TY - JOUR
T1 - Hepatitis B virus exposure and vaccination in a cohort of people who inject drugs: what has been the impact of targeted free vaccination?
AU - Winter, Rebecca Jane
AU - Dietze, Paul Mark
AU - Gouillou, Maelenn
AU - Hellard, Margaret Elena
AU - Robinson, Priscilla
AU - Aitken, Campbell Kynoch
PY - 2013
Y1 - 2013
N2 - Background and Aim: Forty percent of new hepatitis B virus (HBV) infections in Australia occur in people who inject drugs (PWID); long-term infection carries the risk of serious liver disease. HBV incidence among Australian PWID has not been measured since the advent of targeted (2001) and adolescent school-based catch-up (1998) vaccination programs. We measured HBV incidence and prevalence in a cohort of PWID in Melbourne, Australia and examined demographic and behavioral correlates of exposure and vaccination. Methods: Community-recruited PWID were surveyed about blood-borne virus risk behaviors and their sera tested for HBV markers approximately three-monthly over three years. Incidence was assessed using prospectively collected data. A cross-sectional design was used to examine prevalence of HBV exposure and vaccination at baseline. Poisson regression was used to identify correlates of HBV exposure and vaccination. Results: At baseline, 33.1 of participants (114/344) had been vaccinated against HBV, 40.4 (139/344) had been exposed (previously or currently infected), and 26.5 (91/344) were susceptible. HBV incidence was 15.7 per 100 person-years. Independent associations with HBV exposure included female gender, South-East Asian ethnicity, drug treatment in the past three months, injecting in prison, and prior exposure to hepatitis C virus. Independent associations with vaccination included being =25 years old, reporting HBV vaccination, and never having been to prison. Conclusions: HBV infection continues at high incidence among Australian PWID despite the introduction of free vaccination programs. Innovative methods are needed to encourage PWID to complete HBV vaccination.
AB - Background and Aim: Forty percent of new hepatitis B virus (HBV) infections in Australia occur in people who inject drugs (PWID); long-term infection carries the risk of serious liver disease. HBV incidence among Australian PWID has not been measured since the advent of targeted (2001) and adolescent school-based catch-up (1998) vaccination programs. We measured HBV incidence and prevalence in a cohort of PWID in Melbourne, Australia and examined demographic and behavioral correlates of exposure and vaccination. Methods: Community-recruited PWID were surveyed about blood-borne virus risk behaviors and their sera tested for HBV markers approximately three-monthly over three years. Incidence was assessed using prospectively collected data. A cross-sectional design was used to examine prevalence of HBV exposure and vaccination at baseline. Poisson regression was used to identify correlates of HBV exposure and vaccination. Results: At baseline, 33.1 of participants (114/344) had been vaccinated against HBV, 40.4 (139/344) had been exposed (previously or currently infected), and 26.5 (91/344) were susceptible. HBV incidence was 15.7 per 100 person-years. Independent associations with HBV exposure included female gender, South-East Asian ethnicity, drug treatment in the past three months, injecting in prison, and prior exposure to hepatitis C virus. Independent associations with vaccination included being =25 years old, reporting HBV vaccination, and never having been to prison. Conclusions: HBV infection continues at high incidence among Australian PWID despite the introduction of free vaccination programs. Innovative methods are needed to encourage PWID to complete HBV vaccination.
UR - http://onlinelibrary.wiley.com/doi/10.1111/jgh.12063/pdf
U2 - 10.1111/jgh.12063
DO - 10.1111/jgh.12063
M3 - Article
SN - 0815-9319
VL - 28
SP - 314
EP - 322
JO - Journal of Gastroenterology and Hepatology
JF - Journal of Gastroenterology and Hepatology
IS - 2
ER -