Background:
Unlike the hepatitis C virus (HCV), there are FDA-approved vaccines in the United States to prevent infections with the hepatitis A (HAV) and hepatitis B viruses (HBV). The purpose of this analysis was to examine HAV/HBV vaccine uptake among participants in an HCV treatment trial, the Kentucky Viral Hepatitis Treatment project.
Description of intervention:
HAV and HBV testing to evaluate for vaccine-acquired immunity, and current, prior, and chronic infection was conducted. Those without immunity to HAV were offered the 2-dose inactivated HAV vaccine (VAQTA®) at the 2-week and 6-month follow-up visits. Those without immunity to HBV were offered the 3-dose recombinant hepatitis B vaccine (RECOMBIVAX HB®) at the 2-week follow-up visit, with subsequent doses given at visits at least 1 and 6 months after the initial dose.
Effectiveness:
HAV vaccines were offered to 132 participants without immunity. Vaccine uptake was 92.5%; 10 participants declined. Of the 122 initiating the HAV series, 93 (76.2%) received both doses. The HBV vaccine was offered to 118 participants and uptake was 92.4%; nine participants refused. Of the 109 who initiated the series, 93.5% received two doses and 81.6% received three. There were 31 non-responders, and of those, five (16.1%) declined further vaccination. Of the 26 who received additional doses, 3 (11.5%) were continued non-responders.
Conclusion and next steps:
Results from this study demonstrate that provision of HAV/HBV vaccines in the context of HCV treatment is feasible and acceptable. If HCV treatment is provided in a comprehensive healthcare setting (primary care, MOUD treatment), it is ideal to administer both HAV and HBV vaccines while undergoing HCV treatment, if indicated. However, it will also be critical moving forward to integrate vaccinations for HAV and HBV into low-barrier models of care for hepatitis C to give patients the best chance for liver health. |