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Learning Objectives for this Presentation:
By the end of this presentation, participants will be able to discuss:
(1) Burden of HBV
(2) Vaccination rates and practices for HBV
Background:
Drug users are at risk for infection with HBV. This situation continues although an effective HBV vaccine has existed since 1982 and recommendations for vaccinating injection drug users was first made at that time. Vaccination for hepatitis A virus (HAV) has also been recommended since 1995 for drug users.
Methods:
We conducted automated (using multiple search engines and standardized key terms) and manual searches and reviewed the 1995-2004 literature published in the United States on the burden of HBV morbidity and on vaccination rates and practices.
Results:
Review of over 40 studies showed high HBV rates and low vaccination rates. Among HIV-positive drug users, incidence rates ranged from 3.5 cases per 100 person years for recent injectors to 1.9 for recent users of non-injection drugs. Among HIV-negative injection drug users, incidence rates were 10.0 cases per 100 person years. HBV prevalence rates, as high as 67%, were reported. Vaccination rates for all 3 doses of HBV ranged from 10% in health clinics to 86% in drug treatment settings. A low proportion of drug users (10% - 25%) perceived themselves to be at risk for HBV infection. Cash incentives, outreach efforts, flexible immunization schedules, and coordination between public health practitioners and medical care providers were useful in improving vaccination rates.
Conclusions:
Medical providers need to educate drug users about the risk for HBV infection and seriousness of the disease and offer them vaccination. A coordinated and well-funded approach at facilities frequented by drug users (e.g., STD clinics, HIV counseling and testing sites, needle exchange programs, drug treatment facilities) is needed to improve vaccination rates. Use of a combined HAV and HBV vaccine would be also valuable.
See more of Poster Session #2
See more of The 2005 National Viral Hepatitis Prevention Conference