title: Annual influenza vaccination reduces total hospitalization in patients with chronic hepatitis B virus infection: A population-based analysis.
abstract: BACKGROUND
  This study evaluated hospitalization and mortality in patients with chronic hepatitis B virus infection (HBV (+)) and matched comparison patients after stratifying the patients according to annual influenza vaccination (Vaccine (+)).
  
  
  METHODS
  Data from Taiwan's National Health Insurance program from 2000 to 2009 were used to identify HBV(+)/vaccine(+) (n=4434), HBV(+)/Vaccine(-) (n=3646), HBV(-)/Vaccine(+) (n=8868), and HBV(-)/Vaccine(-) (n=8868) cohorts. The risk of pneumonia/influenza, respiratory failure, intensive care, hospitalization, and mortality in the four cohorts was evaluated.
  
  
  RESULTS
  The total hospitalization rate was significantly lower in patients with chronic HBV infection who received an annual influenza vaccination than in chronic HBV-infected patients who did not receive an influenza vaccination (16.29 vs. 24.02 per 100 person-years), contributing to an adjusted hazard ratio (HR) of 0.56 (95% confidence interval (CI)=0.50-0.62). The HBV(+)/Vaccine(+) cohort also had lower risks than the HBV(+)/Vaccine(-) cohort for pneumonia and influenza (adjusted HR=0.79, 95% CI=0.67-0.92), intensive care unit admission (adjusted HR=0.33, 95% CI=0.25-0.43), and mortality (adjusted HR=0.19, 95% CI=0.15-0.24).
  
  
  CONCLUSIONS
  Our results suggest that annual influenza vaccination can reduce the risk of hospitalization and mortality in patients with chronic HBV infection.
authors.affiliation: Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan; Department of Family Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan; Master Program in Long-Term Care, College of Nursing, Taipei medical University, Taipei, Taiwan; School of Medicine, Flinders University, Bedford Park, Adelaide, SA, Australia.
authors.forename: Fu-Hsiung
authors.initials: FH
authors.lastname: Su
authors.affiliation: Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Ya-Li
authors.initials: YL
authors.lastname: Huang
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
authors.affiliation: Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan; School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chien-Tien
authors.initials: CT
authors.lastname: Su
authors.affiliation: Department of Gastroenterology and Hepatology, Yuan's General Hospital, Kaoshiung, Taiwan.
authors.forename: Wen-Hsin
authors.initials: WH
authors.lastname: Hsu
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Shih-Ni
authors.initials: SN
authors.lastname: Chang
authors.affiliation: School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan. Electronic address: ccyeh@tmu.edu.tw.
authors.forename: Chih-Ching
authors.initials: CC
authors.lastname: Yeh
mesh_terms: D000368:Aged; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D007251:Influenza, Human / Q000150:complications / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012131:Respiratory Insufficiency / Q000453:epidemiology; D018570:Risk Assessment; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D007252:Influenza Vaccines
keywords: Hepatitis B virus; Influenza; Population-based study; Vaccination