title: Impact of a new vaccine clinic on hepatitis B vaccine completion and immunological response rates in an HIV-positive cohort.
abstract: BACKGROUND
  Hepatitis B virus vaccination (HBVV) in the HIV-infected population has poor reported completion rates and immunological response rates. At our HIV clinic, we established a vaccine clinic to improve HBVV outcomes using interventions such as SMS text reminders and double-dose (DD) HBVV for standard-dose non-responders (SD NRs).
  
  
  METHODS
  A five-year (2003-2008) retrospective review of the completion rates and immunological response rates for HBVV after the establishment of the dedicated vaccine clinic was conducted. Statistical significance was assumed at p<0.05, and the analysis was performed using SPSS (v16).
  
  
  RESULTS
  A total of 354 HIV-infected patients were included. Seventy-five percent (268/354) of patients completed the SD HBVV, an 84% (226/268) returned for the hepatitis B surface antibody evaluation. Only 47.3% (107/226) responded to standard-dose hepatitis B vaccination. Responders had higher absolute numbers (p=0.017) and percentages of CD4 cells (p<0.001) and were more likely to be receiving HAART (p=0.001). There was a 70% (48/69) response rate to DD HBVV among SD NRs. On-treatment analysis showed an 88% (155/176) overall immunological response to SD HBVV and DD HBVV, if required.
  
  
  CONCLUSIONS
  High HBVV completion and response rates in this HIV cohort were enabled through the use of multiple interventions, including the use of SMS text message reminders and routine referral for DD vaccination.
authors.affiliation: Department of Infectious Diseases, University of Maryland, Baltimore, MD 21201, USA. clarerock@hotmail.com
authors.forename: Clare
authors.initials: C
authors.lastname: Rock
authors.forename: Eoghan
authors.initials: E
authors.lastname: de Barra
authors.forename: Corinna
authors.initials: C
authors.lastname: Sadlier
authors.forename: Sinead
authors.initials: S
authors.lastname: Kelly
authors.forename: Catherine
authors.initials: C
authors.lastname: Dowling
authors.forename: Cora
authors.initials: C
authors.lastname: McNally
authors.forename: Colm
authors.initials: C
authors.lastname: Bergin
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D004306:Dose-Response Relationship, Immunologic; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006293:Health Promotion / Q000379:methods*; D006509:Hepatitis B / Q000150:complications / Q000276:immunology* / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D017010:Reminder Systems; D012189:Retrospective Studies
chemical_list: D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines