FAILURE OF PROVIDERS TO VACCINATE HIV-INFECTED MEN AGAINST HEPATITIS-B - A MISSED OPPORTUNITY

Objective: To carry out an audit of hepatitis B immunization practices in an out patient HIV clinic. Methods: We reviewed the medical record s of all new HIV-infected patients seen between October 1, 1990 and De cember 31, 1991. Results: The 125 patients were men with a mean age an d CD4 count of 43 yr and 240 cells/mm3, respectively. Fourteen percent (14%) of men who showed a clear need for vaccine, having no HBV marke rs, were not vaccinated by the clinic staff. Further, 16% whose suscep tibility to HBV infection was unclear, with anti-HBc as a sole HBV mar ker, were not evaluated with a booster dose of hepatitis B vaccine in an attempt to elicit an anamnestic response. Conclusions: In failing t o vaccinate or evaluate the 30% of patients without HBsAg or anti-HBs, our providers are missing an important opportunity in preventive medi cine. We urge others to examine their own hepatitis B screening and va ccination practices.