Abstract
Hepatitis B vaccination (HBV) is recommended for high-risk groups, such as people who inject drugs (PWIDs). As part of a harm reduction program by a non-governmental organization, hepatitis B screening, vaccination and antibody (HBAb) testing after completion of the vaccination schedule were offered to PWIDS in Myanmar. We determined the proportions of HBV non-completion and sero-unprotection among PWIDs enrolled in the program and their association with socio-demographic and clinical characteristics. We conducted a descriptive study based on routine program data in five selected clinics in Hpakant Township, Myanmar. PWIDs who were Hepatitis B antigen negative at screening during January 2015–December 2018 were included. Among 5386 participants eligible for HBV, 9% refused vaccination. Among those who accepted vaccination (n = 3177 individuals), 65% completed vaccination. Of those tested for HBsAb (n = 2202), 30% were sero-unprotected. Young-adults (aged 18–44 years) and migrant workers had a higher risk of incomplete vaccination. However, participants who used methadone had a lower risk of incomplete vaccination. Migrant workers had higher risk of not returning for HBsAb testing and HIV-positive participants had a higher risk of being HBV sero-unprotected. Efforts to increase HBV vaccination in PWIDs for young adults and clients during methadone and anti-retroviral services should be prioritized.
Highlights
In South-East Asia there were an estimated 39 million people living with chronic hepatitis B viral infection in 2015 [1]
A total of 6011 people who inject drugs (PWIDs) were screened for Hepatitis B vaccination (HBV) antigen (HBsAg) during the study period (Figure 1)
Among the 5386 PWIDs who were eligible for HBV vaccination, 89% were 18–44 years of age, 10% 45–64 years of age and 1% 65–75 years of age
Summary
In South-East Asia there were an estimated 39 million people living with chronic hepatitis B viral infection in 2015 [1]. Among adults, ongoing HBV transmission occurs primarily among incompletely immunized clients with behavioural risks for HBV transmission including individuals with multiple sex partners, people who inject drugs (PWIDs), men who have sex with men and household contacts and sex partners of persons with chronic HBV infection. Hepatitis B vaccination is an effective measure to prevent HBV infection and its consequences, including cirrhosis of the liver, liver cancer, liver failure and death [2]. In Myanmar, the prevalence of viral hepatitis in the general population was 10%−12% in 2013, and viral hepatitis places a heavy burden on the health care system because of the costs of treatment of liver failure and chronic liver disease [3]. There were an estimated 93,000 people who inject drugs (PWIDs) in 2017 who accessed the prevention and medical intervention services in Myanmar [4]
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