Hepatitis A and B vaccination practices for ambulatory patients infected with HIV.
Few studies exist of adherence to guidelines for vaccination of persons infected with human immunodeficiency virus (HIV), especially in the era of highly active antiretroviral therapy (HAART). In a retrospective, cross-sectional analysis in the HIV Outpatient Study sites, 198 (32.4%) of 612 patients eligible for hepatitis B vaccine received at least 1 dose. In multivariate analysis, hepatitis B vaccination was associated with HIV risk category, education level, and number of visits to the HIV clinic per year. Among 716 patients eligible for hepatitis A vaccine, 167 (23.3%) received > or =1 dose. Response to hepatitis B vaccination was associated with higher nadir CD4+ cell counts (P=.008) and HIV RNA levels less than the level of detection (P=.04), although some response was documented at all CD4+ levels. Although there were low rates of complete hepatitis vaccination in this cohort of ambulatory patients, prompt efforts to vaccinate patients entering care, receipt of antiretroviral therapy, and practice reminder systems may enhance vaccination practices.
Tedaldi
Ellen M
EM
General Internal Medicine, Temple University Hospital, Philadelphia, Pennsylvania 19140, USA. etedaldi@temple.edu
Baker
Rose K
RK
Moorman
Anne C
AC
Wood
Kathleen C
KC
Fuhrer
Jack
J
McCabe
Robert E
RE
Holmberg
Scott D
SD
D000328:Adult; D018791:CD4 Lymphocyte Count; D005260:Female; D006678:HIV / Q000235:genetics / Q000502:physiology; D015658:HIV Infections / Q000276:immunology* / Q000821:virology; D022362:Hepatitis A Vaccines / Q000008:administration & dosage* / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D014611:Vaccination
D022362:Hepatitis A Vaccines; D017325:Hepatitis B Vaccines; D012367:RNA, Viral