الفهرس 
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Abstract
Internationally, chronic hepatitis B (HBV) and C virus (HCV) infections are a serious public health concern. Patients with mild to moderate chronic liver disease have high sero-conversion rates for the HBV vaccine, but their efficacy declines as the disease progresses. This study’s goals are to assess the effectiveness of hepatitis B immunisation in patients with HCV-related chronic liver disease and to pinpoint potential causes of hyporesponsiveness in those patients.
This study was an observational clinical study carried out at the Endemic Medicine Department, Liver and Digestive system center, Minia University hospital. It was conducted on 100 individuals (80 chronic HCV patients and 20 healthy controls). Individuals were divided into 5 groups: A (control group), B (cirrhotic patient not receiving treatment), C (chronic hepatitis patients receiving treatment), D (cirrhotic patients receiving treatment), and E (HCC patients receiving treatment). All individuals were subjected for comprehensive history taking, clinical examination, laboratory investigations, and assessment of anti-HBs Abs titer.
The study showed an inverse relationship between the level of anti-HBs Abs and the duration of vaccine. Age, gender and smoking have statistically non-significant effect on serum anti-HBs Abs titer while diabetes and liver disease severity have statistically significant effect on serum anti-HBs Abs titer. Diabetes and severity of liver disease are independently associated with anti-HBs antibodies titer. Oral DAAs therapy is associated with lower response to HBV vaccine.
In conclusion, HCV infection and its complications significantly impair HBV vaccine response. Levels of anti-HBs Abs decline progressively with increasing duration from the last dose in immunization schedule of HBV vaccine. Diabetes and severity of liver disease being the main risk factors for vaccine hypo-responsiveness, also oral DAAs therapy is associated with reduced response to HBV vaccin