Raju Bhaskar, Andani Anar, Kolhapure Shafi, Agrawal Ashish
Dr Mehta's Children's Hospital, Chennai, India.
Global Medical Affairs, GSK, Wavre, Belgium.
Hum Vaccin Immunother. 2021 May 4;17(5):1520-1529. doi: 10.1080/21645515.2020.1832408. Epub 2020 Nov 25.
The burden of chronic liver disease (CLD) in India is high, particularly among middle-aged men, with nearly 220,000 deaths due to cirrhosis in 2017. CLD increases the risk of infection, severe disease (e.g. hepatitis A virus or HAV superinfection, acute-on-chronic liver failure, fulminant hepatic failure), and mortality. Hence, various countries recommend HAV vaccination for CLD patients. While historic Indian studies showed high seroprevalences of protective HAV antibodies among Indian adults with CLD, the most recent ones found that nearly 7% of CLD patients were susceptible to HAV infection. Studies in healthy individuals have shown that HAV infection in childhood is decreasing in India, resulting in an increasing population of adults susceptible to HAV infection. As patients with CLD are at increased risk of severe HAV infection, now may be the time to recommend HAV vaccination among people with CLD in India.
印度慢性肝病（CLD）的负担很重，在中年男性中尤为突出，2017年因肝硬化导致近22万人死亡。慢性肝病会增加感染风险、严重疾病（如甲型肝炎病毒或HAV重叠感染、慢加急性肝衰竭、暴发性肝衰竭）以及死亡风险。因此，各国建议为慢性肝病患者接种甲型肝炎疫苗。虽然印度以往的研究表明，患有慢性肝病的印度成年人中保护性甲型肝炎抗体的血清阳性率很高，但最近的研究发现，近7%的慢性肝病患者易感染甲型肝炎病毒。对健康个体的研究表明，印度儿童期甲型肝炎病毒感染率正在下降，导致易感染甲型肝炎病毒的成年人数量增加。由于慢性肝病患者感染严重甲型肝炎病毒的风险增加，现在或许是时候建议在印度的慢性肝病患者中接种甲型肝炎疫苗了。
