The outcome of a rapid hepatitis B vaccination programme in a methadone treatment clinic.
OBJECTIVE
Injecting drug users are a high-risk population for hepatitis B (HBV), but are difficult to engage in vaccination programmes. This study examines the completion rates of a HBV vaccination schedule and seroconversion in a group of patients in methadone maintenance treatment.


METHODS
Patients at a public methadone maintenance programme in Sydney, Australia, were screened for viral hepatitis (hepatitis A, B and C) and offered a rapid HBV vaccination schedule (0, 1 and 2 months). Hepatitis B surface antibody (antiHBs) was retested on completion of the vaccination schedule.


RESULTS
A total of 143 patients [71.3% male, mean age 33.1 (standard deviation +/- 8.3)] enrolled in the project. Forty-nine per cent of patients were HAV antibody (Ab) positive, 81.1% hepatitis C virus (HCV) antibody (Ab) positive and 38.9% antiHBs positive. Exposure to multiple hepatitis viruses was common, with 24.5% testing positive for all three viruses. Seventy-three (83%) of the 88 antiHBs negative patients completed the vaccination schedule. Post-vaccination serology indicated a seroconversion rate of 75.4% (55 of 73) of completors, or 62.5% of eligible participants (55 of 88).


CONCLUSIONS
While there was a high rate of completion of the rapid vaccination schedule in this population, a moderate seroconversion rate was achieved. Further work is required to identify an optimal vaccination schedule in opioid substitution patients.
Ramasamy
Parameswaran
P
Drug Health Service, Sydney South West Area Health Service, Sydney, Australia.
Lintzeris
Nicholas
N
Sutton
Yvonne
Y
Taylor
Helen
H
Day
Carolyn A
CA
Haber
Paul S
PS
D015492:AIDS Serodiagnosis; D000293:Adolescent; D000328:Adult; D001315:Australia; D005240:Feasibility Studies; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D006510:Hepatitis B Antibodies / Q000276:immunology*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000276:immunology*; D006556:Heroin Dependence / Q000276:immunology*; D006801:Humans; D017589:Immunization Programs; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016320:Substance Abuse Treatment Centers; D015819:Substance Abuse, Intravenous / Q000276:immunology*; D055815:Young Adult
D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines