title: Low rates of hepatitis screening and vaccination of HIV-infected MSM in HIV clinics.
abstract: BACKGROUND
  HIV-infected men who have sex with men (MSM) are at increased risk of viral hepatitis because of similar behavioral risk factors for acquisition of these infections. Our objective was to estimate adherence to HIV management guidelines that recommend screening HIV-infected persons for hepatitis A, B, and C infection, and vaccinating for hepatitis A and B if susceptible.
  
  
  METHODS
  We evaluated hepatitis prevention services received by a random sample of HIV-infected MSM in 8 HIV clinics in 6 US cities. We abstracted medical records of all visits made by the patients to the clinic during the period from 2004 to 2007, to estimate hepatitis screening and vaccination rates overall and by clinic site.
  
  
  RESULTS
  Medical records of 1329 patients who had 14,831 visits from 2004 to 2006 were abstracted. Screening rates for hepatitis A, B, and C were 47%, 52%, and 54%, respectively. Among patients who were screened and found to be susceptible, 29% were vaccinated for hepatitis A and 25% for hepatitis B. The percentage of patients screened and vaccinated varied significantly by clinic.
  
  
  CONCLUSIONS
  Awareness of hepatitis susceptibility and hepatitis coinfection status in HIV-infected patients is essential for optimal clinical management. Despite recommendations for hepatitis screening and vaccination of HIV-infected MSM, rates were suboptimal at all clinic sites. These low rates highlight the importance of routine review of adherence to recommended clinical services. Such reviews can prompt the development and implementation of simple and sustainable interventions to improve the quality of care.
authors.affiliation: Division of Sexually Transmitted Disease Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. khoover@cdc.gov
authors.forename: Karen W
authors.initials: KW
authors.lastname: Hoover
authors.forename: Mary
authors.initials: M
authors.lastname: Butler
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Workowski
authors.forename: Stephen
authors.initials: S
authors.lastname: Follansbee
authors.forename: Beau
authors.initials: B
authors.lastname: Gratzer
authors.forename: C Bradley
authors.initials: CB
authors.lastname: Hare
authors.forename: Barbara
authors.initials: B
authors.lastname: Johnston
authors.forename: John L
authors.initials: JL
authors.lastname: Theodore
authors.forename: Guoyu
authors.initials: G
authors.lastname: Tao
authors.forename: Bryce D
authors.initials: BD
authors.lastname: Smith
authors.forename: Terence
authors.initials: T
authors.lastname: Chorba
authors.forename: Charlotte K
authors.initials: CK
authors.lastname: Kent
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D060085:Coinfection; D006506:Hepatitis A / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D018571:Sentinel Surveillance; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D014611:Vaccination / Q000706:statistics & numerical data*; D014761:Viral Hepatitis Vaccines / Q000008:administration & dosage*
chemical_list: D014761:Viral Hepatitis Vaccines