Poster 16th eccmid p596 1 hiv hbv vaccination 2006
Free Anonymous HIV Testing Sites are an opportunity to offer hepatitis B virus vaccination to high risk non immune patients E. Bouvet1, P. Preziosi2, M. Branger3, M. Rotily2 1 Centre de dépistage anonyme et gratuit, Hôpital Bichat – Claude Bernard, Paris, France. 2 ClinSearch, Bagneux, France. 3 Laboratoire de virologie, Hôpital Bichat – Claude Bernard, Paris, France. Abstract Methods Nearly a third (30.5%) of these patients had a history of complete vaccination, 7.3% re-ported an incomplete or ongoingObjectives: Prevention of hepatitis B virus (HBV) transmission relies partly on vaccination, and the remaining 62% had no known his-tory ofvaccination of high risk subjects which are numerous among patients attending Free A random sample of 1021 anonymous patient files was selected vaccination. Their serologic status is detailed on fig. 2.Anonymous HIV Testing Sites (FAHTS). Our purpose was to assess the risk profile,vaccination history and serologic status of a representative sample of high risk patients among 5169 patients having attended a FAHTS in Hôpital Bichat – Figure 2: HBV serologic statusattending a FAHTS in Paris. Claude Bernard, Paris, in the year 2004. Sociodemographic profile,Methods: A sample of 1021 anonymous patient files was randomly selected among risk factors and vaccine history of these patients were drawn form5169 files from patients having attended a FAHTS in Hôpital Bichat – Claude Bernard, patient files. Their serologic profile was obtained from the virology VaccinalParis, in the year 2004. Sociodemographic profile, risk factors, vaccine history and laboratory. These characteristics were depicted using descriptive immunityserologic profile of these patients were depicted using descriptive statistics. statistics. 38%Results: Among 1021 patients, 466 (45.6%) had one or more risk factors for HBV Susceptible 46%infection and were hence tested for HBV: 171 females (37%) and 295 males (63%).Mean age (SD) was 29.4 (8.9) years. Their birth countries were France (58%), sub-Saharan Africa (17%), north Africa (11%), other European country (6%) and others Results(8%). HBV risk factors were: multiple sexual partners (62%), originating from high(20%) or medium (18%) endemic area, history of sexually transmitted disease (15%),professional exposure (8%), history of transfusion (3%) or intravenous drug use (2%). Among these 1021 patients, 466 (45.6%) had one or more risk factorsNearly a third (31%) of these patients had a history of complete HBV vaccination, 7% for Hepatitis B infection and were hence tested: 171 (36.7%) femalesreported an incomplete or ongoing vaccination, the remaining 62% had no knownhistory of vaccination. HBV serology showed that 52% of these patients had natural or and 295 males (63.3%). Mean age (SD) was 29.4 (8.9) years. Their Natural Ag HBs+ immunity 2%vaccine-induced immunity and 1.8% were HBs antigen carriers. Thus more than 46% birth countries were France (55.8%), sub-Saharan Africa (19.0%), 14%of these high risk patients had no HBV immunity. North Africa (10.5%), other European country (5.7%) and others (9.0%). Their HBV risk factors are detailed in figure 1.Conclusion: Patients with a high risk of HBV infection are numerous amongattendants of FAHTS in French large cities. Nearly two thirds of these patients have no ConclusionsHBV immunity. Thus FAHTS consultations appear to be a good opportunity to identifythese patients and offer HBV vaccination. Figure 1: HBV risk factors prevalence Patients with a high risk of HBV infection are numerous among attendants of FAHTS in French large cities. Nearly two thirds of these patients have no HBV immunity. Thus FAHTS consultations appear to Objectives 2.1 be a good opportunity to identify these patients and offer HBV History of i.v. drug use vaccination. History of transfusion 3.4Prevention of hepatitis B infection relies mainly on vaccination; whose 7.8efficacy and cost effectiveness is well documented1. Vaccination of Professionnal exposure 14.1 Referenceshigh risk groups is a widely recognised need and is critical in low History of STDendemicity areas—such as France—where neonatal hepatitis B From medium endemic area 17.1vaccination coverage remains low2. However, evidence points to 22.3 1. Aggarwal R, Ranjan P. Preventing and treating hepatitis B infection. BMJ From high endemic area 2004;329:1080-6.insufficient implementation of high risk groups immunisation in many 2. Antona D, Bussière E, Guignon N, Badeyan G, Levy-Bruhl D. La couverturehigh income countries3 4. Thus all opportunities to identify high risk Multiple sexual partners 59.0 vaccinale en France en 2001. Bull Epidemiol Hebdo 2003;2003:169-72.subjects and offer them vaccination should be taken. Free anonymous 3. Winstock AR. High risk groups are still not being vaccinated. BMJ 2005;330:198. 0 10 20 30 40 50 60HIV testing sites might be such an opportunity. 4. Francois G, Hallauer J, Van Damme P. Hepatitis B vaccination: how to reach risk % groups. Vaccine 2002;21:1-4.