Improved hepatitis A and hepatitis B vaccination strategy is necessary for patients with chronic hepatitis C

Introduction Hepatitis C virus(HCV)is a major cause of chronic liver diseases.Hepatitis A virus(HAV)or hepatitis B virus(HBV)infection on pre-existing hepatitis C can lead to significant morbidity and mortality[1].The Advisory Committee on Immunization Practices(ACIP)recommends HAV and HBV vaccination for patients with chronic liver diseases[2,3].Best-practice advice from the American College of Physicians and the Centers for Disease Control and Prevention(CDC)also emphasized the importance of HBV vaccination for at-risk populations[4].The hepatitis B vaccine response,however,is generally lower among patients with chronic liver diseases,especially those with cirrhosis or older age[5,6].In this study,we reported that a high proportion of patients with chronic hepatitis C remained at risk of HAV or HBV infection at their referral to our tertiary Liver Center.