VACCINATION STATUS OF PATIENTS WITH CHRONIC LIVER DISEASE FOLLOWED UP AT A REFERENCE CENTER IN BRAZIL.

BACKGROUND: Patients with chronic liver disease (CLD) often experience varying degrees of immune dysfunction, making them vulnerable to multiple preventable infectious diseases through appropriate vaccination. OBJECTIVE: To evaluate vaccination status and vaccine coverage among patients with chronic liver disease (CLD) receiving care at a tertiary referral center. METHODS: This cross-sectional observational study was conducted at the Hepatology Outpatient Clinic of Hospital São Paulo, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, Brazil. A convenience sample of adult patients with different etiologies of CLD was prospectively included. Participants underwent a standardized interview, review of vaccination records, and serological testing for hepatitis A and hepatitis B. RESULTS: Among 104 patients (61.5% women, median age 51 years), chronic hepatitis C (63.5%) and hepatitis B (10.6%) were the most common causes of CLD. Advanced liver fibrosis was identified in 46.1% of the patients. Vaccination records were available for 82.7% of participants, but only 45.1% showed serological evidence of hepatitis B immunization (anti-HBs positive). Positive anti-HAV IgG serology was detected in 75% of patients, whereas only 14.4% had documented hepatitis A vaccination. Vaccination coverage for other vaccines was as follows: meningococcal conjugate vaccine (8.7%), pneumococcal vaccine PPSV23 (25%), influenza vaccine (53.8%), tetanus-diphtheria vaccine (60.6%), measles-mumps-rubella vaccine (23%), yellow fever vaccine (28.8%), and COVID-19 vaccination coverage was 92.3%. CONCLUSION: Vaccination coverage among patients with chronic liver disease remained lower than expected for several recommended vaccines, even in a specialized referral center. These findings highlight the importance of systematic assessment of immunization status and reinforcement of vaccination strategies in patients with chronic liver disease.