title: Vaccination coverage against hepatitis A and B viruses, Streptococcus pneumoniae, seasonal flu, and A(H1N1)2009 pandemic influenza in HIV-infected patients.
abstract: BACKGROUND
  Several vaccines are recommended in HIV-infected patients due to an increased risk of vaccine-preventable infections, severe forms of the disease, or shared transmission routes. Few data are available regarding vaccination coverage and its determinants in this population.
  
  
  METHODS
  A cross-sectional study was performed in HIV-infected patients included in a hospital-based cohort in 2011. Vaccination coverage against hepatitis A virus (HAV), hepatitis B virus (HBV), seasonal and A(H1N1)2009 pandemic influenza, and invasive pneumococcal diseases (IPD) were recorded. Factors associated with vaccination were assessed by multivariate logistic regression.
  
  
  RESULTS
  2467 patients were included (median age: 47 years; male gender 71.5%; men having sex with men (MSM): 43.9%; CDC stage C: 24.3%; HBV and/or hepatitis C virus co-infection: 14.4%). Median duration of HIV infection was 10 years and 93.1% of patients received combination antiretroviral therapy. At baseline, the median CD4 count was 527 cells/mm(3) and HIV viral load was <50 copies/mL in 83.3% of cases. Vaccination coverage for HBV, HAV, seasonal influenza, A(H1N1)2009 pandemic influenza, and IPD were 61.9%, 47.4%, 30.9, 48.3%, and 64.6%, respectively. Factors independently associated with vaccination were a younger (HBV) or an older age (influenza), male gender (HBV, HAV), MSM (HBV), CD4 count >200/mm(3) and HIV-RNA <50 copies/mL (IPD, influenza), longer duration of HIV infection (IPD, influenza), and follow-up by an experienced physician (HBV, IPD).
  
  
  CONCLUSIONS
  Vaccination coverage remained insufficient for all vaccine-preventable infections investigated in this study. Determinants for vaccination were largely not evidence-based, and efforts should be focused on improving physicians' knowledge about guidelines.
authors.affiliation: Infectious Diseases Department, Hospices Civils de Lyon, Lyon, France; INSERM U1111, International Center for Research in Infectiology, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France. Electronic address: florent.valour@chu-lyon.fr.
authors.forename: Florent
authors.initials: F
authors.lastname: Valour
authors.affiliation: Infectious Diseases Department, Hospices Civils de Lyon, Lyon, France; INSERM U1052, Lyon, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Cotte
authors.affiliation: Université Claude Bernard Lyon 1, Lyon, France; Department of Hygiene and Epidemiology, Hospices Civils de Lyon, Lyon, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Voirin
authors.affiliation: Infectious Diseases Department, Hospices Civils de Lyon, Lyon, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Godinot
authors.affiliation: Infectious Diseases Department, Hospices Civils de Lyon, Lyon, France; INSERM U1111, International Center for Research in Infectiology, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Ader
authors.affiliation: Infectious Diseases Department, Hospices Civils de Lyon, Lyon, France; INSERM U1111, International Center for Research in Infectiology, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France.
authors.forename: Tristan
authors.initials: T
authors.lastname: Ferry
authors.affiliation: Université Claude Bernard Lyon 1, Lyon, France; Department of Hygiene and Epidemiology, Hospices Civils de Lyon, Lyon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Vanhems
authors.affiliation: Infectious Diseases Department, Hospices Civils de Lyon, Lyon, France; INSERM U1111, International Center for Research in Infectiology, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Chidiac
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000276:immunology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000276:immunology*; D014611:Vaccination / Q000379:methods / Q000706:statistics & numerical data*; D014765:Viral Vaccines / Q000008:administration & dosage / Q000276:immunology*; D014777:Virus Diseases / Q000276:immunology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D022242:Pneumococcal Vaccines; D014765:Viral Vaccines
keywords: HAV; HBV; HIV; Influenza; Invasive pneumococcal disease; Vaccination coverage