Division of Sexually Transmitted Disease Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Sex Transm Dis. 2012 May;39(5):349-53. doi: 10.1097/OLQ.0b013e318244a923.
HIV-infected men who have sex with men (MSM) are at increased risk of viral hepatitis because of similar behavioral risk factors for acquisition of these infections. Our objective was to estimate adherence to HIV management guidelines that recommend screening HIV-infected persons for hepatitis A, B, and C infection, and vaccinating for hepatitis A and B if susceptible.
We evaluated hepatitis prevention services received by a random sample of HIV-infected MSM in 8 HIV clinics in 6 US cities. We abstracted medical records of all visits made by the patients to the clinic during the period from 2004 to 2007, to estimate hepatitis screening and vaccination rates overall and by clinic site.
Medical records of 1329 patients who had 14,831 visits from 2004 to 2006 were abstracted. Screening rates for hepatitis A, B, and C were 47%, 52%, and 54%, respectively. Among patients who were screened and found to be susceptible, 29% were vaccinated for hepatitis A and 25% for hepatitis B. The percentage of patients screened and vaccinated varied significantly by clinic.
Awareness of hepatitis susceptibility and hepatitis coinfection status in HIV-infected patients is essential for optimal clinical management. Despite recommendations for hepatitis screening and vaccination of HIV-infected MSM, rates were suboptimal at all clinic sites. These low rates highlight the importance of routine review of adherence to recommended clinical services. Such reviews can prompt the development and implementation of simple and sustainable interventions to improve the quality of care.
由于感染这些传染病的行为风险因素相似，男男性行为者（MSM）中的 HIV 感染者患病毒性肝炎的风险增加。我们的目的是评估对 HIV 管理指南的依从性，该指南建议对 HIV 感染者进行甲型、乙型和丙型肝炎感染筛查，如果易感，则对甲型和乙型肝炎进行疫苗接种。
我们评估了 8 个美国 6 个城市的 8 个 HIV 诊所中随机抽样的 HIV 感染 MSM 所获得的肝炎预防服务。我们从 2004 年至 2007 年期间，对患者到诊所的所有就诊记录进行了摘要，以总体和按诊所地点估计肝炎筛查和疫苗接种率。
从 2004 年至 2006 年，共摘录了 1329 名患者的 14831 次就诊的医疗记录。甲型、乙型和丙型肝炎的筛查率分别为 47％、52％和 54％。在接受筛查且易感的患者中，有 29％接种了甲型肝炎疫苗，有 25％接种了乙型肝炎疫苗。筛查和接种疫苗的患者百分比在各诊所之间存在显著差异。
了解 HIV 感染者的肝炎易感性和肝炎合并感染状况对于最佳临床管理至关重要。尽管对 HIV 感染的 MSM 进行了肝炎筛查和疫苗接种的建议，但所有诊所的比率都不理想。这些低比率突出了常规审查建议的临床服务依从性的重要性。这种审查可以促使制定和实施简单且可持续的干预措施，以改善护理质量。
