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“…Early studies in patients with cirrhosis showed good response to the pneumococcal vaccine. Patients with alcoholic cirrhosis produced adequate titers at 3 months with a 14-valent polysaccharide vaccine (83). Increased antibody and opsonic titers were demonstrated in both serum and ascitic fluids (92).…”

Section: Pneumococcal Vaccinementioning

confidence: 99%

Vaccinations for Adult Solid-Organ Transplant Recipients: Current Recommendations and Protocols

Duchini¹,

Goss²,

et al. 2003

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Recipients of solid-organ transplantation are at risk of severe infections due to their life-long immunosuppression. Despite emerging evidence that vaccinations are safe and effective among immunosuppressed patients, most vaccines are still underutilized in these patients. The efficacy, safety, and protocols of several vaccines in this patient population are poorly understood. Timing of vaccination appears to be critical because response to vaccinations is decreased in patients with end-stage organ disease and in the first 6 months after transplantation. For these reasons, the primary immunizations should be given before transplantation, as early as possible during the course of disease. Vaccination strategy should include vaccination of household contacts and health care workers at transplant centers unless contraindicated. No conclusive data are available on the use of immunoadjuvants and screening for protective titers. Most vaccines appear to be safe in solid-organ transplantation recipients, but live vaccines should be avoided until further studies are available. The risk of rejection appears minimal. Recommended vaccines include pneumovax, hepatitis A and B, influenza, and tetanus-diphtheria. We outline specific protocols and recommendations in this particular patient population. Specific contraindications exist for other vaccines, such as yellow fever, oral polio vaccine, bacillus Calmette-Guerin, and vaccinia. We conclude that solid-organ recipients will benefit from consistent immunization practices. Further studies are recommended to improve established protocols in this patient population

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Pneumococcal Vaccination: The Response of Patients with Alcoholic Liver Cirrhosis

Cited by 35 publications

References 19 publications

Immunization Needs of Chronic Liver Disease Patients Seen in Primary Care Versus Specialist Settings

Immunization Needs of Chronic Liver Disease Patients Seen in Primary Care Versus Specialist Settings

Immunogenicity and immunochemistry ofStreptococcus pneumoniae capsular polysaccharides

Vaccinations for Adult Solid-Organ Transplant Recipients: Current Recommendations and Protocols

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