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Gerin L, Gir E, Neves LADS, Passos LMR, Kfouri RDÁ, Reis RK. Online course on vaccinating people with HIV/AIDS - effectiveness in the knowledge of nursing professionals. Rev Lat Am Enfermagem 2024; 32:e4278. [PMID: 39140564 PMCID: PMC11321195 DOI: 10.1590/1518-8345.7004.4278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 04/19/2024] [Indexed: 08/15/2024] Open
Abstract
OBJECTIVE analyzing the effectiveness of an educational intervention on the knowledge of nursing professionals regarding the immunization of people with the human immunodeficiency virus. METHOD a quasi-experimental study evaluated professionals' knowledge through a knowledge test applied before and after the development of an online training course. The data was analyzed using frequency, median, mean, standard deviation, and association tests. RESULTS the sample consisted of 77 nursing professionals whose mean age was 43.2 years (SD+/-8.2). More than half of the individuals worked in basic health units (58.4%), 22.1% worked in specialized services that provide clinical monitoring for people with the human immunodeficiency virus, and 42 (54.5%) were nursing assistants or technicians. The professionals' performance improved after the intervention, with an increase in the median number of correct answers from 23.0 to 27.0 (p<0.001). CONCLUSION offering an online training course on the immunization of people with the human immunodeficiency virus, as a continuing education activity, proved to be effective in improving nursing professionals' knowledge on this subject. HIGHLIGHTS (1) Services do not evaluate the vaccination status of people living with HIV.(2) The knowledge of health professionals may influence vaccination rates.(3) Health professionals' knowledge of immunization may be insufficient.
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Affiliation(s)
- Larissa Gerin
- Secretaria Municipal da Saúde, Divisão de Vigilância Epidemiológica, Ribeirão Preto, SP, Brazil
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Elucir Gir
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | | | | | | | - Renata Karina Reis
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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Bieńkowski C, Żak Z, Fijołek F, Cholewik M, Stępień M, Skrzat-Klapaczyńska A, Kowalska JD. Immunological and Clinical Responses to Vaccinations among Adults Living with HIV. Life (Basel) 2024; 14:540. [PMID: 38792562 PMCID: PMC11122059 DOI: 10.3390/life14050540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/07/2024] [Accepted: 04/17/2024] [Indexed: 05/26/2024] Open
Abstract
People living with human immunodeficiency virus (HIV) are at higher risk of morbidity and mortality due to vaccine-preventable diseases. At the same time, they are less likely to respond to vaccinations, and might have a higher rate of vaccine adverse event and faster waning of protective effect. International and national guidelines emphasize the importance of vaccinating people living with HIV against respiratory system disease pathogens including seasonal influenza, Streptococcus pneumoniae, and COVID-19, as well as against sexually transmitted infections, i.e., Hepatitis A and B (HAV, HBV) and human papillomavirus (HPV). This narrative review aims to provide a comprehensive examination of the current knowledge regarding the immune and clinical responses elicited by vaccinations in the older adult population living with HIV.
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Affiliation(s)
- Carlo Bieńkowski
- Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland; (F.F.); (A.S.-K.); (J.D.K.)
- Department of Adults’ Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland
| | - Zuzanna Żak
- Department of Internal Medicine, Endocrinology, and Diabetes, Medical University of Warsaw, 01-201 Warsaw, Poland;
| | - Filip Fijołek
- Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland; (F.F.); (A.S.-K.); (J.D.K.)
- Department of Adults’ Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland
| | - Martyna Cholewik
- Student’s Scientific Group at the Department of Adults’ Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland; (M.C.); (M.S.)
| | - Maciej Stępień
- Student’s Scientific Group at the Department of Adults’ Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland; (M.C.); (M.S.)
| | - Agata Skrzat-Klapaczyńska
- Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland; (F.F.); (A.S.-K.); (J.D.K.)
- Department of Adults’ Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland
| | - Justyna D. Kowalska
- Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland; (F.F.); (A.S.-K.); (J.D.K.)
- Department of Adults’ Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland
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Ciocca ET, Staggers KA, Carey J, Opekun AR, Hollinger FB, Keitel WA, Atmar RL, El Sahly HM, Whitaker JA. Delays in Hepatitis A vaccination in people with HIV in Houston, Texas between 2010 and 2018. Vaccine X 2024; 16:100422. [PMID: 38192618 PMCID: PMC10772366 DOI: 10.1016/j.jvacx.2023.100422] [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: 04/30/2023] [Revised: 11/30/2023] [Accepted: 12/11/2023] [Indexed: 01/10/2024] Open
Abstract
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.
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Affiliation(s)
- Emily T. Ciocca
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Kristen A. Staggers
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA
| | | | - Antone R. Opekun
- Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USA
| | - F. Blaine Hollinger
- Department 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, USA
| | - Wendy A. Keitel
- Department 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
| | - Robert L. Atmar
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USA
| | - Hana M. El Sahly
- Department 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
| | - Jennifer A. Whitaker
- Department 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
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Seong H, Choi Y, Ahn KH, Choi JY, Kim SW, Kim SI, Kee MK, Choi BY, Park B, Hyun HJ, Yoon JG, Noh JY, Cheong HJ, Kim WJ, Song JY. Assessment of Disease Burden and Immunization Rates for Vaccine-Preventable Diseases in People Living with HIV: The Korea HIV/AIDS Cohort Study. Infect Chemother 2023; 55:441-450. [PMID: 37674339 PMCID: PMC10771952 DOI: 10.3947/ic.2023.0045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/17/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Prophylactic immunization is important for human immunodeficiency virus (HIV)-infected patients; however, there are insufficient data on the burden of vaccine-preventable diseases (VPDs), vaccination rates, and factors influencing vaccination. MATERIALS AND METHODS The incidence and prevalence of VPDs in HIV-infected patients between 2006 and 2017 were estimated using the Korean HIV/acquired immune deficiency syndrome (AIDS) cohort database. In addition, we evaluated the vaccination rates and influencing factors for vaccination in HIV-infected patients through multilevel analysis of clinico-epidemiological factors, immune status, and psychological status. A questionnaire survey was conducted among experts to determine whether they recommend vaccination for HIV-infected patients. RESULTS The incidence rates of hepatitis B virus (HBV) infection, herpes zoster, and anogenital warts were 1.74, 7.38, and 10.85 per 1,000 person-years, respectively. The prevalence of HBV infection and anogenital warts at enrollment was 4.8% and 8.6%, respectively, which increased to 5.3% and 12.0%, respectively, by 2017. In HIV-infected patients, HBV (21.7% in 2008, 56.3% in 2013, and 75.4% in 2017) and pneumococcal vaccination rates (3.0% in 2015, 7.6% in 2016, and 9.6% in 2017) increased annually, whereas the influenza vaccination rate remained similar by season (32.7 - 35.6%). In the multilevel analysis, peak HIV viral load (≥50 copies/mL: odds ratio [OR] = 0.64, 95% confidence interval [CI]: 0.44 - 0.93; reference, <50 copies/mL) was an influencing factor for pneumococcal vaccination, while nadir CD4 T-cell counts (200 - 350 cells/mm3: OR = 0.54, 95% CI: 0.38 - 0.76; <200 cells/mm3: OR = 0.89, 95% CI: 0.62 - 1.28; reference, ≥350 cells/mm3) was an influencing factor for HBV vaccination. Influenza vaccination was associated with male sex (OR = 1.94) and the number of antiretroviral therapy (ART) regimen change (OR = 1.16), but was not significantly associated with HIV viral load or CD4 T-cell counts. Most experts responded that they administer hepatitis A virus, HBV, pneumococcal, and influenza vaccines routinely, but not human papillomavirus (12.9%) or herpes zoster vaccines (27.1%). CONCLUSION The burden of vaccine-preventable diseases was quite high in HIV-infected patients. Nadir CD4 T-cell counts, peak HIV viral loads, and the number of ART regimen change are significant factors related to vaccination. Considering the low vaccination rates for VPDs, there was a discordance between experts' opinions and real clinical practice in the medical field.
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Affiliation(s)
- Hye Seong
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
- Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Korea
- Vaccine Innovation Center-KU Medicine, Seoul, Korea
| | - Yunsu Choi
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
- Institute for Health and Society, Hanyang University, Seoul, Korea
| | - Kyoung Hwan Ahn
- Institute for Health and Society, Hanyang University, Seoul, Korea
| | - Jun Yong Choi
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Shin-Woo Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sang Il Kim
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Mee-Kyung Kee
- Division of Viral Disease Research, Center for Infectious Diseases Research, Korea National Institute of Health, Cheongju, Korea
| | - Bo Youl Choi
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Boyoung Park
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hak Jun Hyun
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
- Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Korea
- Vaccine Innovation Center-KU Medicine, Seoul, Korea
| | - Jin Gu Yoon
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
- Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Korea
- Vaccine Innovation Center-KU Medicine, Seoul, Korea
| | - Ji Yun Noh
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
- Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Korea
- Vaccine Innovation Center-KU Medicine, Seoul, Korea
| | - Hee Jin Cheong
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
- Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Korea
- Vaccine Innovation Center-KU Medicine, Seoul, Korea
| | - Woo Joo Kim
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
- Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Korea
- Vaccine Innovation Center-KU Medicine, Seoul, Korea
| | - Joon Young Song
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
- Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Korea
- Vaccine Innovation Center-KU Medicine, Seoul, Korea.
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Garcia A, Vigil KJ, Taylor B, Kshirsagar O, Thamer M, Jain MK. Persistent low prevalence of hepatitis B vaccination among people with HIV: Time for a change? J Viral Hepat 2023; 30:790-792. [PMID: 37401399 DOI: 10.1111/jvh.13868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 06/13/2023] [Accepted: 06/16/2023] [Indexed: 07/05/2023]
Abstract
Hepatitis B virus (HBV) infection is one of the leading causes of hepatocellular carcinoma and mortality among people living with HIV (PLWH). HBV vaccination provides protection from infection; however, vaccination rates are low. We conducted a retrospective analysis at three HIV centres in Texas to determine the proportion of PLWH who received the recommended 3 doses of hepatitis B vaccine within 1 year. Factors associated with vaccination completion were explored. In our sample of three sites in a state with high HIV transmission and high rates of liver disease from 2011 to 2021, showed low rates of hepatitis B vaccination. Among eligible PLWH, only 9% completed the 3-dose hepatitis B vaccine series in 1 year. There is an urgent need to improve HBV vaccination to reach 2030 target for hepatitis B elimination.
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Affiliation(s)
- Angie Garcia
- UT Southwestern Medical Center, Dallas, Texas, USA
| | - Karen J Vigil
- University of Texas Health Science Center, Houston, Texas, USA
| | - Barbara Taylor
- University of Texas Health Science Center, San Antonio, Texas, USA
| | - Onkar Kshirsagar
- Medical Technology and Practice Patterns Institute, Bethesda, Maryland, USA
| | - Mae Thamer
- Medical Technology and Practice Patterns Institute, Bethesda, Maryland, USA
| | - Mamta K Jain
- UT Southwestern Medical Center, Dallas, Texas, USA
- Parkland Health, Dallas, Texas, USA
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Gerin L, Antonini M, Santos KDS, Gir E, Reis RK. O conhecimento dos profissionais de saúde sobre vacinação de pessoas vivendo com HIV – uma revisão integrativa. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Identificar evidências na literatura acerca do conhecimento dos profissionais de saúde sobre vacinação das pessoas vivendo com HIV. Método Trata-se de uma revisão integrativa. Para a busca, foram utilizados os descritores: pessoal de saúde (health personnel), conhecimento (knowledge), vacinação (vaccination), HIV e seus sinônimos, sem utilização de filtros, nas bases de dados Pubmed, Biblioteca Virtual em Saúde, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Embase, Scopus, Science Direct e Cochrane. Foram incluídos apenas artigos primários analisados por meio do aplicativo RAYYAN. Resultados De 601 publicações iniciais, apenas cinco constituíram a amostra final, todas identificadas no Pubmed publicadas entre 2013 e 2018, sendo nenhum estudo brasileiro. A maioria das publicações estava relacionada a alguma vacina específica e não abordava todo o calendário vacinal. Conclusão e implicações para a prática O déficit de conhecimento dos profissionais de saúde, em relação às vacinas indicadas às pessoas vivendo com HIV, foi o principal aspecto identificado, resultando em insegurança dos profissionais. Há a necessidade de educação permanente das equipes multiprofissionais dos serviços especializados e da atenção primária visando diminuir as barreiras e aumentar a cobertura vacinal desta clientela.
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Affiliation(s)
- Larissa Gerin
- Secretaria Municipal de Saúde de Ribeirão Preto, Brasil; Universidade de São Paulo, Brasil
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Drewes J, Langer PC, Ebert J, Kleiber D, Gusy B. Sociodemographic, HIV-Related Characteristics, and Health Care Factors as Predictors of Self-Reported Vaccination Coverage in a Nationwide Sample of People Aging with HIV in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094901. [PMID: 34064514 PMCID: PMC8125659 DOI: 10.3390/ijerph18094901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/23/2021] [Accepted: 04/29/2021] [Indexed: 11/16/2022]
Abstract
Preventing infectious diseases through vaccination becomes more significant among the growing population of people aging with HIV. Coverage rates for vaccinations and factors associated with vaccination utilization among this population in Germany are unknown. We assessed the coverage of eight recommended vaccinations in a certain time frame in our convenience sample of 903 people living with HIV aged 50 years and older. We analysed coverage rates and used bivariate and multiple linear regression analyses to identify factors associated with number of reported vaccinations. Coverage rates in our sample ranged between 51.0% for meningococcus disease and 84.6% for the triple vaccination against tetanus, diphtheria, and pertussis. All rates were higher compared to the German general population. Seven factors were related to the number of vaccinations in multiple regression analysis: sexual orientation, education, relationship status, CD4 count, time since last visit to HIV specialist, type of HIV specialist, and distance to HIV specialist. Vaccination coverage among people aging with HIV in Germany is high, but not optimal. To improve vaccination uptake, strengthened efforts need to be focused on female and heterosexual male patients, socioeconomically disadvantaged patients, and patients with barriers to access regular HIV care.
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Affiliation(s)
- Jochen Drewes
- Public Health: Prevention and Psychosocial Health Research, Freie Universität Berlin, 14195 Berlin, Germany; (J.E.); (D.K.); (B.G.)
- Correspondence:
| | - Phil C. Langer
- Department of Social Psychology, International Psychoanalytic University, 10555 Berlin, Germany;
| | - Jennifer Ebert
- Public Health: Prevention and Psychosocial Health Research, Freie Universität Berlin, 14195 Berlin, Germany; (J.E.); (D.K.); (B.G.)
| | - Dieter Kleiber
- Public Health: Prevention and Psychosocial Health Research, Freie Universität Berlin, 14195 Berlin, Germany; (J.E.); (D.K.); (B.G.)
| | - Burkhard Gusy
- Public Health: Prevention and Psychosocial Health Research, Freie Universität Berlin, 14195 Berlin, Germany; (J.E.); (D.K.); (B.G.)
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