Vaccination in Chronic Liver Disease: An Update.
Vaccination in Chronic Liver Disease: An Update.
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DOI：
10.1016/j.jceh.2021.12.003
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发表时间：
2022-05
影响因子：
3
通讯作者：
Thuluvath PJ
中科院分区：
文献类型：
--
作者：
Alukal JJ;Naqvi HA;Thuluvath PJ
患有或不患有肝硬化的慢性肝病（CLD）患者在感染病毒或细菌病原体时仍面临发生肝功能失代偿的风险。免疫实践咨询委员会 (ACIP) 目前建议慢性肺病患者接种甲型肝炎病毒 (HAV)、乙型肝炎病毒 (HBV)、流感、肺炎球菌、带状疱疹、破伤风、白喉、百日咳和 SARS-CoV-2 疫苗。灭活疫苗优于减毒活疫苗，特别是对于禁忌使用活疫苗的移植受者。随着肝病严重程度的加重，疫苗功效会下降，因此，理想情况下应在病程早期接种疫苗，以获得最佳免疫反应。尽管提出了强烈建议，慢性肺病的总体疫苗接种覆盖率仍然很低；然而，令人鼓舞的是，近年来流感和肺炎球菌的覆盖率有所改善。获得医疗保健的机会不足、缺乏疫苗安全信息、医疗保健提供者的财务报销不佳以及疫苗错误信息往往是导致免疫率低的原因。这篇综述总结了疫苗可预防疾病对慢性肺病患者的影响、更新的疫苗指南、疫苗接种者的血清转化率以及医疗保健专业人员在对肝病患者进行免疫接种时面临的障碍。
Patients with chronic liver disease (CLD) with or without cirrhosis remain at risk of developing hepatic decompensation when infected with viral or bacterial pathogens. The Advisory Committee on Immunization Practices (ACIP) currently recommends vaccination in CLD against hepatitis A virus (HAV), hepatitis B virus (HBV), influenza, pneumococcus, herpes zoster, tetanus, diphtheria, pertussis, and SARS-CoV-2. Inactivated vaccines are preferred over live attenuated ones, especially in transplant recipients where live vaccines are contraindicated. As the severity of the liver disease progresses, vaccine efficacy declines, and therefore, vaccines should be ideally administered early in the disease course for optimal immune response. Despite the strong recommendations, overall vaccination coverage in CLD remains poor; however, it is encouraging to note that in recent years coverage against influenza and pneumococcus has shown some improvement. Inadequate access to healthcare, lack of information on vaccine safety, poor financial reimbursement for healthcare providers, and vaccine misinformation are often responsible for low immunization rates. This review summarizes the impact of vaccine-preventable illness in those with CLD, updated vaccine guidelines, seroconversion rates in the vaccinated, and barriers faced by healthcare professionals in immunizing those with liver disease.
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影响因子：
5.5
作者：
Balloni, A;Assael, BM;Luraschi, C
通讯作者：
Luraschi, C
DOI：
10.1002/lt.500040208
发表时间：
1998-03-01
期刊：
LIVER TRANSPLANTATION AND SURGERY
影响因子：
--
作者：
Chalasani, N;Smallwood, G;Boyer, TD
通讯作者：
Boyer, TD
DOI：
10.1056/nejmoa2035389
发表时间：
2021-02-04
期刊：
The New England journal of medicine
影响因子：
--
作者：
Baden LR;El Sahly HM;Essink B;Kotloff K;Frey S;Novak R;Diemert D;Spector SA;Rouphael N;Creech CB;McGettigan J;Khetan S;Segall N;Solis J;Brosz A;Fierro C;Schwartz H;Neuzil K;Corey L;Gilbert P;Janes H;Follmann D;Marovich M;Mascola J;Polakowski L;Ledgerwood J;Graham BS;Bennett H;Pajon R;Knightly C;Leav B;Deng W;Zhou H;Han S;Ivarsson M;Miller J;Zaks T;COVE Study Group
通讯作者：
COVE Study Group
影响因子：
--
作者：
Duchini, A;Viernes, ME;Pockros, PJ
通讯作者：
Pockros, PJ
影响因子：
29.4
作者：
FERAY, C;GIGOU, M;BRECHOT, C
通讯作者：
BRECHOT, C