2156. Compliance with Hepatitis A and B Vaccination Recommendations in a Cohort of Patients with HIV and Hepatitis C coinfection
Session: Poster Abstract Session: HIV/HCV Coinfection and Liver Disease
Saturday, October 29, 2016
Room: Poster Hall
Posters
  • HCV-HIV HepA HepB Vaccination Poster 2016.10.04 FINAL.pdf (102.1 kB)
  • Background: Guidelines recommend Hepatitis A and B viral immunity for patients with Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) co-infection. Inactivated vaccines are available for both Hepatitis A(HAV) and Hepatitis B(HBV) viruses and neither has administration restrictions or contraindications for use in HIV infection, thus both should be given to all co-infected patients unless serology confirms immunity. Upon completion, serology is recommended to confirm appropriate vaccine response. As HAV or HBV infection can result in a more severe disease in these patients, completion of these vaccines is an important measure of quality of care.

    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.

    Madelyne Bean, PharmD1, Amanda Schnee, MD2 and Lauren Richey, MD, MPH1, (1)Infectious Diseases, Medical University of South Carolina, Charleston, SC, (2)Medical University of South Carolina, Charleston, SC

    Disclosures:

    M. Bean, None

    A. Schnee, None

    L. Richey, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.