Vaccination in patients with cirrhosis

Patients with cirrhosis are immunocompromised and hove an increased risk of infection, with a worse outcome. Some of those infections may be prevented by vaccination. Immunization con reduce the morbidity and mortality associated with cirrhosis. Immunizations against hepatitis A and 8 viruses, influenza and pneumococcus are recommended by the French Haute Autorite de Sante since 2007. Vaccination against hepatitis A is recommended in non-immunized cirrhotic patients. Vaccination agasint hepatitis B is recommended in every cirrhotic patient with no serological markers, and post-vaccinal antibodies titer should be checked. Annual influenza immunization con be done in cirrhotic patients, and pneumococcal polysaccharide vaccination should be repeted after 5 years. Few data regarding vaccination coverage are available, but studies suggest that immunization rates are too low in this population