Delays in Hepatitis A vaccination in people with HIV in Houston, Texas between 2010 and 2018
Background: Studies have demonstrated low hepatitis A virus (HAV) vaccination rates among persons with HIV (PWH). Methods: We conducted a retrospective study of persons entering HIV care at two clinics in Houston, Texas between 2010 and 2018. We defined those eligible for HAV vaccination as those wh...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-01-01
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| Series: | Vaccine: X |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590136223001638 |
| _version_ | 1797302509745733632 |
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| author | Emily T. Ciocca Kristen A. Staggers Jennifer Carey Antone R. Opekun F. Blaine Hollinger Wendy A. Keitel Robert L. Atmar Hana M. El Sahly Jennifer A. Whitaker |
| author_facet | Emily T. Ciocca Kristen A. Staggers Jennifer Carey Antone R. Opekun F. Blaine Hollinger Wendy A. Keitel Robert L. Atmar Hana M. El Sahly Jennifer A. Whitaker |
| author_sort | Emily T. Ciocca |
| collection | DOAJ |
| description | Background: Studies have demonstrated low hepatitis A virus (HAV) vaccination rates among persons with HIV (PWH). Methods: We conducted a retrospective study of persons entering HIV care at two clinics in Houston, Texas between 2010 and 2018. We defined those eligible for HAV vaccination as those who had no history of HAV vaccination and had a negative anti-HAV IgG at entry to care. Kaplan-Meier curves summarized time to receipt of HAV vaccines. The proportions of patients who received 1 and 2 HAV vaccines at 6, 12, and 24 months were estimated. Cox proportional hazards regression evaluated associations between patient characteristics and vaccination. Significant factors were included in a multivariable Cox proportional hazards model. Results: Of 6,515 patients, 1372 were eligible for HAV vaccination. Of eligible patients, 29.2 % received 1 HAV vaccination at 6 months, 37.1 % at 12 months, and 47.8 % at 24 months. At 6 months, 10 % received 2 HAV vaccinations, 21.1 % at 12 months, and 33.4 % at 24 months. In multivariable analysis, men who have sex with men (adjusted HR 1.35, 95 % CI 1.06, 1.73) or those who had CD4 count ≥ 200 cells/µl (adjusted HR 2.52, 95 % CI 1.89, 3.37) had their second vaccination sooner than those who were not men who have sex with men or who had CD4 counts < 200 cells/µl, respectively. Patients > 50 years of age had their second vaccination sooner than those aged 30–50 years (adjusted HR 1.47, 95 % CI 1.08, 1.99). Those with active substance history had a longer time to second vaccination compared to those with no substance use history (adjusted HR 0.57, 95 % CI 0.40, 0.82). Conclusions: HAV vaccination rates were low and highlight the need for effective solutions to address HAV immunization gaps in PWH, especially among young patients, those with active substance use disorders, and those with significant immunocompromise. |
| first_indexed | 2024-03-07T23:38:51Z |
| format | Article |
| id | doaj.art-ee9023edd7154b80bddfdd8cd1057694 |
| institution | Directory Open Access Journal |
| issn | 2590-1362 |
| language | English |
| last_indexed | 2024-03-07T23:38:51Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Vaccine: X |
| spelling | doaj.art-ee9023edd7154b80bddfdd8cd10576942024-02-20T04:19:36ZengElsevierVaccine: X2590-13622024-01-0116100422Delays in Hepatitis A vaccination in people with HIV in Houston, Texas between 2010 and 2018Emily T. Ciocca0Kristen A. Staggers1Jennifer Carey2Antone R. Opekun3F. Blaine Hollinger4Wendy A. Keitel5Robert L. Atmar6Hana M. El Sahly7Jennifer A. Whitaker8Department of Pediatrics, Baylor College of Medicine, Houston, TX, USAInstitute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USAHarris Health System, Houston, TX, USADepartment of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USADepartment of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USA; Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USADepartment of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USADepartment of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USADepartment of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USADepartment of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USA; Corresponding author at: Baylor College of Medicine, Molecular Virology & Microbiology and Medicine – Infectious Diseases, 1 Baylor Plaza, MS-280, Houston, TX 77030, USA.Background: Studies have demonstrated low hepatitis A virus (HAV) vaccination rates among persons with HIV (PWH). Methods: We conducted a retrospective study of persons entering HIV care at two clinics in Houston, Texas between 2010 and 2018. We defined those eligible for HAV vaccination as those who had no history of HAV vaccination and had a negative anti-HAV IgG at entry to care. Kaplan-Meier curves summarized time to receipt of HAV vaccines. The proportions of patients who received 1 and 2 HAV vaccines at 6, 12, and 24 months were estimated. Cox proportional hazards regression evaluated associations between patient characteristics and vaccination. Significant factors were included in a multivariable Cox proportional hazards model. Results: Of 6,515 patients, 1372 were eligible for HAV vaccination. Of eligible patients, 29.2 % received 1 HAV vaccination at 6 months, 37.1 % at 12 months, and 47.8 % at 24 months. At 6 months, 10 % received 2 HAV vaccinations, 21.1 % at 12 months, and 33.4 % at 24 months. In multivariable analysis, men who have sex with men (adjusted HR 1.35, 95 % CI 1.06, 1.73) or those who had CD4 count ≥ 200 cells/µl (adjusted HR 2.52, 95 % CI 1.89, 3.37) had their second vaccination sooner than those who were not men who have sex with men or who had CD4 counts < 200 cells/µl, respectively. Patients > 50 years of age had their second vaccination sooner than those aged 30–50 years (adjusted HR 1.47, 95 % CI 1.08, 1.99). Those with active substance history had a longer time to second vaccination compared to those with no substance use history (adjusted HR 0.57, 95 % CI 0.40, 0.82). Conclusions: HAV vaccination rates were low and highlight the need for effective solutions to address HAV immunization gaps in PWH, especially among young patients, those with active substance use disorders, and those with significant immunocompromise.http://www.sciencedirect.com/science/article/pii/S2590136223001638hepatitis AHuman immunodeficiency virusVaccinationImmunizationHepatitis |
| spellingShingle | Emily T. Ciocca Kristen A. Staggers Jennifer Carey Antone R. Opekun F. Blaine Hollinger Wendy A. Keitel Robert L. Atmar Hana M. El Sahly Jennifer A. Whitaker Delays in Hepatitis A vaccination in people with HIV in Houston, Texas between 2010 and 2018 Vaccine: X hepatitis A Human immunodeficiency virus Vaccination Immunization Hepatitis |
| title | Delays in Hepatitis A vaccination in people with HIV in Houston, Texas between 2010 and 2018 |
| title_full | Delays in Hepatitis A vaccination in people with HIV in Houston, Texas between 2010 and 2018 |
| title_fullStr | Delays in Hepatitis A vaccination in people with HIV in Houston, Texas between 2010 and 2018 |
| title_full_unstemmed | Delays in Hepatitis A vaccination in people with HIV in Houston, Texas between 2010 and 2018 |
| title_short | Delays in Hepatitis A vaccination in people with HIV in Houston, Texas between 2010 and 2018 |
| title_sort | delays in hepatitis a vaccination in people with hiv in houston texas between 2010 and 2018 |
| topic | hepatitis A Human immunodeficiency virus Vaccination Immunization Hepatitis |
| url | http://www.sciencedirect.com/science/article/pii/S2590136223001638 |
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