Wednesday, June 25, 2014

Vaccination coverage against hepatitis A and B viruses, Streptococcus pneumoniae, seasonal flu, and A(H1N1)2009 pandemic influenza in HIV-infected patients.

Vaccine. 2014 Jun 18. pii: S0264-410X(14)00804-4. doi: 10.1016/j.vaccine.2014.06.015. [Epub ahead of print]
Vaccination coverage against hepatitis A and B viruses, Streptococcus pneumoniae, seasonal flu, and A(H1N1)2009 pandemic influenza in HIV-infected patients.
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Abstract
BACKGROUND:
Several vaccines are recommended in HIV-infected patients due to an increased risk of vaccine-preventable infections, severe forms of the disease, or shared transmission routes. Few data are available regarding vaccination coverage and its determinants in this population.
METHODS:
A cross-sectional study was performed in HIV-infected patients included in a hospital-based cohort in 2011. Vaccination coverage against hepatitis A virus (HAV), hepatitis B virus (HBV), seasonal and A(H1N1)2009 pandemic influenza, and invasive pneumococcal diseases (IPD) were recorded. Factors associated with vaccination were assessed by multivariate logistic regression.
RESULTS:
2467 patients were included (median age: 47 years; male gender 71.5%; men having sex with men (MSM): 43.9%; CDC stage C: 24.3%; HBV and/or hepatitis C virus co-infection: 14.4%). Median duration of HIV infection was 10 years and 93.1% of patients received combination antiretroviral therapy. At baseline, the median CD4 count was 527 cells/mm3 and HIV viral load was <50 copies/mL in 83.3% of cases. Vaccination coverage for HBV, HAV, seasonal influenza, A(H1N1)2009 pandemic influenza, and IPD were 61.9%, 47.4%, 30.9, 48.3%, and 64.6%, respectively. Factors independently associated with vaccination were a younger (HBV) or an older age (influenza), male gender (HBV, HAV), MSM (HBV), CD4 count >200/mm3 and HIV-RNA <50 copies/mL (IPD, influenza), longer duration of HIV infection (IPD, influenza), and follow-up by an experienced physician (HBV, IPD).
CONCLUSIONS:
Vaccination coverage remained insufficient for all vaccine-preventable infections investigated in this study. Determinants for vaccination were largely not evidence-based, and efforts should be focused on improving physicians' knowledge about guidelines.
Copyright © 2014. Published by Elsevier Ltd.
KEYWORDS:
HAV; HBV; HIV; Influenza; Invasive pneumococcal disease; Vaccination coverage

PMID: 24951870 [PubMed - as supplied by publisher]

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