Florent Valour1, Laurent Cotte2, Nicolas Voirin3, Matthieu Godinot4, Florence Ader5, Tristan Ferry5, Philippe Vanhems3, Christian Chidiac5. 1. Infectious Diseases Department, Hospices Civils de Lyon, Lyon, France; INSERM U1111, International Center for Research in Infectiology, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France. Electronic address: florent.valour@chu-lyon.fr. 2. Infectious Diseases Department, Hospices Civils de Lyon, Lyon, France; INSERM U1052, Lyon, France. 3. Université Claude Bernard Lyon 1, Lyon, France; Department of Hygiene and Epidemiology, Hospices Civils de Lyon, Lyon, France. 4. Infectious Diseases Department, Hospices Civils de Lyon, Lyon, France. 5. Infectious Diseases Department, Hospices Civils de Lyon, Lyon, France; INSERM U1111, International Center for Research in Infectiology, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France.
Abstract
BACKGROUND: Several vaccines are recommended in HIV-infected patients due to an increased risk of vaccine-preventable infections, severe forms of the disease, or shared transmission routes. Few data are available regarding vaccination coverage and its determinants in this population. METHODS: A cross-sectional study was performed in HIV-infected patients included in a hospital-based cohort in 2011. Vaccination coverage against hepatitis A virus (HAV), hepatitis B virus (HBV), seasonal and A(H1N1)2009 pandemic influenza, and invasive pneumococcal diseases (IPD) were recorded. Factors associated with vaccination were assessed by multivariate logistic regression. RESULTS: 2467 patients were included (median age: 47 years; male gender 71.5%; men having sex with men (MSM): 43.9%; CDC stage C: 24.3%; HBV and/or hepatitis C virus co-infection: 14.4%). Median duration of HIV infection was 10 years and 93.1% of patients received combination antiretroviral therapy. At baseline, the median CD4 count was 527 cells/mm(3) and HIV viral load was <50 copies/mL in 83.3% of cases. Vaccination coverage for HBV, HAV, seasonal influenza, A(H1N1)2009 pandemic influenza, and IPD were 61.9%, 47.4%, 30.9, 48.3%, and 64.6%, respectively. Factors independently associated with vaccination were a younger (HBV) or an older age (influenza), male gender (HBV, HAV), MSM (HBV), CD4 count >200/mm(3) and HIV-RNA <50 copies/mL (IPD, influenza), longer duration of HIV infection (IPD, influenza), and follow-up by an experienced physician (HBV, IPD). CONCLUSIONS: Vaccination coverage remained insufficient for all vaccine-preventable infections investigated in this study. Determinants for vaccination were largely not evidence-based, and efforts should be focused on improving physicians' knowledge about guidelines.
BACKGROUND: Several vaccines are recommended in HIV-infectedpatients due to an increased risk of vaccine-preventable infections, severe forms of the disease, or shared transmission routes. Few data are available regarding vaccination coverage and its determinants in this population. METHODS: A cross-sectional study was performed in HIV-infectedpatients included in a hospital-based cohort in 2011. Vaccination coverage against hepatitis A virus (HAV), hepatitis B virus (HBV), seasonal and A(H1N1)2009 pandemic influenza, and invasive pneumococcal diseases (IPD) were recorded. Factors associated with vaccination were assessed by multivariate logistic regression. RESULTS: 2467 patients were included (median age: 47 years; male gender 71.5%; men having sex with men (MSM): 43.9%; CDC stage C: 24.3%; HBV and/or hepatitis C virus co-infection: 14.4%). Median duration of HIV infection was 10 years and 93.1% of patients received combination antiretroviral therapy. At baseline, the median CD4 count was 527 cells/mm(3) and HIV viral load was <50 copies/mL in 83.3% of cases. Vaccination coverage for HBV, HAV, seasonal influenza, A(H1N1)2009 pandemic influenza, and IPD were 61.9%, 47.4%, 30.9, 48.3%, and 64.6%, respectively. Factors independently associated with vaccination were a younger (HBV) or an older age (influenza), male gender (HBV, HAV), MSM (HBV), CD4 count >200/mm(3) and HIV-RNA <50 copies/mL (IPD, influenza), longer duration of HIV infection (IPD, influenza), and follow-up by an experienced physician (HBV, IPD). CONCLUSIONS: Vaccination coverage remained insufficient for all vaccine-preventable infections investigated in this study. Determinants for vaccination were largely not evidence-based, and efforts should be focused on improving physicians' knowledge about guidelines.
Authors: Rulin C Hechter; Lei Qian; Sara Y Tartof; Lina S Sy; Nicola P Klein; Eric Weintraub; Cheryl Mercado; Allison Naleway; Huong Q McLean; Steven J Jacobsen Journal: Vaccine Date: 2019-05-04 Impact factor: 3.641