Failure of providers to vaccinate HIV-infected men against hepatitis B: a missed opportunity.
OBJECTIVE
To carry out an audit of hepatitis B immunization practices in an outpatient HIV clinic.


METHODS
We reviewed the medical records of all new HIV-infected patients seen between October 1, 1990 and December 31, 1991.


RESULTS
The 125 patients were men with a mean age and CD4 count of 43 yr and 240 cells/mm3, respectively. Fourteen percent (14%) of men who showed a clear need for vaccine, having no HBV markers, were not vaccinated by the clinic staff. Further, 16% whose susceptibility to HBV infection was unclear, with anti-HBc as a sole HBV marker, were not evaluated with a booster dose of hepatitis B vaccine in an attempt to elicit an anamnestic response.


CONCLUSIONS
In failing to vaccinate or evaluate the 30% of patients without HBsAg or anti-HBs, our providers are missing an important opportunity in preventive medicine. We urge others to examine their own hepatitis B screening and vaccination practices.
Rabeneck
L
L
Department of Medicine, Baylor College of Medicine, VA Medical Center, Houston, Texas.
Risser
J M
JM
Murray
N G
NG
McCabe
B K
BK
Lacke
C E
CE
Lucco
L J
LJ
D000328:Adult; D000368:Aged; D015658:HIV Infections / Q000150:complications / Q000276:immunology / Q000382:microbiology*; D006509:Hepatitis B / Q000150:complications / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014611:Vaccination
D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens