Methods: A retrospective cohort study was used to evaluate patients with HCV/HIV co-infection in our clinic whose initial visit was between 2006 and 2012. Patients seen prior to 2006 who were lost to follow up for more than 2 years then re-established care were also included. Forty-nine patients were identified from our clinic population of 1242.
Results: Within our cohort, 82% were male, 61% were African-American, 29 (59%) were uninsured and the mean age was 55. Thirty-four (69%) had a history of illicit drug use and 10 (20%) with current drug use. Eighteen out of 49 (37%) patients had confirmed HAV antibody showing immunity and 6 (12%) received the complete vaccine series but did not have follow-up serology. Eight (16%) of the patients with negative or unknown serology were not retained in care at one year, reducing the ability for vaccine completion. This represents missed opportunity in 17(35%). For HBV, 28 (57%) had serologic immunity, 4(8%) had active infection with HBV, and 4 (8%) with unknown or negative serology received the vaccination but did not have follow-up serology. Eight (16%) patients with negative or unknown serology were not retained at one year, reducing the ability for vaccine completion. This represents missed opportunity in 5 (10%) patients.
Conclusion: There was missed opportunity to vaccinate for HAV in many patients who were retained in care but far fewer for HBV vaccination. As both vaccine series require 6 months to complete, poor retention in care resulted in additional missed opportunities for vaccination. There is room to improve the quality of care of these patients via vaccination.
L. Richey, None