All persons with hepatitis C should be vaccinated against hepatitis A and B.
An editorial in the New England Journal of Medicine warned that fulminant
hepatitis is associated with hepatitis A virus superinfection in Patients
With Chronic Hepatitis C. What this means is that persons with hepatitis
C who get hepatitis A are at significant risk for fulminant hepatitis and
death. From June 1990 to July 1997, the scientists examined 163 adults
with chronic hepatitis B and 432 patients with chronic hepatitis C who
were seronegative for HAV antibodies; tests were conducted every four
months for serum IgM and IgG antibodies to HAV. Over the course of the
study, 10 patients with HBV infections and 17 with HCV infections
acquired HAV superinfection. Of these patients, fulminant hepatic
failure developed in seven of the HCV-infected individuals, six of whom
died. All but one of the HBV patients who developed HAV had
uncomplicated courses. Since HAV infection rarely has a fulminant course
and is usually non-fatal, the scientists note that "the high mortality
rate among our patients with chronic hepatitis C and HAV superinfection
(35 percent) is thus surprising, as is the even higher percentage of such
patients with fulminant hepatitis (41 percent)." The authors suggest,
therefore, that individuals with chronic HCV infection be vaccinated
against the hepatitis A virus. AUTHOR: Vento, Sandro; Garofano, Tiziana;
Renzini, Carlo; et al. SOURCE: New England Journal of Medicine
(01/29/98) Vol. 338, No. 5, P. 286
Patients with chronic hepatitis C who are at risk for hepatitis B should be
offered vaccination during their first contact with healthcare
professionals, according to a report from Great Britain’s University of
Cambridge. ( “Prospective Study of Hepatitis B Vaccination in Patients
with Chronic Hepatitis C,” British Medical Journal, May 25,
1996;312:1336-1337 ).
Chronic hepatitis C (HCV) infection is estimated to occur in between 70- and 92 percent of intravenous drug users. These IV drug users are also at risk for parenterally or sexually transmitted hepatitis B. Coinfection with hepatitis B virus (HBV) may accelerate underlying liver damage due to hepatitis C.
