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Koc ÖM, van Oorschot E, Brandts L, Lashof AO. Timing of primary three dose hepatitis B vaccination and postvaccination serologic testing among a large cohort of healthy adults. J Med Virol 2022; 94:4433-4439. [PMID: 35538595 PMCID: PMC9543124 DOI: 10.1002/jmv.27848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 05/01/2022] [Accepted: 05/09/2022] [Indexed: 11/20/2022]
Abstract
This study evaluated the optimal timing of a primary three‐dose hepatitis B vaccination and postvaccination serologic testing (PVST) among a large group of healthy naïve adults in the Netherlands. Data were collected from the Ease Travel Clinic hepatitis B vaccination database. The study population consisted of 22,997 adults who received three hepatitis B vaccinations. Seroprotection was attained in 97.3% individuals. When compared with PVST performed at 1–2 months (98.2%) after the final dose, lower seroprotection rates were observed with <1 (97.3%, p = 0.128), 3–6 (90.6%, p < 0.001), and ≥7 (88.4%, p < 0.001) months after vaccination. Among the subpopulation with a PVST 1–2 months, no statistically significant difference was observed for the various intervals between the first and second vaccination (<1, 1–2, 3–4, or ≥5 months). When compared with 4–5 months between the second and third vaccine dose, lower seroprotection rates were observed with <4 (odds ratio [OR]: 0.29, p = 0.020) and ≥12 (OR: 0.22, p < 0.001) months, although comparable rates were observed with 6–11 months interval (OR: 0.85, p = 0.262). Our data indicate that PVST should be obtained 1–2 months after the last vaccination and a delayed PVST was the major determinant of a lower seroprotection rate after primary three‐dose hepatitis B vaccination schedule. Based on our data, the hepatitis B vaccination also leaves room for flexibility for the second dose and the third dose without the necessity of restarting the vaccination series or confirmation of the immune response to the vaccine.
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Affiliation(s)
- Özgür M Koc
- Department of Medical Microbiology, Maastricht University Medical Centre, Maastricht, the Netherlands.,School of Nutrition and Translational Research in Metabolism (NUTRIM), University Maastricht, Maastricht, the Netherlands
| | - Eva van Oorschot
- Department of Medical Microbiology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Lloyd Brandts
- Department of Clinical Epidemiology & Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Astrid Oude Lashof
- Department of Medical Microbiology, Maastricht University Medical Centre, Maastricht, the Netherlands.,School of Nutrition and Translational Research in Metabolism (NUTRIM), University Maastricht, Maastricht, the Netherlands
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Vaccination Coverage among Prisoners: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207589. [PMID: 33086513 PMCID: PMC7589151 DOI: 10.3390/ijerph17207589] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/03/2020] [Accepted: 10/14/2020] [Indexed: 12/26/2022]
Abstract
Prison inmates are highly susceptible for several infectious diseases, including vaccine-preventable diseases. We conducted a systematic international literature review on vaccination coverage against hepatitis B virus (HBV), hepatitis A virus (HAV), combined HAV/HBV, tetanus-diphtheria, influenza, pneumococcal, and combined measles, mumps, and rubella (MMR) in prison inmates, according to the PRISMA guidelines. The electronic databases were used Web of Science, MEDLINE, Scopus, and Cinhal. No language or time limit were applied to the search. We defined vaccination coverage as the proportion of vaccinated prisoners. There were no limitations in the search strategy regarding time period or language. Of 1079 identified studies, 28 studies were included in the review. In total, 21 reported on HBV vaccine coverage (range between 16–82%); three on HAV (range between 91–96%); two studies on combined HAV/HBV (77% in the second dose and 58% in the third); three studies on influenza vaccine (range between 36–46%), one of pneumococcal vaccine coverage (12%), and one on MMR coverage (74%). We found that data on vaccination coverage in prison inmates are scarce, heterogeneous, and do not include all relevant vaccines for this group. Current published literature indicate that prison inmates are under-immunized, particularly against HBV, influenza, MMR, and pneumococci. Strengthen immunization programs specifically for this population at risk and improvement of data record systems may contribute to better health care in prisoners.
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Koc ÖM, Menart C, Theodore J, Kremer C, Hens N, Koek GH, Oude Lashof AML. Ethnicity and response to primary three-dose hepatitis B vaccination in employees in the Netherlands, 1983 through 2017. J Med Virol 2019; 92:309-316. [PMID: 31621084 DOI: 10.1002/jmv.25610] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 10/13/2019] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND AIMS Hepatitis B virus (HBV) vaccination is recommended to all employees who have an occupational risk in the Netherlands. This study assessed the determinants of the immune response to primary standard three-dose HBV vaccination (0, 1, 6 months), with the main focus on ethnicity. METHODS Out of 76 239 individuals who received HBV vaccination between April 1983 and December 2017, 11 567 persons with a known country of birth and complete vaccination schedule were included in this study. Weighted multiple logistic regression with Firth's bias adjustment was used to assess the determinants of nonresponse (anti-HBs < 10 mIU/mL) and low response (anti-HBs 10-99 mIU/mL). RESULTS Baseline characteristics of the study population (n = 11 567) were as follows: mean age 27.5 years (95% confidence interval [CI], 27.23-27.72), 99.4% born in the Netherlands and 93.5% of Western European origin. Of all identified subjects, 180 (1.6%) were HBV vaccine nonresponders and 549 (4.8%) were low responders. When compared with individuals aged <40 years, the rate of nonresponse (4.3% vs 0.8%; P < .001) and low response (11.9% vs 2.9%; P < .001) was higher in those aged 40 years or older. The height of anti-HBs levels were lower in those subjects aged >40 years in comparison with those younger than 40 years, P < .001. All nonresponders were born in the Netherlands. Although no significant association was found between nonresponse and individuals of Western European origin (adjusted odds ratio [aOR] = 1.20; 95% CI, 0.66-2.44; P = .163), low response to HBV vaccination was significantly associated with Western European origin (aOR = 2.21; 95% CI, 1.41-3.86; P = .001). Significant determinants for nonresponse were older age at vaccination (aOR = 1.06; 95% CI, 1.06-1.07; P < .001) and male gender (aOR = 2.51; 95% CI, 1.97-3.22; P < .001). CONCLUSIONS The nonresponse rate was low in our study population. Our findings suggest that the vaccines being used for the primary vaccination are probably less immunogenic for older individuals, males, and persons of Western European origin.
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Affiliation(s)
- Özgür M Koc
- Department of Medical Microbiology, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Charlotte Menart
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jemimah Theodore
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Cécile Kremer
- Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-Biostat), Hasselt University, Hasselt, Belgium
| | - Niel Hens
- Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-Biostat), Hasselt University, Hasselt, Belgium.,Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Ger H Koek
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Visceral Surgery and Transplantation, University Hospital of the RWTH, Aachen, Germany
| | - Astrid M L Oude Lashof
- Department of Medical Microbiology, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
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Madeddu G, Vroling H, Oordt-Speets A, Babudieri S, O'Moore É, Noordegraaf MV, Monarca R, Lopalco PL, Hedrich D, Tavoschi L. Vaccinations in prison settings: A systematic review to assess the situation in EU/EEA countries and in other high income countries. Vaccine 2019; 37:4906-4919. [PMID: 31327651 DOI: 10.1016/j.vaccine.2019.07.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 06/06/2019] [Accepted: 07/02/2019] [Indexed: 01/06/2023]
Abstract
INTRODUCTION In 2016, more than 600,000 persons were being held in EU/EEA correctional facilities on a given day. People in prison may be at risk of vaccine-preventable diseases. While vaccination recommendations for people in prison exist, little is known on coverage and implementation options. METHODS We performed a systematic review on existing evidence on vaccination in prison settings in the EU/EEA. We searched peer-reviewed and grey literature following international methodology and reporting standards, to gather records published between 1980 and 2016 in all languages. We analysed quantitative (acceptance, uptake, cost-effectiveness) and qualitative (barriers) outcomes. RESULTS Out of 7041 identified records, 19 full-text articles were included from peer-reviewed literature and two from grey literature. Of these, 18 reported on hepatitis A and/or B virus (HAV/HBV), two on influenza and one on MMR vaccination. Two studies on HAV vaccine reported varying acceptance (5-91%) and uptake rates (62.9-70.5%). Seven studies reported on HBV vaccination. A comparative study showed a significantly higher uptake of the third HBV vaccine dose with the very rapid (63%) compared to the standard schedule (20%). HBV vaccination was generally well accepted (54-100%), whereas uptake was variable (dose 1:23-100%, dose 2:48-92%, dose 3:19-80%). One study on the combined HAV/HBV vaccine reported an acceptance rate of 34%, and declining uptake following dose 1. One study on influenza vaccine showed an uptake of 42-46%, while another reported a MMR vaccine acceptance of 80% and an uptake of 74%. Overall, main reasons for non-vaccination included release from/or transfer between prisons, and refusal. CONCLUSIONS This systematic review highlighted important knowledge gaps and operational challenges for vaccination in prison settings. Vaccination is an effective measure that warrants comprehensive and tailored implementation to reduce the preventable disease burden, avoid risks of large outbreaks of vaccine-preventable diseases, and contribute to health equity for people in prison.
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Affiliation(s)
- Giordano Madeddu
- Department of Medical, Surgical and Experimental Sciences, Unit of Infectious Diseases, University of Sassari, Sassari, Italy.
| | - Hilde Vroling
- Pallas Health Research and Consultancy B.V., Rotterdam, the Netherlands
| | | | - Sergio Babudieri
- Department of Medical, Surgical and Experimental Sciences, Unit of Infectious Diseases, University of Sassari, Sassari, Italy
| | - Éamonn O'Moore
- Health and Justice Team, Public Health England and UK Collaborating Centre, WHO Health in Prisons Programme (Europe), Reading, United Kingdom
| | | | - Roberto Monarca
- Health Without Barriers - European Federation for Prison Health, Viterbo, Italy
| | - Pier Luigi Lopalco
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Dagmar Hedrich
- European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy; European Centre for Disease Prevention and Control, Stockholm, Sweden
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Stasi C, Monnini M, Cellesi V, Salvadori M, Marri D, Ameglio M, Gabbuti A, Di Fiandra T, Voller F, Silvestri C. Screening for hepatitis B virus and accelerated vaccination schedule in prison: A pilot multicenter study. Vaccine 2019; 37:1412-1417. [PMID: 30733091 DOI: 10.1016/j.vaccine.2019.01.049] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/23/2019] [Accepted: 01/28/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIM Vaccine against hepatitis B virus (HBV) is highly effective in preventing HBV infection. The aims of this study were to (1) increase the epidemiological knowledge on the impact of HBV in Tuscany region prisons by registering the results of serum screening on a clinical medical record and (2) increase the anti-HBV vaccination using an accelerated schedule. METHODS Our study population was composed of all detainees present in prisons and all constrained from freedom or at institutions in the Tuscany region and not vaccinated at these facilities from 1 December 2016 to 31 May 2017. RESULTS Of 17 detention facilities in the Tuscany region, 15 were enrolled in the study. On 28 February 2017, there were 3068 detainees present in these institutions. Considering the 1075 subjects screened for HBV serum markers, 730 (67.9%) were susceptible to infection and needed to be vaccinated. Five hundred and ninety-six agreed to be vaccinated (82%); 27 (2.5%) of our subjects had an isolated anti-HBc, 20 (1.9%) were HBV infected (HBsAg+), 127 (11.8%) had previous HBV infection (anti-HBs+, anti-HBc+ and HBsAg-), and 171 had been previously vaccinated. Five hundred and fifty-five inmates (95.1%) received the first vaccine dose, and 404 (83%) underwent the third dose at day 21. CONCLUSION This study showed that of a high percentage of subjects who underwent screening, more than half needed to be vaccinated. Moreover, our study reached very high levels of vaccination coverage, considering both the entire enrolled population and the new inmates.
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Affiliation(s)
- Cristina Stasi
- Observatory of Epidemiology, Regional Health Agency of Tuscany, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
| | - Mirko Monnini
- Observatory of Epidemiology, Regional Health Agency of Tuscany, Florence, Italy
| | - Valerio Cellesi
- Prison Healthcare of Volterra, Local Healthcare Tuscany North West, Volterra, Italy
| | - Marco Salvadori
- "Sollicciano" District House, Local Healthcare Tuscany Centre, Florence, Italy
| | - Daniele Marri
- Infectious Diseases and Hepatology Unit, University Hospital of Siena, Siena, Italy
| | - Mateo Ameglio
- Departmental Operational Units in Prison, Local Healthcare Tuscany Southest, Colle Val D'Elsa, Siena, Italy
| | - Andrea Gabbuti
- Infectious Diseases Unit, Local Healthcare Tuscany Centre, Firenze, Italy
| | - Teresa Di Fiandra
- General Directorate for Health Prevention, Ministry of Health, Rome, Italy
| | - Fabio Voller
- Observatory of Epidemiology, Regional Health Agency of Tuscany, Florence, Italy
| | - Caterina Silvestri
- Observatory of Epidemiology, Regional Health Agency of Tuscany, Florence, Italy
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Van Den Ende C, Marano C, Van Ahee A, Bunge EM, De Moerlooze L. The immunogenicity and safety of GSK’s recombinant hepatitis B vaccine in adults: a systematic review of 30 years of experience. Expert Rev Vaccines 2017; 16:811-832. [DOI: 10.1080/14760584.2017.1338568] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
| | | | - Ayla Van Ahee
- Pallas Health Research and Consultancy, Rotterdam, The Netherlands
| | - Eveline M. Bunge
- Pallas Health Research and Consultancy, Rotterdam, The Netherlands
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Stone J, Martin NK, Hickman M, Hellard M, Scott N, McBryde E, Drummer H, Vickerman P. The Potential Impact of a Hepatitis C Vaccine for People Who Inject Drugs: Is a Vaccine Needed in the Age of Direct-Acting Antivirals? PLoS One 2016; 11:e0156213. [PMID: 27224423 PMCID: PMC4880220 DOI: 10.1371/journal.pone.0156213] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Accepted: 05/10/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND AND AIMS The advent of highly effective hepatitis C (HCV) treatments has questioned the need for a vaccine to control HCV amongst people who inject drugs (PWID). However, high treatment costs and ongoing reinfection risk suggest it could still play a role. We compared the impact of HCV vaccination amongst PWID against providing HCV treatment. METHODS Dynamic HCV vaccination and treatment models among PWID were used to determine the vaccination and treatment rates required to reduce chronic HCV prevalence or incidence in the UK over 20 or 40 years. Projections considered a low (50% protection for 5 years), moderate (70% protection for 10 years) or high (90% protection for 20 years) efficacy vaccine. Sensitivities to various parameters were examined. RESULTS To halve chronic HCV prevalence over 40 years, the low, moderate and high efficacy vaccines required annual vaccination rates (coverage after 20 years) of 162 (72%), 77 (56%) and 44 (38%) per 1000 PWID, respectively. These vaccination rates were 16, 7.6 and 4.4 times greater than corresponding treatment rates. To halve prevalence over 20 years nearly doubled these vaccination rates (moderate and high efficacy vaccines only) and the vaccination-to-treatment ratio increased by 20%. For all scenarios considered, required annual vaccination rates and vaccination-to-treatment ratios were at least a third lower to reduce incidence than prevalence. Baseline HCV prevalence had little effect on the vaccine's impact on prevalence or incidence, but substantially affected the vaccination-to-treatment ratios. Behavioural risk heterogeneity only had an effect if we assumed no transitions between high and low risk states and vaccinations were targeted or if PWID were high risk for their first year. CONCLUSIONS Achievable coverage levels of a low efficacy prophylactic HCV vaccine could greatly reduce HCV transmission amongst PWID. Current high treatment costs ensure vaccination could still be an important intervention option.
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Affiliation(s)
- Jack Stone
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
- * E-mail:
| | - Natasha K. Martin
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
- Division of Global Public Health, University of California San Diego, La Jolla, United States of America
| | - Matthew Hickman
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Margaret Hellard
- Centre for Population Health, Burnet Institute, Melbourne, Australia
| | - Nick Scott
- Centre for Population Health, Burnet Institute, Melbourne, Australia
| | - Emma McBryde
- Centre for Population Health, Burnet Institute, Melbourne, Australia
| | - Heidi Drummer
- Centre for Biomedical Research, Burnet Institute, Melbourne, Australia
| | - Peter Vickerman
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
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Sequera VG, Valencia S, García-Basteiro AL, Marco A, Bayas JM. Vaccinations in prisons: A shot in the arm for community health. Hum Vaccin Immunother 2015; 11:2615-26. [PMID: 26158401 PMCID: PMC4685700 DOI: 10.1080/21645515.2015.1051269] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 04/27/2015] [Accepted: 05/10/2015] [Indexed: 02/08/2023] Open
Abstract
From the first day of imprisonment, prisoners are exposed to and expose other prisoners to various communicable diseases, many of which are vaccine-preventable. The risk of acquiring these diseases during the prison sentence exceeds that of the general population. This excess risk may be explained by various causes; some due to the structural and logistical problems of prisons and others to habitual or acquired behaviors during imprisonment. Prison is, for many inmates, an opportunity to access health care, and is therefore an ideal opportunity to update adult vaccination schedules. The traditional idea that prisons are intended to ensure public safety should be complemented by the contribution they can make in improving community health, providing a more comprehensive vision of safety that includes public health.
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Affiliation(s)
| | - Salomé Valencia
- Preventive Medicine and Epidemiology Service; Hospital Clínic of Barcelona; Barcelona, Spain
| | - Alberto L García-Basteiro
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB); Hospital Clínic - Universitat de Barcelona, Rossello, Barcelona, Spain
- Centro de Investigação em Saude de Manhiça (CISM); Maputo, Mozambique
| | - Andrés Marco
- Health Services of Barcelona Men's Penitentiary Center; Barcelona, Spain
| | - José M Bayas
- Preventive Medicine and Epidemiology Service; Hospital Clínic of Barcelona; Barcelona, Spain
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB); Hospital Clínic - Universitat de Barcelona, Rossello, Barcelona, Spain
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Factors associated with hepatitis B vaccine series completion in a randomized trial for injection drug users reached through syringe exchange programs in three US cities. BMC Public Health 2014; 14:820. [PMID: 25107530 PMCID: PMC4138371 DOI: 10.1186/1471-2458-14-820] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 07/29/2014] [Indexed: 11/10/2022] Open
Abstract
Background Hepatitis B virus (HBV) is a vaccine preventable infection yet vaccination rates are low among injection drug users (IDUs) despite the high risk of infection and longstanding recommendations to promote vaccination. We sought to improve vaccination rates by reaching IDUs through syringe exchange programs (SEPs) in three U.S. cities. Methods IDUs were randomized in a trial comparing the standard HBV vaccination schedule (0, 1, and 6 months) to an accelerated schedule (0, 1, and 2 months) and participation data were analyzed to identify determinants of completion of the three-dose vaccine series. Independent variables explored included sociodemographics, injection and syringe access behaviors, assessment of health beliefs, HBV-associated knowledge, and personal health status. Results Covariates associated with completion of the three-dose vaccine series were accelerated vaccine schedule (aOR 1.92, 95% CI 1.34, 2.58, p = <0.001), older age (aOR 1.05, 95% CI 1.03, 1.07, p = <0.001), and poorer self-rated health score (aOR 1.26, 95% CI 1.05, 1.5, p = 0.02). Completion was less likely for those getting syringes from SEP customers than for SEP customers (OR 0.33, 95% CI 0.19, 0.58, p = <0.001). Conclusions SEPs should offer hepatitis vaccination in a manner that minimizes time between first and last visits by accelerating the dosing schedule. Public health interventions should target younger, less healthy, and non-SEP customer participants. Other health interventions at SEPs may benefit from similar approaches that reach out beyond regular SEP customers.
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Sequera VG, Garcia-Basteiro AL, Bayas JM. The role of vaccination in prisoners' health. Expert Rev Vaccines 2013; 12:469-71. [PMID: 23659294 DOI: 10.1586/erv.13.28] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Costumbrado J, Stirland A, Cox G, El-Amin AN, Miranda A, Carter A, Malek M. Implementation of a hepatitis A/B vaccination program using an accelerated schedule among high-risk inmates, Los Angeles County Jail, 2007–2010. Vaccine 2012; 30:6878-82. [DOI: 10.1016/j.vaccine.2012.09.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 08/11/2012] [Accepted: 09/03/2012] [Indexed: 10/27/2022]
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12
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Mena G, Llupià A, García-Basteiro AL, Díez C, León A, García F, Bayas JM. Assessing the immunological response to hepatitis B vaccination in HIV-infected patients in clinical practice. Vaccine 2012; 30:3703-9. [DOI: 10.1016/j.vaccine.2012.03.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Revised: 02/13/2012] [Accepted: 03/08/2012] [Indexed: 01/05/2023]
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13
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Vaccination against hepatitis B among prisoners in Iran: accelerated vs. classic vaccination. Health Policy 2011; 100:297-304. [PMID: 21269722 DOI: 10.1016/j.healthpol.2010.12.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Revised: 12/21/2010] [Accepted: 12/25/2010] [Indexed: 02/05/2023]
Abstract
BACKGROUND Prisoners and injecting drug users are at constant risk of hepatitis B virus (HBV) infection and the classic 6-months HBV vaccination might not provide immunization rapidly enough. In this randomized clinical trial we investigated the efficacy of an accelerated vaccination protocol vs. classic schedule among prisoners in Iran. METHODS 180 prisoners were randomized into 2 vaccination groups; group A underwent accelerated vaccination at 0, 1, 4 and 8 weeks and group C were vaccinated at 0, 1 and 6 months. Antibody against Hepatitis-B surface-antigen (anti-HBs) was assessed at baseline, one, two, six and eight months after the first vaccine dose using immunoenzymatic assays. Seroprotection was defined as anti-HBs titer of 10 IU/L or more. Anti-HBc and HBsAg were measured at baseline and 8th month to evaluate new HBV infection and failure of vaccination. RESULTS Overall compliance was 100% and 90.4% in groups A and C respectively. While seroprotection rate at one month was significantly higher in group A (22.4%) compared to group C (4.7%), in the 8th month 78.8% and 93.4% seroprotection was achieved in groups A and C respectively (P < 0.002). CONCLUSION Compared to classic HBV vaccination regimen, an accelerated 0, 1, 4 and 8 weeks vaccination schedule can achieve early seroprotection more rapidly, provides clinically sufficient seroprotection with higher compliance in prisoners and can be suggested in situations that rapid immunization against HBV infection is warranted.
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15
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Sabidó M, Gavaldà L, Olona N, Ramon JM. Timing of hepatitis B vaccination: its effect on vaccine response in health care workers. Vaccine 2007; 25:7568-72. [PMID: 17870215 DOI: 10.1016/j.vaccine.2007.08.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2007] [Revised: 08/11/2007] [Accepted: 08/13/2007] [Indexed: 11/26/2022]
Abstract
We assessed the effect of timing and other biological variables on immune response among health care workers (HCW) vaccinated with hepatitis B vaccine. A total of 2.058 HCW received three doses and were tested for anti-HBs within 6 months. 92.2% of the HCW had evidence of seroprotection. Multivariable analysis showed that controlling for age, the estimated non-response OR associated with a delayed second dose was 2.16 (95% CI: 1.46, 3.18, p=0.004). We found a decreasing response rate with increasing age. Particular attention should be given to those HCW who are late for the second vaccine dose and to older subjects.
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Affiliation(s)
- Meritxell Sabidó
- Department of Preventive Medicine and Public Health, Hospital Universitari de Bellvitge, Crta. Feixa Llarga s/n, L'Hospitalet de Llobregat 08907, Spain.
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Buck JM, Morrow KM, Margolis A, Eldridge G, Sosman J, MacGowan R, Binson D, Kacanek D, Flanigan TP, Gaiter J, MacGowan R, Wolitski R, Margolis A, Belcher L, Lifshay J, McFarlane M, O’Leary A, Eldridge G, Askew J, Fitterling J, Fortenberry M, Griebler J, Kennedy S, McGregor S, Vardaman J, Sturges J, Seal D, Hartmann B, Simms R, Reed R, Rompa D, Sosman J, Morrow K, Niaura R, Flanigan T, Fitzgerald C, Lugo R, Strother D, Kacanek D, Grinstead O, Faigeles B, Binson D, Woods W, Zack B, Bracho R, Johnson C, Silber E. Hepatitis B Vaccination in Prison: The Perspectives of Formerly Incarcerated Men. JOURNAL OF CORRECTIONAL HEALTH CARE 2006. [DOI: 10.1177/1078345806287937] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jessica M. Buck
- Pritzker School of Medicine, University of Chicago, Illinois
| | - Kathleen M. Morrow
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital and Brown Medical School, Providence, Rhode Island
| | - Andrew Margolis
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - James Sosman
- Department of Medicine, University of Wisconsin Medical School, Madison
| | - Robin MacGowan
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Timothy P. Flanigan
- Department of Medicine, The Miriam Hospital and Brown Medical School, Providence, Rhode Island
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Fonseca MO, Pang LW, de Paula Cavalheiro N, Barone AA, Heloisa Lopes M. Randomized trial of recombinant hepatitis B vaccine in HIV-infected adult patients comparing a standard dose to a double dose. Vaccine 2005; 23:2902-8. [PMID: 15780739 DOI: 10.1016/j.vaccine.2004.11.057] [Citation(s) in RCA: 172] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2004] [Revised: 11/08/2004] [Accepted: 11/11/2004] [Indexed: 01/01/2023]
Abstract
Because HIV and hepatitis B virus share many common risk factors, it is important to try to vaccinate HIV patients against hepatitis B. There are numerous reports describing a variety of dose schedules, limited success and markers associated with impaired response to HBV vaccine in these individuals. All studies have been small in size making it difficult to draw conclusions within and between studies. The purpose of this study was to evaluate a double dose of hepatitis B vaccine under more definitive guidelines: double blinded, randomized, controlled, with numbers for statistical validity. Two hundred and ten HIV infected subjects received a standard dose (20 microg) or a double dose (40 microg) of recombinant hepatitis B vaccine IM 0, 1 and 6 months. Ninety-four receiving standard dose and 98 receiving double dose completed the study. The seroconversion rate (anti-HBs > or = 10 mIU/mL) was 47 and 34% for double dose and standard dose, respectively (p = 0.07). A statistically significant higher seroconversion rate was associated with double dose comparing with standard dose for patients with CD4 cell counts > or = 350 cells/mm3 (64.3% x 39.3%; p = 0.008) but made no difference to seroconversion in those with CD4 <350 (23.8% x 26.3%; p = 0.80). Double dose also improved seroconversion comparing with standard dose for patients with HIV viral load <10,000 copies/mL (58.3% x 37.3%; p = 0.01) but made no difference to seroconversion in those with HIV viral load > or = 10,000 copies/mL (16% x 17%; p = 0.7). Based on the results of this study, the best current strategy for hepatitis B vaccination in HIV patients would be to use a double dose as a primary series when the viral load is likely to be low and CD4> or = 350, when there is likely to be an adequate immune response.
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Affiliation(s)
- Marise Oliveira Fonseca
- Infectious Deseases Department, University Medical School of São Paulo, Av Dr Eneas de Carvalho Aguiar 500, 100 andar, sala 12, CEP 05403-000 São Paulo, SP, Brazil.
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18
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Vallabhaneni S, Macalino GE, Reinert SE, Schwartzapfel B, Wolf FA, Rich JD. Prisoners' attitudes toward Hepatitis B vaccination. Prev Med 2004; 38:828-33. [PMID: 15193905 DOI: 10.1016/j.ypmed.2003.12.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Hepatitis B continues to be a substantial problem in the United States despite the existence of a safe and effective vaccine. Vaccination programs for inmates could reach many high-risk individuals but little is known about U.S. inmates' willingness to accept hepatitis B virus (HBV) vaccination while incarcerated. The goal of this study was to assess inmates' knowledge about hepatitis B and their willingness to accept hepatitis B vaccination while incarcerated. METHODS We interviewed 153 male and female inmates at the Rhode Island Department of Corrections (RIDOC) using a voluntary, anonymous survey. RESULTS Ninety-three percent of inmates said they would agree to receive the hepatitis B vaccine while incarcerated. More than half of the 30% who reported having risk factors for hepatitis B did not consider themselves to be at risk for hepatitis B and almost half (44%) of all inmates were not aware that hepatitis B can be transmitted through unprotected sex. CONCLUSION Hepatitis B vaccination programs in correctional settings are a public health priority and would be well received by the target population. Such programs would help protect the health of incarcerated persons and the communities to which they return.
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Bruguera M, Forns X. Epidemiología actual de las hepatitis virales: ¿quién las padece y quién puede protegerse? Enferm Infecc Microbiol Clin 2004; 22:443-7. [PMID: 15482684 DOI: 10.1016/s0213-005x(04)73137-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
MESH Headings
- Adult
- Child
- Child, Preschool
- Female
- Food Contamination/prevention & control
- Food Handling
- Hepatitis, Viral, Human/congenital
- Hepatitis, Viral, Human/epidemiology
- Hepatitis, Viral, Human/prevention & control
- Hepatitis, Viral, Human/transmission
- Humans
- Infant
- Infant, Newborn
- Male
- Middle Aged
- Occupational Diseases/epidemiology
- Occupational Diseases/prevention & control
- Pregnancy
- Pregnancy Complications, Infectious
- Prevalence
- Renal Dialysis
- Risk Factors
- Seafood/virology
- Sexual Behavior
- Spain/epidemiology
- Substance Abuse, Intravenous
- Transfusion Reaction
- Transplantation/adverse effects
- Vaccination
- Viral Hepatitis Vaccines
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20
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Fotiadou M, Livaditis M, Manou I, Kaniotou E, Samakouri M, Tzavaras N, Xenitidis K. Self-reported substance misuse in Greek male prisoners. Eur Addict Res 2004; 10:56-60. [PMID: 15004448 DOI: 10.1159/000076114] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of this survey was to determine levels and severity of self-reported alcohol and drug misuse and associated physical and mental health problems in Greek male prisoners. The sample consisted of 80 randomly selected convicted and remanded male prisoners in a prison in northern Greece. The Mini International Neuropsychiatric Interview (MINI) was used to assess psychiatric disorders including substance abuse and dependence. All prisoners who participated completed the Alcohol Use Disorders Identification Test (AUDIT). Those who reported daily use of opiates and stimulants completed the Severity of Dependence Scale (SDS). Information was obtained from medical notes about the prisoners' hepatitis B and HIV status. The MINI identified 27.5% of the prisoners as dependent on opiates, 26.3% on alcohol and 73.8% as cannabis users, while 13.8% were misusing both alcohol and illicit drugs. Severity of dependence was rated, using SDS, as serious for all opiate and stimulant users. In terms of physical health examination of medical records indicated that no prisoner was HIV-positive but 26.5% were hepatitis-B-positive. Of those who had a previous history of substance misuse, 31.2% fulfilled the criteria for depression and 37.5% for antisocial personality disorder. Similarly, 15% of those misusing substances had a previous history of deliberate self-harm and 16% were assessed to have moderate to high suicide risk.
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Abstract
The purpose of this paper is to determine the cost-effectiveness of vaccinating inmates against hepatitis B. From the prison perspective, vaccinating inmates at intake is not cost-saving. It could be economically beneficial when the cost of a vaccine dose is <US dollars 30 per dose, or there is no prevalence of infection upon intake, or the costs of treating acute or chronic disease are about 70% higher than baseline costs, or the incidence of infection during and after custody were >1.6 and 50%, respectively. The health care system realizes net savings even when there is no incidence in prison, or there is no cost of chronic liver disease, or when only one dose of vaccine is administered. Thus, while prisons might not have economic incentives to implement hepatitis B vaccination programs, the health care system would benefit from allocating resources to them.
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Affiliation(s)
- Maria Pisu
- Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, MS D59, Atlanta, GA 30333, USA.
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22
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Awofeso N. Managerial considerations in implementing hepatitis B vaccination programs among drug-using cohorts. Addiction 2002; 97:1611-3; author reply 1613-4. [PMID: 12472648 DOI: 10.1046/j.1360-0443.2002.00284.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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23
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Fisman DN, Agrawal D, Leder K. The effect of age on immunologic response to recombinant hepatitis B vaccine: a meta-analysis. Clin Infect Dis 2002; 35:1368-75. [PMID: 12439800 DOI: 10.1086/344271] [Citation(s) in RCA: 140] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2002] [Accepted: 08/08/2002] [Indexed: 01/16/2023] Open
Abstract
Hepatitis B vaccine is a key tool for the prevention of hepatitis B infection. Age-associated changes in immune function may contribute to decreased vaccine efficacy in older individuals, although research related to this topic has yielded contradictory findings. We performed a meta-analysis of 24 published trials and studies that evaluated the association of age with response to hepatitis B vaccine, using a random-effects model. Pooling of study results suggested a significantly increased risk of nonresponse to hepatitis B vaccine among older individuals (relative risk [RR], 1.76; 95% confidence interval [CI], 1.48-2.10). An elevated risk of nonresponse persisted even after exclusion of poor-quality studies (RR, 1.63; 95% CI, 1.23-2.15) and adjustment for publication bias (RR, 1.52; 95% CI, 1.26-1.83), and it was present even when "older" individuals were defined as being as young as 30 years. These findings have important implications for individuals at risk for hepatitis B infection, including health care workers and travelers.
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Affiliation(s)
- David N Fisman
- City of Hamilton Social and Public Health Services Department, Hamilton, Ontario, Canada.
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24
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Quaglio G, Talamini G, Lugoboni F, Lechi A, Venturini L, Jarlais DCD, Mezzelani P. Compliance with hepatitis B vaccination in 1175 heroin users and risk factors associated with lack of vaccine response. Addiction 2002; 97:985-92. [PMID: 12144601 DOI: 10.1046/j.1360-0443.2002.00147.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS To investigate the feasibility of hepatitis B vaccination among heroin users, assessing adherence to the vaccination schedules and identifying factors associated with antibody response. DESIGN AND PARTICIPANTS A large cohort study in nine public centres for drug users (PCDUs) in north-eastern Italy, with data collected between January 1989 and December 1998. A total of 1175 heroin users were selected and vaccinated with a recombinant vaccine using two schedules (0-1-6 months and 0-1-2 months). FINDINGS Eighty-eight per cent of patients completed the vaccination series and a protective antibody response occurred in 77% of subjects. Completion of the vaccination series was not related to the length of the vaccination schedule or whether the patient was still in drug abuse treatment at the end of the series, but was related strongly to the number of patients enrolled at each PCDU (Spearman correlation = - 0.93, P < 0.001). Four variables were significantly associated with lack of seroconversion in response to vaccination: older age (AOR = 0.91 per year, 95% CI 0.88-0.94, P < 0.001), 2-month vaccination schedule (AOR = 3.10, 95% CI 2.06-4.68, P < 0.001), HCV seropositivity (AOR = 0.69, 95% CI 0.47-0.99, P = 0.04), HIV seropositivity (AOR = 0.27, 95% CI 0.10-0.77, P = 0.01). CONCLUSIONS A large-scale, multi-site hepatitis B vaccination programme for heroin users proved feasible and effective. The factors associated with a lack of antibody response may be useful in identifying patients who would benefit most from routine post-vaccination testing, with booster doses for non-responders. These results suggest that hepatitis B vaccination for drug users should become a routine public health practice.
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Affiliation(s)
- Gianluca Quaglio
- Medical Service for Addictive Disorders, Department of Internal Medicine, University of Verona, Italy
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25
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García-Samaniego J, Soriano V, Miró JM, Romero JD, Bruguera M, Castilla J, Esteban JI, Gonźlez J, Lissen E, Moreno A, Moreno S, Moreno-Otero R, Ortega E, Quereda C, Rodríguez M, Sánchez-Tapias JM. Management of chronic viral hepatitis in HIV-infected patients: Spanish Consensus Conference. October 2000. HIV CLINICAL TRIALS 2002; 3:99-114. [PMID: 11976988 DOI: 10.1310/h2cf-3kna-q3y9-c3g1] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Co-infection by human immunodeficiency virus and hepatitis B and C viruses is quite common because they share similar routes of transmission. The introduction of highly active antiretroviral therapy has significantly improved the life expectancy of HIV-infected patients in the last few years. However, chronic viral hepatitis represents an emerging cause of morbidity and mortality in this population, either as a result of end-stage liver disease or as a consequence of hepatotoxicity induced by antiretroviral drugs. The main goal of the Consensus Conference was to establish specific recommendations for the management of chronic viral hepatitis B and C in HIV-infected patients. The role of orthotopic liver transplantation for co-infected individuals with end-stage liver disease was also assessed.
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26
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Awofeso N, Levy M, Harper S, Jones M, Hayes M, Douglas J, Fisher M, Folpp D. Response to HBV vaccine in relation to vaccine dose and anti-HCV positivity: a New South Wales correctional facilities' study. Vaccine 2001; 19:4245-8. [PMID: 11457551 DOI: 10.1016/s0264-410x(01)00172-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Currently, about two-thirds of inmates in NSW correctional facilities have a history of injection drug use, and about half have serological evidence of exposure to hepatitis C virus. The introduction of an accelerated hepatitis B vaccination program (0-1-2 months) in 1998, using a 20 microg/dose vaccine was necessitated by the need to vaccinate eligible inmates in this high-risk environment characterised by rapid client mobility. Since 1999, both 10 and 20 microg doses of vaccine were introduced. We found that sero-response rates were not significantly influenced by HCV antibody status, but were significantly lower in cohorts of inmates vaccinated with the 10 microg dose of vaccine.
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Affiliation(s)
- N Awofeso
- New South Wales Corrections Health Service, P.O. Box 150, NSW 2036, Matraville, Australia.
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27
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Asensio F, Bayas JM, Bertran MJ, Asenjo MA. Prevalence of hepatitis B infection in long-stay mentally handicapped adults. Eur J Epidemiol 2001; 16:725-9. [PMID: 11142500 DOI: 10.1023/a:1026793900057] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The objective was to determine the prevalence of hepatitis B virus (HBV) infection in long-stay institutionalized mentally handicapped adults and to develop a vaccination programme for them. The study was carried out in 1994. The subjects were 171 mentally handicapped adults aged 37-76 (median age 56) with a median hospital stay of 30 years (range 6-47). Markers for infection were determined using ELISA. Seronegative patients were vaccinated using the standard schedule, and the titre of antiHBs reached was determined later. The prevalence of seropositive subjects was 81.3%. Seropositive subjects had a longer hospital stay (median stay of 32 years, range: 15-47) than seronegative ones (median stay of 15 years, range: 6-33). A total of 43.3% of the vaccinated subjects developed antiHBs antibodies (GMT: 135 IU/l). The high prevalence of HBV exposure is probably a legacy of a past era which is reflected in patients with prolonged institutionalisation in a closed regime. The need for immediate vaccination of mentally handicapped subjects is of the utmost importance, as it has been shown that the response to the vaccine worsens with age.
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Affiliation(s)
- F Asensio
- Hospital Sant Joan de Déu-Services of Mental Health, Sant Boi, Spain
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28
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Cuende J. Estudio de casos de infección por el virus de la inmunodeficiencia humana en prisiones de Castilla y León. Rev Clin Esp 2001. [DOI: 10.1016/s0014-2565(01)70811-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Claudon-Charpentier A, Hoibian M, Glasser P, Lalanne H, Pasquali JL. [Drug-addicted prisoners: seroprevalence of human immunodeficiency virus and hepatitis B and C virus soon after the marketing of buprenorphine]. Rev Med Interne 2000; 21:505-9. [PMID: 10909149 DOI: 10.1016/s0248-8663(00)89225-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE Considering the importance to public health and the frequency with which drug addicts are imprisoned, we studied the prevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV), as well as drug addiction of patients admitted to the Elsau prison in Strasbourg (France). METHODS The prospective study included all entering inmates from 1 September to 31 October 1997 (270 persons) to whom HIV, HBV and HCV blood tests were offered as well as a questionnaire on their drug addiction. RESULTS Thirty-six percent of the entering inmates were drug addicts, of whom 1% were HIV positive, 11.2% HBV positive and 30% HCV positive, compared to, respectively, 0.6, 9.9 and 6.4% for non-drug addicts. Ninety-five of the 98 patients used several drugs, including buprenorphine for 53 patients. At the beginning of this study, buprenorphine had been available in France for 9 months. CONCLUSION The results are to be taken seriously regarding the misuse of this product in this selected population (intravenous use, multiple drug use, dealing).
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Affiliation(s)
- A Claudon-Charpentier
- Service pharmacie, hôpital de Hautepierre, Hôpitaux universitaires de Strasbourg, France
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30
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Rodríguez-Méndez ML, González-Quintela A, Aguilera A, Barrio E. Prevalence, patterns, and course of past hepatitis B virus infection in intravenous drug users with HIV-1 infection. Am J Gastroenterol 2000; 95:1316-22. [PMID: 10811346 DOI: 10.1111/j.1572-0241.2000.01981.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) share common routes of transmission. Therefore, markers of either active or past HBV infection are present in many HIV-infected patients, particularly in intravenous drug users (IDUs). The aim of this study was to analyze the serological pattern of past HBV infection (presence or absence of anti-HBs) and the course of past HBV infection (changes in anti-HBs status, and HBV reactivation) in two cohorts of IDUs with and without HIV infection. METHODS HBV serum markers were studied in 388 HIV-positive and 197 HIV-negative IDUs. Among them, 263 HIV-positive and 50 HIV-negative patients with past HBV infection (serum HBsAg negative and anti-HBc positive, with or without anti-HBs) were followed-up for a median of 21 and 13 months, respectively, to detect changes in anti-HBs status and HBV reactivation. RESULTS The prevalence of HBV infection (either active or past) was higher in HIV-positive than in HIV-negative cases (90% vs 62%, p < 0.001), even when stratified by years of drug use. Most cases (92% of HIV-positive and 89% of HIV-negative) had markers of past infection. Among those patients with past HBV infection, 60% of HIV-positive and 72% of HIV-negative presented serum anti-HBs (p = 0.03). The incidence of anti-HBs loss was 1.8 cases/100 person-year in HIV-positive, and 1.8 cases/100 person-year in HIV-negative patients (RR 1.0, 95% CI 0.1-94, p = NS). Incidence of anti-HBs development was 17.6 cases/100 person-year in HIV-positive and 25.6 cases/100 person-year in HIV-negative IDUs (RR, 1.5, 95% CI, 0.6-3.5, p = NS). Only one HIV-positive patient with markers of past HBV infection developed an active infection (0.2 events/100 person-year). CONCLUSIONS HBV infection (either active or past) is particularly frequent in HIV-positive IDUs. Most cases have markers of past infection. Isolated detection of anti-HBc (absence of anti-HBs) is more common in HIV-positive than in HIV-negative IDUs. Despite their progressive immunosuppression, both anti-HBs loss and HBV reactivation are rare in HIV-infected IDUs.
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Affiliation(s)
- M L Rodríguez-Méndez
- Department of Internal Medicine, Complejo Hospitalario Universitario, Santiago de Compostela, Spain
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Butler T, Spencer J, Cui J, Vickery K, Zou J, Kaldor J. Seroprevalence of markers for hepatitis B, C and G in male and female prisoners--NSW, 1996. Aust N Z J Public Health 1999; 23:377-84. [PMID: 10462860 DOI: 10.1111/j.1467-842x.1999.tb01278.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES 1. Establish the prevalence of markers for hepatitis B (HBV), C (HCV) and G (HGV) in a sample of male and female inmates. 2. Examine exposure to multiple viruses. 3. Compare risk factors for HGV infection with known risk factors for HBV and HCV. DESIGN Cross-sectional random sample stratified by sex, age and Aboriginality. Inmates were screened for three hepatitis markers. Participants were 789 inmates (657 male, 132 female) in 27 correctional centres in New South Wales, 1996. RESULTS Overall detection of each of the three screening markers was 35% for HBV, 39% for HCV and 10% for HGV. Exposure rates were higher in female prisoners than males. Increased rates of anti-HBc were observed in Aboriginal inmates compared with non-Aboriginals (54% cf. 27%); anti-HCV and HGV-RNA were comparable between the two groups (36% cf. 41% and 9% cf. 10%). Markers were significantly higher in female injecting drug users (IDU), particularly HCV (90% cf. 66%). Thirty-five per cent of inmates were unaware of their HCV status. For HBV, 72% did not self-report past or present exposure despite serological evidence to the contrary. The multivariate analysis identified Aboriginality, long-term injecting and injecting while in prison as risk factors for HBV. HCV risk factors were female sex, non-Aboriginality, institutionalisation and IDU-associated behaviours. For HGV, female sex and previous imprisonment were significant risk factors but IDU was not. CONCLUSIONS Blood-borne hepatitis viruses are common in prison inmates, particularly females (HBV, HCV and HGV), Aboriginals (HBV) and IDU (HBV and HCV). Infection can be related to a number of risk factors, which appear similar for HBV and HCV, but distinct from HGV.
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Affiliation(s)
- T Butler
- New South Wales Health Department, Olympic Planning Unit, North Sydney, NSW.
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Abstract
Compromised travelers represent a diverse and challenging group of individuals. They include HIV-infected patients who are at risk for potentially adverse reactions to immunizations, and new exposures to enteric water-borne opportunistic pathogens associated with chronic infections. Such travelers may encounter unfamiliar opportunistic fungi and classical tropical infections, such as leishmaniasis, whose pathogenesis can be enhanced by the presence of prior HIV infection. Other immunocompromised groups include those who are functionally or anatomically asplenic, and patients who are iatrogenically immunosuppressed from medications utilized for solid organ transplantation, chemotherapy, or treatment of malignancies. This population of travelers also includes those with diabetes mellitus who may require adjustments in their dosing, administration, and possibly even the types of insulin used on their trips. These patients are also at greater risk for acquisition of tuberculosis, severe community-acquired pneumonia, urinary tract infections, and pyomyositis. Older travelers present both the infectious disease and travel medicine specialist with issues such events, malignancy-related infections, myocardial infarction, and other forms of cardiopulmonary compromise, which the authors address in this article.
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Affiliation(s)
- M D Mileno
- Department of Medicine, Brown University, Providence, Rhode Island, USA
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Hammett TM, Gaiter JL, Crawford C. Reaching seriously at-risk populations: health interventions in criminal justice settings. HEALTH EDUCATION & BEHAVIOR 1998; 25:99-120. [PMID: 9474502 DOI: 10.1177/109019819802500108] [Citation(s) in RCA: 139] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
More than 6 million people are under some form of criminal justice supervision in the United States on any given day. The vast majority are arrested in and return to urban, low-income communities. These are men, women, and adolescents with high rates of infectious diseases such as HIV/AIDS, other sexually transmitted diseases (STDs), and tuberculosis (TB), as well as substance abuse and other health problems. A review of recent literature indicates that an increasing problem for these populations is that they have had little prior access to primary health care or health interventions, and many are returning to their communities without critical preventive health information and skills, appropriate medical services, and other necessary support. Periods of incarceration and other criminal justice supervision offer important opportunities to provide a range of health interventions to this underserved population, and general evaluations show the potential for this strategy. Public health and criminal justice agencies have the expertise and should collaborate to provide interventions needed by incarcerated populations. Moreover, many recently released inmates require primary care for HIV/AIDS, other STDs, and TB. Consequently, timely discharge planning is essential, as are linkages with community-based organizations and agencies that can provide medical care, health education, and necessary supportive services.
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Affiliation(s)
- T M Hammett
- Abt Associates, Inc., Cambridge, MA 02138-1168, USA.
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Butler TG, Dolan KA, Ferson MJ, McGuinness LM, Brown PR, Robertson PW. Hepatitis B and C in New South Wales prisons: prevalence and risk factors. Med J Aust 1997; 166:127-30. [PMID: 9059433 DOI: 10.5694/j.1326-5377.1997.tb140041.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To determine the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection among inmates entering the New South Wales correctional system and to examine risk factors for infection. DESIGN Cross-sectional survey. SETTING Reception Centre at Long Bay Correctional Centre, Sydney, New South Wales, June to December 1994. PARTICIPANTS 408 adult male inmates received at the Reception Centre (28% of the 1450 new inmates eligible for compulsory HIV testing). OUTCOME MEASURES Presence of HBV core and surface antibody and surface antigen; HCV antibody; risk factors; inmates' knowledge about risk factors. RESULTS 37% of inmates tested positive for HCV antibody, 31% for HBV core antibody and 3.2% for HBV surface antigen (indicating recent infection or carrier status). Among those who reported a history of injecting illegal drugs, rates rose to 66% for HCV antibody and 43% for HBV core antibody. Prevalence of HBV and HCV antibodies was similar in Aboriginal and non-Aboriginal inmates, but HBV antigen carrier rate was significantly higher among Aboriginals (12% versus 2.2%). Knowledge about hepatitis risk factors was poor (only 20% named injecting drug use), although recidivists were significantly better informed than those new to the correctional system. Multivariate analysis identified injecting drug use, past exposure to hepatitis B virus and previous imprisonments as significant predictors for HCV infection, and age over 25 years and HCV antibodies for HBV infection. CONCLUSIONS Results suggest that about a third of adult male prisoners entering the NSW correctional system may have been infected with HBV or HCV. Measures such as education about hepatitis risk factors and HBV vaccination are needed to reduce hepatitis transmission in this population.
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Affiliation(s)
- T G Butler
- New South Wales Health Department, AIDS/Infectious Diseases Branch, Sydney
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Crofts N, Stewart T, Hearne P, Ping XY, Breshkin AM, Locarnini SA. Spread of bloodborne viruses among Australian prison entrants. BMJ (CLINICAL RESEARCH ED.) 1995; 310:285-8. [PMID: 7866168 PMCID: PMC2548691 DOI: 10.1136/bmj.310.6975.285] [Citation(s) in RCA: 118] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To assess spread of bloodborne viruses among prison entrants in Victoria, Australia. DESIGN Voluntary confidential testing of all prison entrants for markers of exposure to bloodborne viruses with collection of minimal data on demography and risk factors over 12 months. SETTING Her Majesty's Prisons, Pentridge and Fairlea, Victoria, Australia. SUBJECTS 3429 male and 198 female prison entrants (> 99% of all prison entrants); 344 entered prison and were tested more than once. MAIN OUTCOME MEASURES Prevalence and incidence of antibodies to HIV, hepatitis B, and hepatitis C viruses, and minimal data on risk factors. RESULTS 1562 (46%) gave a history of use of injected drugs, 1171 (33%) had antibody to hepatitis B core antigen, 1418 (39%) were anti-hepatitis C positive including 914 (64%) of the men who injected drugs, 91 (2.5%) were positive for hepatitis B surface antigen, and 17 (0.47%) were positive for antibody to HIV. Incidence rates for infection with hepatitis B and C virus were 12.6 and 18.3 per 100 person years, respectively; in men who injected drugs and were aged less than 30 years (29% of all prison entrants) these were 21 and 41 per 100 person years. Seroconversion to hepatitis B or C was associated with young age and shorter stay in prison. Only 5% of those who were not immune to hepatitis B reported hepatitis B immunisation. CONCLUSIONS Hepatitis B and C are spreading rapidly through some populations of injecting drug users in Victoria, particularly among men aged less than 30 years at risk of imprisonment in whom rates of spread are extreme; this group constitutes a sizeable at risk population for spread of HIV. This spread is occurring in a context of integrated harm reduction measures outside prisons for prevention of viral spread but few programmes within or on transition from prisons; it poses an urgent challenge to these programmes.
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Affiliation(s)
- N Crofts
- Epidemiology and International Health Unit, Macfarlane Burnet Centre of Medical Research, Fairfield, Victoria, Australia
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Wodak A, Crofts N. HIV revisited: preventing the spread of blood-borne viruses among injecting drug users. AUSTRALIAN JOURNAL OF PUBLIC HEALTH 1994; 18:239-41. [PMID: 7841248 DOI: 10.1111/j.1753-6405.1994.tb00236.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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