In countries where the incidence of hepatitis A is low outbreaks of hepatitis A regularly occur among injecting drug users (IDUs) and homosexual men. Obviously these groups are important reservoirs of hepatitis A virus (HAV) and vaccination within these groups should be encouraged. In elderly patients, as well as in patients with chronic liver disease, hepatitis A infection may have a worse prognosis than in young and healthy patients. Also for that reason, patients with chronic liver disease, especially those with chronic hepatitis B and C, are target groups for vaccination against hepatitis A.
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Sten Iwarson (1998) studied this question.
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