Vaccination Against Hepatitis A Has Been Most Neglected Among People With Liver Disease

A New Vaccine for Risk Groups

The groups most at risk of COVID-19 infection remain the same as during the pandemic. These include people over 65 years of age who are generally frail for any reason, or those suffering from chronic diseases that weaken the immune system —⁠ for example, oncological, autoimmune, or pulmonary conditions. A combination of several risk factors from the category of lifestyle diseases, such as diabetes, obesity, and hypertension, can also be dangerous.

A new vaccine is now available for these groups, which, according to MUDr. Chrdle, should “work well” against the current variant of SARS-CoV-2. He recommends using it for annual booster vaccination in representatives of the above-mentioned groups (classified as desirable).

“People sometimes say they are tired of hearing about ‘covid’ —⁠ but unfortunately, covid is not tired of us. It has become part of our lives, especially in the autumn months,” he reminds us. Among hospitalized patients, it manifests similarly to previous years —⁠ mainly as general weakness, dehydration, confusion, or sometimes pneumonia.

Testing for the presence of the virus is currently recommended primarily for people over 65, as a positive result is a prerequisite for prescribing antiviral medication. “For others, testing makes sense when they are around someone vulnerable and do not want to infect them. We live in a time when no mandatory anti-epidemic measures are in place, but we expect people to show responsibility and consideration for others by voluntarily following infection-prevention principles,” adds MUDr. Chrdle.

The Importance of Prevention

The current epidemiological situation is particularly unsatisfactory in the case of hepatitis A, despite the availability of an effective and well-tolerated vaccine. According to MUDr. Chrdle, preventive vaccination has been underestimated, especially among people with liver diseases.

“There are many people out there with undiagnosed liver cirrhosis, but if we vaccinated those we already know about, we could save several lives,” he appealed to fellow physicians. One reason is that the vaccine is not covered by public health insurance, although reimbursement is possible through preventive care programs offered by insurance companies.

Preventive hygiene measures against the spread of infection (such as handwashing and cleaning potential transmission areas) are also essential. According to MUDr. Chrdle, these should be followed voluntarily and consistently —⁠ “even when no one is watching.” And what does he recommend in case of infection for a smooth recovery? Above all, complete abstinence from alcohol. Maintaining a liver-friendly diet and reducing physical exertion are, in his view, secondary. The importance of diet is often overestimated, he says, while moderate exercise may actually help restore one’s previous condition.

Proactive Testing for Hepatitis C

According to MUDr. Chrdle, a proactive approach is needed when testing for the presence of the hepatitis C virus —⁠ silent fibrosis may be progressing in the liver, potentially leading to cirrhosis. This is despite the availability of highly effective treatments capable of complete cure. Testing is recommended once or twice a year in the traditionally defined group of injection-drug users.

However, it may also be appropriate for men who have sex with men, people from countries with a high prevalence of hepatitis C (such as parts of southern or eastern Europe) or those who have resided there long-term, and for individuals who received a blood transfusion in the Czech Republic before 1992 or at any time abroad. Elevated liver transaminase levels should also prompt testing.

Editorial Team, Medscope.pro