14th ICID - Poster Abstracts - International Society for Infectious ...

When citing these abstracts please use the following reference:
Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number.
Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1
is available electronically on http://www.sciencedirect.com
Final Abstract Number: 78.012
Session: HIV: Opportunistic Infections & Malignancies
Date: Friday, March 12, 2010
Time: 12:30-13:30
Room: Poster & Exhibition Area/Ground Level
Type: Poster Presentation
An assessment of the seroprevalence of hepatitis A antibody and vaccination among HIV patients
in an inner city HIV clinic
A. ADEJUMO, V. Sivapalan, S. Mannheimer
Columbia University College Of Physicians and Surgeons affiliation at Harlem Hospital Center,
New York, NY, USA
Background: Routine hepatitis A virus (HAV) screening and vaccination is recommended in the
guidelines for the management of high risk persons infected with the human immunodeficiency
virus (HIV). Scientific evidence shows that patients with no immunity against HAV suffer
prolonged clinical course and hepatitis related liver abnormalities if infected with acute hepatitis
when compared to those who have immunity.
The objective of this study is to assess the seroprevalence of anti-HAV and hepatitis A
vaccination among high risk patients in the outpatient HIV clinic.
Methods: A retrospective review of medical records of high risk adult patients (age > 18y) who
attended the outpatient HIV clinic between the period of July 2007 - December 2008. The clinic
provides primary care services to approximately 750 HIV-infected patients. The clinic
demographics include 47% women, 83% Blacks and 14% Latinos.
Results: 244 high risk HIV infected adult patients had at least one visit within the study period. All
received anti-HAV screening, of which 87.3% (n=213) tested negative for anti-HAV and 12.7%
(n=31) tested positive. Among those who tested negative, 12% (n=26) had only 1 visit and did not
follow up. Of the remaining 187 patients who followed up, 60% (n=113) received at least 1 dose
of hepatitis A vaccine and 40% (n=74) did not receive a single dose of vaccine. Among the total
244 patients, 18 had perinatally acquired HIV infection. 88% (n=16) of these patients with
perinatal HIV had positive anti-HAV and are responsible for 52% of the total 31 patients with
positive antibody. All the 31 patients with anti-HAV had more than 1 visit.
Conclusion: In our cohort of high risk HIV infected adults, patients with perinatal HIV are more
likely to have anti-HAV. The seroprevalence of anti-HAV in our chort is low (12.7%) and similar to
the rate reported in other studies. The hepatitis A vaccination rate of 60% in our cohort is below
the target of greater than 90% vaccination rate needed for herd immunity to lessen the impact of
the disease in the community. The high rate of anti-HAV in patients with perinatal HIV highlights
the effectiveness of the strategy for childhood hepatitis A vaccination schedule. Comparable
success in adult patients will require a higher adherence to vaccination recommendations in order
to prevent HAV infection in HIV patients.