Copyright 1998 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
To the Editor.—The Centers for Disease Control and Prevention (CDC) offered 6 recommendations for follow-up protocol of health care workers after occupational exposure to hepatitis C virus (HCV).1 However, the CDC also should consider immediate vaccination against hepatitis A virus as part of these follow-up recommendations.
As the article pointed out, at least 85% of patients with HCV develop chronic liver disease. Patients with chronic liver disease may experience grave consequences if they become infected with other liver diseases, such as hepatitis A. In fact, patients with chronic liver disease infected with hepatitis A are at increased risk for fulminant hepatitis, which may lead to liver failure or even death.
The Food and Drug Administration recently approved Havrix (Smith-Kline Beecham Biologicals, Rixensart, Belguim) as the first vaccine specifically licensed for active immunization against the hepatitis A virus in patients with chronic liver disease. With the vast majority of patients infected with HCV developing chronic liver disease, and the possible fatal consequences of secondary liver infection (such as hepatitis A) in patients with chronic liver disease, vaccination against hepatitis A should be strongly recommended as a follow-up after exposure to HCV.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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