title: Prevalence of immunity to hepatitis viruses A and B in a large cohort of HIV/HCV-coinfected patients, and factors associated with HAV and HBV vaccination.
abstract: Hepatitis A (HAV) and B (HBV) vaccination is strongly recommended for HIV-infected patients, especially those with hepatitis C coinfection. The aim of this study was to determine the prevalence of antibodies directed against HAV and HBV in a large cohort of HIV/HCV-coinfected patients, and to identify factors associated with HAV and HBV vaccination.
  
  
  METHODS
  We studied 1175 HIV/HCV-coinfected patients enrolled in the ANRS CO13 HEPAVIH cohort, whose HAV and HBV serostatus was known.
  
  
  RESULTS
  1056 patients (89.9%) have been tested for anti-HBc IgG, anti-HBs, and HbsAg. Only 10.9% of patients had received HBV vaccination and 70% of the patients with no HBV immunity (231/265) had never received HBV vaccination. In multivariate analysis, male sex (OR 2.0. 95% CI 1.1-3.8; p=0.02), a higher level of school education (OR 2.5, 95% CI 1.3-4.5; p=0.003), a higher CD4 cell nadir (OR 1.05, 95% CI 1.009-1.103; p=0.018) and no cirrhosis (OR 2.7, 95% CI 1.2-6.4; p=0.02) were associated with HBV vaccination. Only 368 patients (31.3%) were tested for immunity to HAV. Despite a frequent lack of HAV immunity (48.3%), a low rate of HAV vaccination (6%) was observed. In multivariate analysis, a higher level of school education (OR 3.6, 95% CI 1.03-12.4; p=0.045) was the only factor associated with HAV vaccination. HAV screening rates and HAV and HBV vaccination rates were low in this population of HIV/HCV-coinfected patients. The benefits of routine HAV and HBV screening, vaccination and post-vaccination testing should be emphasized.
authors.affiliation: Université Victor Segalen, Bordeaux, France.
authors.forename: M
authors.initials: M
authors.lastname: Winnock
authors.forename: F
authors.initials: F
authors.lastname: Bani-Sadr
authors.forename: E
authors.initials: E
authors.lastname: Pambrun
authors.forename: M-A
authors.initials: MA
authors.lastname: Loko
authors.forename: C
authors.initials: C
authors.lastname: Lascoux-Combe
authors.forename: D
authors.initials: D
authors.lastname: Garipuy
authors.forename: E
authors.initials: E
authors.lastname: Rosenthal
authors.forename: P
authors.initials: P
authors.lastname: Carrieri
authors.forename: F
authors.initials: F
authors.lastname: Dabis
authors.forename: D
authors.initials: D
authors.lastname: Salmon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015658:HIV Infections / Q000150:complications*; D006506:Hepatitis A / Q000276:immunology*; D035922:Hepatitis A Antibodies / Q000097:blood*; D006509:Hepatitis B / Q000276:immunology*; D006510:Hepatitis B Antibodies / Q000097:blood*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D035922:Hepatitis A Antibodies; D006510:Hepatitis B Antibodies