Vaccination against hepatitis B virus among people who inject drugs – A 20 year experience from a Swedish needle exchange program
Alanko Blomé, M. LU ; Björkman, P. LU
; Flamholc, L.
LU
; Jacobsson, H.
and Widell, A.
LU
(2017)
In Vaccine
35(1).
p.84-90
- Abstract
Background People who inject drugs (PWID) are at particular risk of hepatitis B virus (HBV) acquisition, but often have poor access or adherence to HBV vaccination. Vaccination against HBV has been offered at a major Swedish needle exchange program (NEP) since 1994. The aim of this study was to evaluate vaccine completion and response rates, and the effect of sequential booster doses to non-responders to the standard vaccination schedule. Methods PWID enrolled in the NEP 1994–2013, without serological markers for HBV at baseline (negative for HBsAg/anti-HBc/anti-HBs), were offered a three-dose standard intramuscular vaccination schedule (Engerix®-B, GSK, 20 μg/mL, intended to be received at months 0, 1 and 6). Vaccination response was... (More)
Background People who inject drugs (PWID) are at particular risk of hepatitis B virus (HBV) acquisition, but often have poor access or adherence to HBV vaccination. Vaccination against HBV has been offered at a major Swedish needle exchange program (NEP) since 1994. The aim of this study was to evaluate vaccine completion and response rates, and the effect of sequential booster doses to non-responders to the standard vaccination schedule. Methods PWID enrolled in the NEP 1994–2013, without serological markers for HBV at baseline (negative for HBsAg/anti-HBc/anti-HBs), were offered a three-dose standard intramuscular vaccination schedule (Engerix®-B, GSK, 20 μg/mL, intended to be received at months 0, 1 and 6). Vaccination response was defined as protective levels of anti-HBs (⩾10 mIU/mL). Up to three booster doses were then offered for non-responders, each followed by anti-HBs testing. Results HBV data was available for 2352 identifiable individuals at NEP enrolment, of whom 1516 (64.5%) had no markers for previous HBV exposure or vaccination. Vaccination was initiated for 1142 (75.3%) individuals and 898 (59.2%) completed the standard vaccination schedule. Post-vaccination anti-HBs levels were available from 800 individuals, with 598 (74.8%) responding to the basic vaccination schedule. After up to three booster doses a total of 676 (84.5%) individuals achieved protective anti-HBs levels. Non-response to vaccination was associated with higher age and anti-HCV positivity (p < 0.001). Eighteen incident cases of HBV infection were observed among vaccine non-responders, as well as 30 cases among those who had not completed vaccination. Conclusion We demonstrate the feasibility of including HBV vaccination in the services offered by a NEP, with completion of vaccination in a majority of HBV-susceptible PWID. The response to HBV vaccination among PWID was relatively low; however, the addition of up to three booster doses improved the response rate from 74.8 to 84.5%.
(Less)
- author
- Alanko Blomé, M.
LU
; Björkman, P.
LU
; Flamholc, L.
LU
; Jacobsson, H.
and Widell, A.
LU
- organization
- publishing date
- 2017-01-03
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Hepatitis B, Needle exchange program, NEP, People who inject drugs, PWID, Vaccination
- in
- Vaccine
- volume
- 35
- issue
- 1
- pages
- 7 pages
- publisher
- Elsevier
- external identifiers
-
- pmid:27894721
- wos:000390517900012
- scopus:84999780494
- ISSN
- 0264-410X
- DOI
- 10.1016/j.vaccine.2016.11.041
- language
- English
- LU publication?
- yes
- id
- 162d9a06-5356-4ee0-80a8-23664bea20c6
- date added to LUP
- 2016-12-28 11:03:22
- date last changed
- 2025-02-22 22:17:00
@article{162d9a06-5356-4ee0-80a8-23664bea20c6,
abstract = {{<p>Background People who inject drugs (PWID) are at particular risk of hepatitis B virus (HBV) acquisition, but often have poor access or adherence to HBV vaccination. Vaccination against HBV has been offered at a major Swedish needle exchange program (NEP) since 1994. The aim of this study was to evaluate vaccine completion and response rates, and the effect of sequential booster doses to non-responders to the standard vaccination schedule. Methods PWID enrolled in the NEP 1994–2013, without serological markers for HBV at baseline (negative for HBsAg/anti-HBc/anti-HBs), were offered a three-dose standard intramuscular vaccination schedule (Engerix®-B, GSK, 20 μg/mL, intended to be received at months 0, 1 and 6). Vaccination response was defined as protective levels of anti-HBs (⩾10 mIU/mL). Up to three booster doses were then offered for non-responders, each followed by anti-HBs testing. Results HBV data was available for 2352 identifiable individuals at NEP enrolment, of whom 1516 (64.5%) had no markers for previous HBV exposure or vaccination. Vaccination was initiated for 1142 (75.3%) individuals and 898 (59.2%) completed the standard vaccination schedule. Post-vaccination anti-HBs levels were available from 800 individuals, with 598 (74.8%) responding to the basic vaccination schedule. After up to three booster doses a total of 676 (84.5%) individuals achieved protective anti-HBs levels. Non-response to vaccination was associated with higher age and anti-HCV positivity (p < 0.001). Eighteen incident cases of HBV infection were observed among vaccine non-responders, as well as 30 cases among those who had not completed vaccination. Conclusion We demonstrate the feasibility of including HBV vaccination in the services offered by a NEP, with completion of vaccination in a majority of HBV-susceptible PWID. The response to HBV vaccination among PWID was relatively low; however, the addition of up to three booster doses improved the response rate from 74.8 to 84.5%.</p>}},
author = {{Alanko Blomé, M. and Björkman, P. and Flamholc, L. and Jacobsson, H. and Widell, A.}},
issn = {{0264-410X}},
keywords = {{Hepatitis B; Needle exchange program; NEP; People who inject drugs; PWID; Vaccination}},
language = {{eng}},
month = {{01}},
number = {{1}},
pages = {{84--90}},
publisher = {{Elsevier}},
series = {{Vaccine}},
title = {{Vaccination against hepatitis B virus among people who inject drugs – A 20 year experience from a Swedish needle exchange program}},
url = {{http://dx.doi.org/10.1016/j.vaccine.2016.11.041}},
doi = {{10.1016/j.vaccine.2016.11.041}},
volume = {{35}},
year = {{2017}},
}