Hepatitis B Vaccination Low Among HIV-Positive Patients

More than one-third of HIV-positive patients are not vaccinated against hepatitis B virus.

Patients with HIV are at an increased risk of numerous comorbidities and infections, including hepatitis B virus (HBV). Due to the opioid epidemic, injection drug users have a significantly increased risk of contracting HBV and hepatitis C virus, especially those coinfected with HIV.

Recently, the American College of Physicians and CDC released new best practice guidelines to address HBV. The guidelines stress that all adults, including at-risk pregnant women, should be vaccinated against HBV. Vaccination is crucially important for patients with liver disease, end-stage renal disease, or HIV, according to the guidelines.

A new study published by the Annals of Internal Medicine showed that the HBV vaccination rate among HIV-positive patients is particularly low, highlighting the importance of the new guidelines.

Included in the cross-sectional survey were 18,089 adults receiving medical care for HIV between 2009 and 2012.

The authors analyzed the data to determine the prevalence of no documentation for HBV vaccination, laboratory evidence of immunity or infection, and the initiation of vaccination among eligible patients.

At baseline, approximately 44.2% of HIV-positive patients were candidates to receive the HBV vaccine.

Although nearly half of study participants were eligible, only 9.6% actually received the vaccine, according to the study. Another 7.5% of patients had no record of vaccination, but had evidence of infection or immunity against HBV.

The remaining 82.9% of candidates remained unvaccinated at the end of the trial, according to the study.

Specifically, among patients receiving care at clinics funded by the Ryan White HIV/AIDS Program (RWHAP), 12.5% received the vaccine compared with 3.7% of patients treated at facilities not funded by RWHAP, according to the study.

The authors discovered that overall, more than one-third of HIV-positive patients missed opportunities to receive the HBV vaccine.

These findings highlight a significant gap in care for HIV-positive patients who have a higher risk of contracting HBV than the general population. The authors concluded that increasing vaccination—especially at facilities not funded by RWHAP—is critical for meeting World Health Organization goals of HBV elimination by 2030.