Author information
1Department of Tropical and Infectious Diseases, Policlinico Umberto I, Roma, Italy.
2Liver Unit, Cardarelli Hospital, Naples, Italy.
3Department of Gastroenterology, Ospedale Molinette, Torino, Italy.
4Gastroenterology Unit, Fondazione Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy.
5Internal Medicine Unit, Policlinico S. Pietro, Bergamo, Italy.
6Department of Digestive and Liver Diseases, S. Andrea Hospital and School of Medicine, Rome.
7Department of Gastroenterology, Ospedale Niguarda, Milano, Italy.
8Department of Clinical Medicine and Surgery, Gastroenterology and Hepatology Unit, University of Naples Federico II, Italy. Electronic address: filomena.morisco@unina.it.
9Clinic of Infectious Diseases, University of Sassari, Italy.
10National Health Institute, National Center for Global Health, Rome, Italy.
11Clinic of Infectious Diseases, University of Naples, Italy.
Abstract
Background: in Italy, Hepatitis-B-vaccine is advised and provided free-of-charge for subjects with chronic liver disease (CLD), including liver cirrhosis.
Aims: to evaluate HB-vaccine-coverage and variables associated with lack of vaccination in cirrhotic patients with particular attention to cirrhosis' etiology.
Methods: cirrhotic patients of any etiology (excluding HBsAg+) referring to 8 tertiary-centers were prospectively enrolled for a-six-months-period in 2019. Subjects were asked if they received HB-vaccine previously. Multiple-logistic-regression-analysis was performed to identify independent predictors of lack of vaccination.
Results: 731 cases were recruited. Overall-vaccine-coverage was 16.3% (23.7% in those younger than 65y, 10.0% in those older than 64y; p<0.001). Lack of information was the most frequent reason (78.5% of cases) reported by the 608 unvaccinated subjects, without statistical difference by area-of-birth (77.3% in Italians, 80.0% in people-born-abroad). Age>64 y (OR: 4.27; CI 95%: 2.52-7.24), educational level<9 years (OR: 3.52; CI 95%: 2.10-5.90), residence in South/Sardinia (OR 2.52; CI 95%:1.45-4.39), birth-abroad (OR 5.09; CI 95%: 1.07-24-.17), and Child grade B/C(OR 2.68; CI 95%: 1.35-5.33) all resulted independent predictors of likelihood of lack of vaccination.
Conclusions: Vaccination-rate in cirrhotic patients results very low. Vaccine-coverage implementation in these subjects, is warranted. Vaccine should be provided in early CLD, when immunization is most effective.