Patients with chronic hepatitis C virus (HCV) are at increased risk for complications of liver disease if they become infected with the hepatitis A (HAV) or hepatitis B (HBV) viruses. All major guidelines for the management of patients with chronic HCV include the recommendation for vaccination against HAV and HBV for those who are not already immune. We examined the rates of testing for HAV, HBV, and HCV, as well as rates of vaccination against HAV and HBV in patients with chronic HCV infection at a methadone maintenance program (MMP).
Design, Participants, and Setting
Retrospective review of a random sample (n=207) of medical records of patients enrolled in an academically affiliated, urban MMP providing on-site primary care services.
Serostatus for HAV, HBV, and HCV and rates of vaccination for HAV and HBV in those patients with chronic HCV.
Almost all patients reviewed were tested for HAV, HBV, and HCV. Of the 111 patients found to be chronically infected with HCV, 53 (48.6%) and 68 (63%) were found to lack immunity to HAV and HBV respectively. Of those lacking immunity, 29 (54.7%) and 2 (2.9%) were then vaccinated for HAV and HBV respectively.
Despite high rates of testing for HAV, HBV, and HCV at an urban methadone maintenance program, approximately half of those with chronic HCV eligible for the HAV vaccine received it and very few of those eligible for HBV vaccine received it.