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Examining Hepatitis, A and B Vaccination, and HBV Reactivation Monitoring During Direct-Acting Antiviral Therapy for Hepatitis C

Journal of Community Health volume 43, pages 1124–1127 (2018)Cite this article

Abstract

The objective of this study was to examine Hepatitis A (HAV) and Hepatitis B (HBV) screening, and the risk of HBV reactivation during Hepatitis C (HCV) therapy with direct-acting antivirals (DAAs). A retrospective chart review was performed of patients treated with second generation DAA therapy from January 2014 to September 2016 at the Iowa City VA Healthcare System. In total 409 patients initiated HCV treatment, 308 (75%) and 241 (59%) were HAV and HBV vaccine eligible, respectively. Among those, 24 (8%) received a HAV vaccine, while only 20 (8%) received a HBV vaccine. Of these, 7 patients initiating an immunization in the clinic had record of completing the series. Further, 101 patients had a reactive Hepatitis B core Antibody indicating previous HBV infection, and 3 of these were tested for HBV reactivation during HCV therapy. Overall, the assessment found low rates of HAV and HBV vaccine administration, indicating missed opportunities for preventative care during HCV therapy. With the known risk of HBV reactivation with DAAs, the need for HAV and HBV screening is essential.

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Acknowledgements

This research study is based on research conducted through the Iowa City VA Quality Improvement and Patient Safety initiatives at the Iowa City VA Health Care System in Iowa City, IA with no funding by the Department of Veterans Affairs. The findings and conclusions in this document are those of the author(s) who are responsible for its contents; the findings and conclusions do not necessarily represent the views of the Department of Veterans Affairs or the United States government. Therefore, no statement in this presentation should be construed as an official position of the Department of Veterans Affairs. No investigators have any affiliations or financial involvement or financial investment that conflict with material presented in this presentation. The authors would like to acknowledge Andrea Henson RN, for her case management work as related to the Iowa City VA Healthcare System Hepatitis C Clinic.

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Affiliations

  1. Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA

    John Davison

  2. Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Amy O’Shea & Yolanda Villalvazo

  3. Comprehensive Access and Delivery Research & Evaluation (CADRE) at the Iowa City Iowa City VA Healthcare System, Iowa City, IA, USA

    Amy O’Shea

  4. College of Pharmacy, University of Iowa, Iowa City, IA, USA

    Nancee Waterbury

  5. Department of Pharmacy, Iowa City VA Healthcare System, Iowa City, IA, USA

    Nancee Waterbury

  6. Department of Internal Medicine, Iowa City VA Healthcare System, Iowa City, IA, USA

    Yolanda Villalvazo

Authors
  1. John Davison
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  2. Amy O’Shea
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  3. Nancee Waterbury
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  4. Yolanda Villalvazo
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Corresponding author

Correspondence to John Davison.

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Conflict of interest

The authors do not have any conflicts of interest to declare.

Ethical Approval

This study was approved by the University of Iowa Institutional Review Board and the Iowa City Veterans Affairs Research and Development Committee.

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Davison, J., O’Shea, A., Waterbury, N. et al. Examining Hepatitis, A and B Vaccination, and HBV Reactivation Monitoring During Direct-Acting Antiviral Therapy for Hepatitis C. J Community Health 43, 1124–1127 (2018). https://doi.org/10.1007/s10900-018-0530-0

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  • DOI: https://doi.org/10.1007/s10900-018-0530-0

Keywords

  • Viral Hepatitis
  • Prevention
  • Immunization
  • Hepatitis B reactivation