535. Hepatitis B Vaccination Series Completion and Post-vaccination Immunity Testing in HIV-infected Adults
Session: Poster Abstract Session: Vaccine Use in Immunocompromised Hosts
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
  • Poster - ID Week HIV.pdf (530.8 kB)
  • Background: Hepatitis B vaccination is recommended for all individuals infected with human immunodeficiency virus (HIV) without immunity, and post-vaccination testing for Hepatitis B surface antibody (HBsAb) is recommended due to impaired vaccine response in HIV patients. We examined completion of hepatitis B vaccination series and post-vaccination HBsAb testing in HIV-infected adults enrolled in Kaiser Permanente Southern California (KPSC) health plan.

    Methods:  The analysis included adults diagnosed with HIV from 2008-2011 who initiated hepatitis B vaccination series at KPSC. Patients were followed for a minimum of 6 months and until December 31, 2012, for series completion and post-vaccination testing. Patients were considered vaccine responders if they received a post-vaccination HBsAb testing and had a positive result. Logistic regression model was used to determine association between patients’ demographics and completion of the vaccination series, adjusted for calendar year and membership length.

    Results: We identified 524 HIV patients who initiated the vaccination series (459 males and 65 females). Among 282 (53.8%) patients completed the 3-dose series during the study period, 92 (32.6%) completed the series within 6 months and another 157 (55.7%) completed within a year. Completion rates were higher among females and those aged 25-34. Blacks had the lowest completion rate (45.2%) compared to patients of other race/ethnicity. In adjusted analysis, the likelihood of completion of the 3-dose series was not associated with age and sex. Blacks were less likely to complete the series, but the association did not reach a statistical significance (odds ratio =0.58 [95% confidence interval: 0.32-1.05], P=0.07). Of those who completed the vaccination series, 182 patients (64.5%) received a testing for HBsAb. Among tested, 103 (56.6%) developed detectable HBsAb. Of 79 non-responders, 46 patients (58.2%) initiated a second series.

    Conclusion: The rates of the completion of hepatitis B vaccination series and post-vaccination testing were low in HIV patients. Innovative reminder tools may improve hepatitis B vaccination series completion and post-vaccination testing.

    Rulin Hechter, MD, PhD1, Steven Jacobsen, MD, PhD1, Yi Luo, MS1, William Towner, MD2 and Hung Fu Tseng, Ph.D., MPH1, (1)Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, (2)Kaiser Permanente, Los Angeles, CA


    R. Hechter, None

    S. Jacobsen, None

    Y. Luo, None

    W. Towner, None

    H. F. Tseng, None

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