DeGroote Nicholas P, Mattson Christine L, Tie Yunfeng, Brooks John T, Garg Shikha, Weiser John
Oak Ridge for Science and Education, 1299 Bethel Valley Rd, Oak Ridge, TN 37830, United States.
Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, United States.
Prev Med Rep. 2018 Jun 20;11:139-144. doi: 10.1016/j.pmedr.2018.06.006. eCollection 2018 Sep.
United States guidelines recommend hepatitis A virus (HAV) vaccination for persons living with HIV (PLWH) who are at increased risk for HAV infection, including men who have sex with men (MSM) and persons who inject drugs (PWID). However, nationally representative estimates of vaccine coverage and immunity for this population are lacking. We used medical record and interview data from the 2009-2012 cycles of the Medical Monitoring Project, a nationally representative surveillance system of PLWH receiving HIV medical care in the United States, to estimate the prevalence of HAV immunity, defined as receipt of at least one dose of vaccine or laboratory documentation of anti-HAV antibodies, among 8695 MSM and PWID. Among HAV-nonimmune PLWH, we then examined factors associated with HAV vaccination during the 12-month retrospective observation period using Rao-Scott chi-square tests. Among MSM and PWID receiving HIV medical care, 64% had evidence of HAV immunity. Among those who were nonimmune, 10% were vaccinated during the 12-month retrospective observation period. Factors associated with vaccination during follow-up included younger age (i.e., 18-29 years), self-reported black non-Hispanic race/ethnicity, having detectable HIV RNA, and having been diagnosed with HIV within the past 5 years. Over one third of MSM and PWID receiving HIV medical care during 2009-2012 cycles were not immune to HAV. This analysis suggests that a sizeable proportion of at risk MSM and PWID receiving HIV medical care do not receive HAV vaccination, which is currently recommended.
美国指南建议，对于感染甲型肝炎病毒（HAV）风险增加的艾滋病毒感染者（PLWH），包括男男性行为者（MSM）和注射毒品者（PWID），接种HAV疫苗。然而，目前缺乏针对这一人群的疫苗接种覆盖率和免疫力的全国代表性估计数据。我们利用医疗监测项目2009 - 2012周期的病历和访谈数据，该项目是美国一个具有全国代表性的针对接受艾滋病毒医疗护理的PLWH的监测系统，来估计8695名MSM和PWID中HAV免疫力的流行情况，HAV免疫力定义为至少接种一剂疫苗或有抗HAV抗体的实验室记录。在HAV无免疫力的PLWH中，我们随后使用Rao - Scott卡方检验，研究在12个月回顾性观察期内与HAV疫苗接种相关的因素。在接受艾滋病毒医疗护理的MSM和PWID中，64%有HAV免疫证据。在那些无免疫力的人中，10%在12个月回顾性观察期内接种了疫苗。随访期间与疫苗接种相关的因素包括较年轻的年龄（即18 - 29岁）、自我报告的非西班牙裔黑人种族/族裔、可检测到的艾滋病毒RNA以及在过去5年内被诊断出感染艾滋病毒。在2009 - 2012周期接受艾滋病毒医疗护理的MSM和PWID中，超过三分之一对HAV无免疫力。该分析表明，相当一部分接受艾滋病毒医疗护理的高危MSM和PWID没有接种目前推荐的HAV疫苗。
