Low Rates of Hepatitis Screening and Vaccination of HIV-Infected MSM in HIV Clinics

Due to similar behavioral risk factors for the two infections, HIV-positive men who have sex with men are at increased risk of viral hepatitis. The authors of the current study set out to assess adherence to HIV management guidelines that recommend hepatitis A, B, and C testing for HIV-positive patients, and vaccination against hepatitis A and B for those susceptible.

The researchers evaluated the hepatitis prevention services received by a random sample of HIV-positive MSM at eight HIV clinics in six US cities. To estimate rates of hepatitis screening and vaccination both overall and by clinic site, the team abstracted the medical records of all clinic visits by these patients from 2004 to 2007.

The records of 1,329 patients making a total of 14,831 clinic visits from 2004 to 2006 were abstracted, indicating screening rates of 47 percent for hepatitis A, 52 percent for hepatitis B, and 54 percent for hepatitis C. Among screened patients found to be susceptible, 29 percent were vaccinated for hepatitis A, and 25 percent were vaccinated for hepatitis B. Significant variations in screening and vaccination rates by clinic were noted.

"Awareness of hepatitis susceptibility and hepatitis co-infection status in HIV-infected patients is essential for optimal clinical management," the researchers concluded. "Despite recommendations for hepatitis screening and vaccination of HIV-infected MSM, rates were suboptimal at all clinic sites. These low rates highlight the importance of routine review of adherence to recommended clinical services. Such reviews can prompt the development and implementation of simple and sustainable interventions to improve the quality of care."