title: Factors associated with pandemic influenza A/H1N1 vaccine coverage in a French cohort of HIV-infected patients.
abstract: BACKGROUND
  A mass influenza A/H1N1 vaccination campaign took place in France during the 2009 winter. Overall, 7.9% of the general population was vaccinated. However, vaccine coverage data are missing for at-risk groups.
  
  
  METHODS
  A vaccination centre was implemented for HIV-infected patients followed-up in a French University Hospital. Demographical, clinical and biological characteristics were collected. Adjusted odds ratios (aOR) were calculated to identify factors associated with being vaccinated against A/H1N1 influenza.
  
  
  RESULTS
  A/H1N1 vaccine coverage was 44.4% (635/1430) in HIV-infected patients. In univariate analysis, uptake of vaccination was significantly associated with male gender, men who have sex with men, age ≥ 50 years, ≥ 1 seasonal influenza risk factor, longer HIV disease, longer duration of antiretroviral therapy, greater number of lines of antiretroviral treatments, lower nadir CD4, recent HIV-RNA<50 copies/ml, previous pneumococcal vaccination, > 2 visits to the unit during the study period and follow-up by a physician who assessed ≥ 100 patients/year (senior physician). CDC stage, recent CD4 count, diabetes, BMI>30 and pregnancy were not associated with vaccination. After multivariate analysis, vaccination remained significantly associated with age ≥ 50 years (aOR 1.56, CI 1.16-2.09), time since HIV diagnosis (aOR per 1 year 1.02, CI 1.00-1.04), previous pneumococcal vaccination (aOR 2.56, CI 1.96-3.34), >2 visits to the unit (aOR 5.09, CI 3.87-6.68) and follow-up by a senior physician (aOR 1.73, CI 1.20-2.48).
  
  
  CONCLUSIONS
  A/H1N1 vaccination was more successful in HIV-infected patients than in the French general population. Organization of the vaccination in a convenient location and implication of the physicians seem to be determining factors for A/H1N1 acceptability in this population.
authors.affiliation: Hospices Civils de Lyon, Hôpital de l'Hôtel-Dieu, Service d'Hépatologie, 1 Place de l'Hôpital, 69002 Lyon, France. laurent.cotte@chu-lyon.fr
authors.forename: L
authors.initials: L
authors.lastname: Cotte
authors.forename: N
authors.initials: N
authors.lastname: Voirin
authors.forename: C
authors.initials: C
authors.lastname: Richard
authors.forename: C
authors.initials: C
authors.lastname: Brochier
authors.forename: I
authors.initials: I
authors.lastname: Schlienger
authors.forename: P
authors.initials: P
authors.lastname: Lack
authors.forename: B
authors.initials: B
authors.lastname: Lina
authors.forename: P
authors.initials: P
authors.lastname: Vanhems
authors.forename: F
authors.initials: F
authors.lastname: Zoulim
mesh_terms: D000367:Age Factors; D004196:Disease Outbreaks / Q000517:prevention & control; D005260:Female; D005602:France; D015658:HIV Infections / Q000276:immunology; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology; D007251:Influenza, Human / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D008297:Male; D032541:Mass Vaccination; D058873:Pandemics; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D011247:Pregnancy; D012725:Sexual Behavior