Prevalence of immunity to hepatitis viruses A and B in a large cohort of HIV/HCV-coinfected patients, and factors associated with HAV and HBV vaccination

September 27, 2011

Vaccine. 2011 Sep 12. [Epub ahead of print]

Prevalence of immunity to hepatitis viruses A and B in a large cohort of

HIV/HCV-coinfected patients, and factors associated with HAV and HBV

vaccination.

Winnock M, Bani-Sadr F, Pambrun E, Loko MA, Lascoux-Combe C, Garipuy D,

Rosenthal E, ri P, Dabis F, Salmon D.

Source

INSERM, U897, ISPED, Université Victor Segalen, Bordeaux, France.

Abstract

Hepatitis A (HAV) and B (HBV) vaccination is strongly recommended for

HIV-infected patients, especially those with hepatitis C coinfection. The aim of

this study was to determine the prevalence of antibodies directed against HAV

and HBV in a large cohort of HIV/HCV-coinfected patients, and to identify

factors associated with HAV and HBV vaccination. PATIENTS AND METHODS: We

studied 1175 HIV/HCV-coinfected patients enrolled in the ANRS CO13 HEPAVIH

cohort, whose HAV and HBV serostatus was known. RESULTS: 1056 patients (89.9%)

have been tested for anti-HBc IgG, anti-HBs, and HbsAg. Only 10.9% of patients

had received HBV vaccination and 70% of the patients with no HBV immunity

(231/265) had never received HBV vaccination. In multivariate analysis, male sex

(OR 2.0. 95% CI 1.1-3.8; p=0.02), a higher level of school education (OR 2.5,

95% CI 1.3-4.5; p=0.003), a higher CD4 cell nadir (OR 1.05, 95% CI 1.009-1.103;

p=0.018) and no cirrhosis (OR 2.7, 95% CI 1.2-6.4; p=0.02) were associated with

HBV vaccination. Only 368 patients (31.3%) were tested for immunity to HAV.

Despite a frequent lack of HAV immunity (48.3%), a low rate of HAV vaccination

(6%) was observed. In multivariate analysis, a higher level of school education

(OR 3.6, 95% CI 1.03-12.4; p=0.045) was the only factor associated with HAV

vaccination. HAV screening rates and HAV and HBV vaccination rates were low in

this population of HIV/HCV-coinfected patients. The benefits of routine HAV and

HBV screening, vaccination and post-vaccination testing should be emphasized.

PMID: 21920402 [PubMed - as supplied by publisher]

September 27, 2011