Hepatitis B vaccination in HIV-infected patients: a survey of physicians and patients participating in the Aquitaine cohort.
In France, HIV-infected (HIV+) patients are frequently coinfected with hepatitis B virus (HBV) or at risk for this infection. Physicians and their patients should be more committed to HBV prevention than the average population.


OBJECTIVE
To gain insight into the attitude towards HBV and its vaccination in HIV+ patients from the Aquitaine Cohort and their attending physicians in France.


METHODS
A cross-sectional survey based on self-administered questionnaires was performed from November 2002 to June 2003. It targeted 198 physicians from the clinical group on AIDS epidemiology (Groupe d'Epidémiologie Clinique du SIDA en Aquitaine, GECSA) or participating in medical HIV networks in southwestern France; and 512 patients from the cohort. Questions concerned the following items for the physicians: HBV status, prescription of HBV serology and vaccination (frequency, type, schedule), risk factors assessed, reasons for non-vaccination; and for the patients: HBV status, information received, risk factors, attitude towards vaccination.


RESULTS
93% of physicians and 22% of patients stated they were vaccinated against HBV. HBV serological status was reported to be systematically ascertained by 75% of physicians, but post-vaccinal testing was only prescribed by 23% of them. The main reasons for not prescribing more often HBV vaccine were forgetting (79%), difficulty to identify subjects at risk (44%) and being afraid of post-vaccinal complications (32%). Thirty percent of patients reported not to have received any information on HBV vaccination. Overall, 44% considered not to be at risk of infection but 82% of them had been confronted with at least one risk. The main reasons for not having been vaccinated were mostly worry about AIDS (70%), not having been asked by physician (65%) or afraid of complications (58%); nonetheless, 42% of patients were willing to be vaccinated.


CONCLUSIONS
Results from this survey underline the need for specific health actions to be undertaken concerning hepatitis B vaccination in HIV+ patients as well as their health care providers.
Winnock
Maria
M
INSERM U593 - ISPED, Université Victor Ségalen Bordeaux 2. Maria.Winnock@isped.u-bordeaux2.fr
Neau
Didier
D
Castera
Laurent
L
Viot
Julien
J
Lacoste
Denis
D
Pellegrin
Jean Luc
JL
Dupon
Michel
M
Jutand
Marthe Aline
MA
Colombani
Françoise
F
Dabis
François
F
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005602:France; D015658:HIV Infections / Q000453:epidemiology*; D006509:Hepatitis B / Q000517:prevention & control; D017325:Hepatitis B Vaccines; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data
D017325:Hepatitis B Vaccines