Hepatitis B vaccination status and associated factors among people living with HIV attending Gulu Regional Referral Hospital

Abstract

Introduction: Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) have similar modes of transmission and potentiate each other. Among people living with HIV (PLWH), HBV infection s are more likely to progress to chronic hepatitis and liver cirrhosis. It is therefore important that PLWH are vaccinated against HBV. However, in Uganda, Hepatitis B vaccination among PLWH is not standard practice indicating that it’s uptake may be minimal. It is important to understand the hepatitis B vaccination status in this group and the factors associated. Objectives: To assess the hepatitis B vaccination status and associated factors among PLWH attending the ART clinic in Gulu Regional Referral Hospital. Methods: A cross-sectional study with both descriptive and analytical components was conducted among 385 PLWH attending the HIV clinic in Gulu Regional Referral Hospital (GRRH). We used interviewer administered questionnaires to collect participants’ socio-demographic characteristics, knowledge about HBV and Hepatitis B vaccine and Hepatitis B vaccination status. Using systematic random sampling, patients were selected as they visited the ART clinic by the Principal Investigator and research assistants. Data were summarized using proportions and percentages for categorical data and for continuous variables, median and IQR were used. Bivariate analysis was initially done and a modified poisson regression model (with apriori level of significance of p≤0.05) run at multivariable to determine factors that were independently associated with Hepatitis B vaccination Results: Median age for the participants was 37, interquartile range (30-45) years and about two thirds (66.8%) were females. Out of 385 patients that participated in the study, only 30.9% (95% CI; 26.3-35.5) were fully vaccinated against HBV. Residence (aPR=1.59, 95% CI=1.169-2.172, p=0.003), family history of Hepatitis B infection (aPR=1.66, 95% CI=1.057-2.614, p=0.028), and knowledge about HBV and Hepatitis B vaccine (aPR=1.41, 95% CI=1.060-1.888, p=0.018) were independently associated with Hepatitis B vaccination status. Education confounded the relationship between residence and Hepatitis B vaccination status. Conclusion: Out of 385 participants, only 30.9% reported having received three doses of Hepatitis B vaccine. Rural residents, participants that were not knowledgeable about HBV and Hepatitis B vaccine, participants that reported a family member with history of Hepatitis B infection were less likely to get fully vaccinated against Hepatitis B. We recommend provision of vaccination services at the community level so that they are easily accessed by the patients, creating awareness on the epidemiology of Hepatitis B among PLWH and sensitizing PLWH about the importance of them getting fully vaccinated for Hepatitis B to enhance uptake of the vaccine.