Hepatitis B Virus Vaccination Rates Research Articles

Knowledge and Risk Assessment of Hepatitis B Infection among Barbers and Beauty Salon Workers in Mwanza, Tanzania

Background and Objective Community-acquired hepatitis B virus (HBV) infection is increasing in developing countries. In Tanzania, there is an exponential increase in barbershops and beauty salons, which are potential sites of transmission of HBV. Occupational exposure rates and HBV vaccination rates among salon workers are unknown; their level of knowledge about infection prevention and control (IPC) is also unknown. This study aimed to evaluate the risk of infection and the knowledge of barbers and beauty salon workers about HBV transmission and prevention. Methods A cross-sectional study was conducted using a convenience sample of 200 barbers and beauty salon workers from 13 barber shops and 13 beauty salons in the urban district of Mwanza, Tanzania. Data were collected using a self-administered questionnaire, entered into EpiData version 3.1, and analyzed with Stata version 13. Categorical variables were expressed as frequencies, and association levels were compared using Fisher’s exact test. Results Fifty-four percent of the study participants were female, and the mean age was 25 (21.0–29.5) years. A total of 126 (63%) participants were aware of the existence of HBV infection, of which only 22% had general good knowledge of HBV transmission and prevention. Both HBV awareness (P < 0.001) and good knowledge of its transmission and prevention (P = 0.03) were positively associated with higher levels of education. Seventy-three (36.5%) participants reported a history of occupational injuries. Merely 27.8% of participants were familiar with the correct methods of decontamination beauty tools, and only 14.3% understood the correct procedures for post-exposure wound care. Vaccination coverage was low with only (2%) of barbers and beauty salon workers having received vaccines. Conclusion and Implications for Translations The frequent occupational injuries and inadequate vaccination among barbers and beauty salon workers amplify their risk of HBV infection. They also lack basic knowledge about HBV transmission and prevention, placing the clients they serve at high risk for infection. We recommend that training on HBV Infection Prevention and Control (IPC) should focus on this specific group, and the implementation of these measures should be closely monitored in barbershops and beauty salons. Moreover, this vulnerable group should be considered for a global vaccination program.

Improving hepatitis B screening and vaccination rates in a veterans affairs resident-based primary care clinic

IntroductionIn 2022, the Advisory Committee on Immunization Practices (ACIP) updated its recommendation regarding hepatitis B vaccination and advised vaccination for all adults aged 19–59 regardless of risk factors and those...

An Example of the Importance of Electronic Health Records from Mogadishu, Somalia: Hepatitis B Prevalence and Co-infections with Hepatitis C

The epidemiology of hepatitis B virus (HBV) and hepatitis C virus (HCV) has been discussed in detail from different aspects around the world. Current epidemiological data has critical importance in the planning and carrying out of public health policies for the prevention of transmission and spread of these infections, and the treatment of chronic infections, and to reduce the burden and mortality associated with complications such as cirrhosis and liver cancer by national health authorities and international health institutions, especially the World Health Organization. Elimination of a social health problem is possible by first raising awareness, then determining the dimensions of the problem, and planning and implementing interventions for a solution. Somalia was in the position of a region where access to diagnosis and treatment for many life-threatening diseases was difficult, aside from the monitoring of public health criteria due to the unstable situations that has continued for more than 40 years. Until recently, basic health parameters and epidemiological predictions in Somalia were monitored through estimates based on data from neighboring countries or on data obtained from small groups from Somalia immigrants settled different parts of the world. However, this situation is changing rapidly. A tertiary education and research hospital established in the capital, Mogadishu, with the coordination of the Türkiye and Somalia governments, and which has become the largest health center in the country today; contributes to understanding the extent of the serious health problems faced by the country by pioneering specialized training and scientific studies, in addition to providing health care. Electronic health records have been kept regularly since 2015 in this hospital, where hundreds of thousands of patients receive treatment or undergo health checks every year and it has been the source of numerous retrospective epidemiological studies some of which have exceeded 100 thousand cases, in different age groups and sub-populations. These studies include human immunodeficiency virus (HIV) prevalence and complications, HCV prevalence and genotype distribution, prevalence and epidemiology of parasitic infections, incidence of tuberculosis and related complications, cancer incidence and distribution, causes of blindness, thyroid diseases, antibiotic resistance profiles, and the epidemiology of various organ-specific diseases. Dozens of studies using the hospital records were included in the scientific literature between 2020 and 2023. In this study, a four-year period between November 2015 and November 2019, HBV serological test results of more than 100,000 different patients are presented. HBsAg and anti-HBs seropositivity for all age groups was found to be 8.1% (9,405/115,946) and 32.7% (25,988/79,410), respectively. When the anti-HCV test results of HBsAg positive patients were examined, the rate of HCV co-infections was found to be 0.9% (82/9,405). HBsAg and anti-HBs seropositivity were significantly higher in males than females (p<0.001). HBV, HCV, and co-infection incidence tended to decrease. Conversely, vaccination rates (especially in children under one year of age) tended to increase. While the comprehensive data presented in this study provide us with important and new information about the prevalence and co-infection rates of viral hepatitis in the country, many topics including HBV genotypes, hepatitis D frequency, access to treatment rates, complication rates, and HBV vaccination rates are still waiting to be researched in Somalia. In the region where it is not possible to carry out field studies, epidemiological data provided by electronic health records have become a country's window to the world.

Assessment of Disease Burden and Immunization Rates for Vaccine-Preventable Diseases in People Living with HIV: The Korea HIV/AIDS Cohort Study.

Prophylactic immunization is important for human immunodeficiency virus (HIV)-infected patients; however, there are insufficient data on the burden of vaccine-preventable diseases (VPDs), vaccination rates, and factors influencing vaccination. The incidence and prevalence of VPDs in HIV-infected patients between 2006 and 2017 were estimated using the Korean HIV/acquired immune deficiency syndrome (AIDS) cohort database. In addition, we evaluated the vaccination rates and influencing factors for vaccination in HIV-infected patients through multilevel analysis of clinico-epidemiological factors, immune status, and psychological status. A questionnaire survey was conducted among experts to determine whether they recommend vaccination for HIV-infected patients. The incidence rates of hepatitis B virus (HBV) infection, herpes zoster, and anogenital warts were 1.74, 7.38, and 10.85 per 1,000 person-years, respectively. The prevalence of HBV infection and anogenital warts at enrollment was 4.8% and 8.6%, respectively, which increased to 5.3% and 12.0%, respectively, by 2017. In HIV-infected patients, HBV (21.7% in 2008, 56.3% in 2013, and 75.4% in 2017) and pneumococcal vaccination rates (3.0% in 2015, 7.6% in 2016, and 9.6% in 2017) increased annually, whereas the influenza vaccination rate remained similar by season (32.7 - 35.6%). In the multilevel analysis, peak HIV viral load (≥50 copies/mL: odds ratio [OR] = 0.64, 95% confidence interval [CI]: 0.44 - 0.93; reference, <50 copies/mL) was an influencing factor for pneumococcal vaccination, while nadir CD4 T-cell counts (200 - 350 cells/mm3: OR = 0.54, 95% CI: 0.38 - 0.76; <200 cells/mm3: OR = 0.89, 95% CI: 0.62 - 1.28; reference, ≥350 cells/mm3) was an influencing factor for HBV vaccination. Influenza vaccination was associated with male sex (OR = 1.94) and the number of antiretroviral therapy (ART) regimen change (OR = 1.16), but was not significantly associated with HIV viral load or CD4 T-cell counts. Most experts responded that they administer hepatitis A virus, HBV, pneumococcal, and influenza vaccines routinely, but not human papillomavirus (12.9%) or herpes zoster vaccines (27.1%). The burden of vaccine-preventable diseases was quite high in HIV-infected patients. Nadir CD4 T-cell counts, peak HIV viral loads, and the number of ART regimen change are significant factors related to vaccination. Considering the low vaccination rates for VPDs, there was a discordance between experts' opinions and real clinical practice in the medical field.

S1365 Improving Screening and Vaccination Rate for Hepatitis B in Veterans Affair Primary Care Population: A Quality Improvement Study

Introduction: According to Advisory Committee on Immunization Practices (ACIP), acute infection with Hepatitis B virus (HBV) is rising among adults 40 years and older. Hepatitis B (HepB) vaccines have long demonstrated safety and efficacy for decades, however less than a third of U.S. adults reported being vaccinated against HBV in 2018. In 2022, ACIP updated its recommendation and advised vaccinating all adults aged 19-59 and those 60 years and older with risk factors; adults 60 years and older without known risk factors may also be vaccinated. Our project aims to improve HBV screening and vaccination rate among Veterans Affairs (VA) primary care clinic patient population. Methods: Data was collected from pre-intervention (October – December 2021) and post-intervention (March – May 2022); all patients seen in clinic during these months were included. Patients were considered immune against HBV from vaccination if they have positive anti-HBsAg; and susceptible to infection if hepatitis panel negative. Interventions include educating each resident group regarding update in vaccination guideline and hepatitis panel interpretation. Reminder poster regarding HBV vaccine was placed in each clinic room. In addition, reminder for checking HepB status was developed and embedded in VA electronic medical record (EMR) system, which will show up at the end of each visit. (Figure) Results: In the pre-intervention period from October to December 2021, a total of 1242 veterans were seen in primary care clinic. 532 veterans were screened for immunity in the past with 378 veterans noted to have no immunity against hepatitis B. Out of 378 non-immune veterans, only 35 patients were vaccinated against HepB. (Table) In the post-intervention period from March to May 2022, 1174 veterans were seen. 689 veterans were screened for immunity and 402 have no immunity against HBV on hepatitis panel; 123 veterans received HepB vaccine during clinic visit, which is more than 20% increase compared to prior. Conclusion: Our data suggest that HBV vaccination rate was suboptimal among veteran population. A low-cost intervention along with the help of technology could be beneficial in integrating new vaccination guideline in VA standard of care. Our project strikes to encourage clinicians to bear the responsibility and offer the vaccine to adult patients proactively, rather than wait for patients to request for it. The goal of this project is to increase awareness of new vaccination guideline and reach for full vaccination rate among veteran population. Table 1. - Data gathered from pre-intervention and post-intervention period. Pre-Intervention (October to December 2021) Post-Intervention (March to May 2022) Total veterans seen in clinic 1242 1174 Veterans that were screened for Hepatitis B 532 out of 1242 (42.8%) 689 out of 1174 (58.7%) Screened veterans found to have no immunity against Hepatitis B 378 out of 532 (71%) 402 out of 689 (58.3%) Veterans without HepB immunity that received HepB vaccine 35 out of 378 (9%) 123 out of 402 (30.6%) Figure 1.: Example of electronic reminder that was developed and embedded in VA electronic medical record system. The reminder will show up at the end of each clinic visit, which will ask physicians to check veterans' hepatitis B status and offer vaccine if appropriate.

Improving Hepatitis B Vaccination Rates among At-risk Children and Adolescents with Inflammatory Bowel Disease.

Introduction:Patients with inflammatory bowel disease (IBD) receiving tumor necrosis factor alpha inhibitors (TNFai) may be at higher risk for hepatitis B virus (HBV) infection. We conducted a quality improvement (QI) initiative to improve HBV vaccination rates in seronegative children with IBD.Methods:This QI initiative implemented an HBV vaccination strategy from September 2018 to March 2020 in patients with newly diagnosed IBD with hepatitis B surface antibody (HBsAb) <10 mIU/mL. The project aimed to (1) increase HBV vaccination rates in seronegative patients and (2) document immunogenicity after completing a three-dose vaccine series. Outcome measures included the percentage of seronegative patients who received HBV vaccines (dose 1 and three-dose series). Interventions included applying a standardized vaccination protocol, and creating a vaccine workflow in two clinical areas, previsit planning and stakeholder engagement.Results:One hundred seventy-four children and adolescents with IBD were evaluated during the study period, and 132 (76%) were HBsAb negative. After plan-do-study-act (PDSA) 1, the proportion of eligible patients who received HBV vaccine dose 1 increased from a baseline of 7% to 100% and was sustained for over 12 months. During PDSA 2, the proportion of patients completing the three-dose vaccine series improved from a baseline of 0% to 82% (n = 100); among 93 children in this subgroup who had repeat serology performed, 86 (92%) demonstrated serologic evidence of HBV protection.Conclusions:A multidisciplinary approach applying QI methodology allowed for improved and sustained HBV vaccination rates in at-risk seronegative children and adolescents with IBD. A three-dose HBV vaccine series proved immunogenic in 92% of eligible patients.

KNOWLEDGE, ATTITUDE AND PRACTICE OF DENTAL STUDENTS TOWARDS HEPATITIS B INFECTION IN ADEN UNIVERSITY, YEMEN

Hepatitis B virus (HBV) infection is a major worldwide public health issue. The risk of exposure to HBV among healthcare workers (HCWs) is a major concern, especially among students in health professions. This is a cross-sectional survey, aimed to assess the knowledge, attitude, and practices toward HBV infection among dental students, using an administered questionnaire containing 2 sections. The first section for demographic characteristics and the second section contained 15 questions on knowledge of HBV (7 questions), attitude (3 questions), and practices (5 Questions) of HBV infection. Dental students in the third, fourth, and fifth years of Aden University were included in the study. Descriptive statistics like frequencies and proportions were used to summarize the data. A total of 308 dental students participated in the study. Of these, 50.3% were males and 49.7% were females.A total of 77.2% of the students knew about the transmission and prevention of HBV infection. More than 75.0% of participants had a positive attitude towards preventive measures against HBV infection, and 78.2% of participants agreed that the HBV vaccine can prevent HBV infection. Only 0.97% of students were vaccinated against HBV infection and 53.9% of students knew about the postexposure treatment against HBV infection. The overall knowledge regarding HBV infection was found to be adequate among dental students. Dental students are at high risk of exposure to HBV infection owing to the low HBV vaccination rate. Therefore, dental students should be vaccinated prior to their entry into professional practices.

Expanded screening for chronic hepatitis B virus infection in China

Expanded screening for chronic hepatitis B virus infection in China

The prevalence of hepatitis B, influenza, and pneumococcal vaccination in diabetic patients Jeddah, Saudi Arabia

Background: Diabetes is one of the most prevalent diseases in Saudi Arabia to the extent that the country is ranked fourth in terms of incidence rate. Diabetes poses multiple health threats not only to patients but also to society and the healthcare system. Thus, numerous measures have been adapted to contain diabetes risk. One of these is the recommendation of vaccination sets for diabetic patients. This study aims to measure the coverage of hepatitis B virus (HBV), influenza, and pneumococcal vaccines in diabetic patients. Methods: Using a retrospective chart review, data were collected from 385 diabetic patients. An approved data collection sheet was used. Phone calls were utilized for subjective-based questions. The sample size was calculated via Raosoft@. Descriptive or inferential statistical analysis was performed using Statistical Package for the Social Sciences. Results: Type 1 and type 2 diabetic patients represented 44.2% and 55.8%, respectively. Only 15.2% of patients received influenza vaccination in the last 12 months. Approximately 14.2% of diabetic patients received the pneumococcal vaccine, while the HBV vaccination rate was 12.9%. Hospital admission within the last 12 months of influenza-vaccinated patients was 22.8%, while the unvaccinated patients recorded 77.8%. Diabetic patients reported that physicians&amp;apos; recommendation rates of vaccines were 25.8% for influenza vaccine, 15.5% for pneumococcal vaccine, and 10.8% for HBV vaccine. Conclusion: Measuring vaccination rates of 12.9%, 14.2%, and 15.2%, respectively, concludes that compliance with the medical recommendations of vaccinating diabetic patients is suboptimal. Healthcare institutions must collaborate with primary care physicians to integrate more efficient and adherent vaccination programs.

Lack of awareness of Hepatitis B screening and vaccination in high-risk groups

Background/aim Hepatitis B virus (HBV) vaccination rates are insufficient in high-risk patients worldwide. This study aimed to investigate the screening, immunization, and vaccination rates in three high-risk groups for HBV infection: allogeneic hematopoietic stem cell transplantation (AHSCT), renal transplantation (RT), and chronic hepatitis C (CHC) groups. Materials and methods The serological data of consecutive patients between 2014 and 2019 were reviewed using the hospital database. Results The HBV screening rates were 100.0%, 90.4%, and 82.4% in the AHSCT, CHC, and RT groups, respectively (p = 0.003). The immunization rates against HBV through either previous exposure or vaccination were 79.5%, 71.7%, and 46.5% in the AHSCT, RT, and CHC groups, respectively (p < 0.001). The HBV vaccination rate was significantly low in the CHC group (71.5%, 69.0%, 34.6% in the AHSCT, RT, and CHC groups, respectively, p < 0.001). If patients lost their immunity due to immunosuppressive therapy were accounted, the vaccination rates increased to 95.2% in the AHSCT group and 72.9% in the RT group. The rate of annual screening for HBV status was 97.9% in the AHSCT group, but it was only 23.9% in the RT group. Conclusion HBV screening and vaccination rates were significantly lower in the RT and CHC groups than in the AHSCT group.

Hepatitis B Virus Awareness, Infection, and Screening Multiethnic Community Intervention for Foreign-Born Populations.

Hepatitis B virus (HBV) is a potentially deadly viral infection that can lead to liver cancer. Many refugee immigrants resettled in the US come from countries known to have a high prevalence of HBV infections. Unfortunately, most infected refugee immigrants are unaware of their HBV status. The disease is highly preventable through a vaccine, but chronic HBV is incurable once the disease has developed. For the purposes of this cross-sectional study, we conducted analysis of data collected through the Building Bridges Initiative (BBI) to assess HBV awareness, vaccination status, screening, and infection among multiethnic, primarily refugee, immigrant populations living in North Texas. Overall, 74% of study participants reported having heard about HBV, but only 31% knew their HBV status. Whereas 69% of study participants lacked awareness about their HBV status and self-reported prevalence of chronic HBV among study participants was 4%. For the vaccine, only 26% reported to have received at least one dose; 53% did not know, while 21% had not ever received it. For those unaware of their HBV status, the BBI offered participants free HBV screening and assistance for vaccination as needed. 76% of participants that accepted HBV screening from BBI were never screened before (enrollment in BBI). Chronic HBV positivity rate for participants was 6%, which is twenty times higher than the national prevalence of chronic HBV (0.3%). High prevalence of HBV, low awareness and low vaccination rates seen in this study highlights the need for increased HBV prevention among foreign born populations.

Hepatitis B Awareness and Vaccination Patterns among Healthcare Workers in Africa.

Hepatitis B virus (HBV) vaccination patterns and the understanding of its risks among healthcare workers (HCWs) is a critical step to decrease transmission. However, the depth of this understanding is understudied. We distributed surveys to HCWs in 12 countries in Africa. Surveys had nine multiple-choice questions that assessed HCWs' awareness and understanding of HBV. Participants included consultants, medical trainees, nurses, students, laboratory personnel, and other hospital workers. Surveys were completed anonymously. Fisher's exact test was used for analysis, with a P-value of < 0.05 considered significant; 1,044 surveys were collected from Kenya, Egypt, Sudan, Tanzania, Ethiopia, Uganda, Malawi, Madagascar, Nigeria, Cameroon, Ghana, and Sierra Leone. Hepatitis B virus serostatus awareness, vaccination rate, and vaccination of HCWs' children were 65%, 61%, and 48%, respectively. Medical trainees had higher serostatus awareness, vaccination rate, and vaccination of their children than HCWs in other occupations (79% versus 62%, P < 0.001; 74% versus 58%, P < 0.001; and 62% versus 45%, P = 0.006, respectively). Cost was cited as the most frequent reason for non-vaccination. West African countries were more aware of their serostatus but less often vaccinated than East African countries (79% versus 59%, P < 0.0001 and 52% versus 60%, P = 0.03, respectively). West African countries cited cost as the reason for non-vaccination more than East African countries (59% versus 40%, P = 0.0003). Our study shows low HBV serostatus awareness and vaccination rate among HCWs in Africa, and reveals gaps in the perception and understanding of HBV prevention that should be addressed to protect HCWs and improve their capacity to control HBV infection.

Hepatitis B and C virus infection among HIV patients within the public and private healthcare systems in Chile: A cross-sectional serosurvey

BackgroundCoinfections of HIV patients with hepatitis B virus (HBV) and hepatitis C virus (HCV) are mayor public health problems, contributing to the emerging burden of HIV-associated hepatic mortality. Coinfection rates vary geographically, depending on various factors such as predominant transmission modes, HBV vaccination rates, and prevalence of HBV and HCV in the general population. In South America, the epidemiology of coinfections is uncertain, since systematic studies are scarce. Our study aimed to analyze rates of HBV and HCV infection in people living with HIV attending centers of the public and private health system in Chile.MethodsWe performed a cross-sectional study including a public university hospital and a private health center in Santiago, Metropolitan Region in Chile. Serum samples were used to determine serological markers of hepatitis B (HBsAg, anti-HBs, anti-HBc total, HBeAg, anti-HBe) and anti-HCV. Demographic, clinical and laboratory data were obtained from medical records.Results399 patients were included (353 from public, 46 from private health center). Most (92.8%) were male, with a median age of 38.3 years; 99.4% acquired HIV through sexual contact (75.0% MSM); 25.7% had AIDS and 90.4% were on ART. In 78.9%, viral loads were <40 cps/mL; the median CD4 cell count was 468 cells/mm3. According to their serological status, 37.6% of patients were HBV naïve (susceptible), 6.5% were vaccinated, 43.6% had resolved HBV infection, and 5.8% were chronically infected. The rate of vaccination was 4.5% in the public and 21.7% in the private system. HCV coinfection was found in 1.0% of all patients.ConclusionHBV coinfection rate was within the range of other South American countries, but lower than in non-industrialized regions in Asia and Africa. A low percentage of patients were HBV vaccinated, especially within the public system. HCV coinfection rate was very low, most probably due to the rareness of injecting drug use.

Factors associated with self-reported hepatitis B virus vaccination status among men who have sex with men in the Netherlands

We assessed factors associated with the HBV vaccination status of 4270 MSM in the Netherlands. Data were collected through the 2018 online Men & Sexuality survey. Multinomial regression analysis showed that lower education level, having never tested for HIV, not recently diagnosed with a sexually transmissible infection, recently having had sex abroad and unknown HBV testing status were associated with higher odds of being unvaccinated as opposed to fully vaccinated. Living in Amsterdam and testing HBV negative were associated with lower odds of being unvaccinated as opposed to fully vaccinated. Age (25-39 years vs younger ages), living in Amsterdam and using pre-exposure prophylaxis decreased the odds to be partly vaccinated as opposed to fully vaccinated; having a migration background increased these odds. HBV vaccination rates among MSM will not reduce HBV transmission to zero. HBV promotion should focus on MSM outside of Amsterdam who are likely less connected with sexual health services and may be at lower (perceived) risk. The factors identified related to HBV vaccination status provide guidance for health promotion interventions to increase uptake and vaccination completion among MSM.

108. HEPATITIS B VACCINATION IN DUKE UNIVERSITY AND DUKE REGIONAL HOSPITAL NEWBORN NURSERIES

Background Vertical transmission continues to be a mode of Hepatitis B virus (HBV) infection despite implementation of prenatal maternal screening. HBV vaccination induces seroprotection in 98% of term infants. The CDC recommends that all infants should receive the first dose of hepatitis B vaccine at birth or within the first 12- 24 hours of life before they leave the hospital. Nevertheless, HBV vaccination rates prior to discharge were sub-optimal in the Duke newborn nurseries, which consist of the main Duke University Hospital (DUH) nursery and the community-based Duke Regional Hospital (DRH) nursery. Aim Statement We aimed to increase all HBV vaccination rates from a baseline of 94% to 96% at the DUH and from 88% to 90% at the DRH nurseries within 1 year. Interventions Baseline HBV vaccination rates were obtained from the electronic medical record (EMR) by using the 12 months preceding first intervention. The first intervention educated clinicians and nurses on the updated CDC guidelines by displaying posters in work areas. The second intervention aimed to increase project awareness among nursing staff in the nursing newsletter. The third intervention was an interdisciplinary effort among the nursing, physician, and pharmacy teams to coordinate administration of the HBV vaccine with the routine administration of vitamin K injection and erythromycin eye ointment at delivery. Measures After each intervention, a PDSA cycle was completed, assessing vaccination rates over the next three months on average. We assessed the effect on nursing workflow through a survey as a balancing measure. Results At both DUH and DRH nurseries respectively, we saw the rates of HBV vaccination increase slightly from baseline rates of 88% and 94% to 92% and 95% after the first two cycles. The third intervention at DUH resulted in a robust response in vaccination rates (up-trending to 95.8% in the month of November). Rates have been above the means for 7 and 10 consecutive months for DUH and DRH since the project began. Conclusions and Next Steps We have demonstrated a trend in improvements in HBV vaccination rates in the DUH and DRH newborn nurseries over several PDSA cycles. Most notably, the multi-disciplinary intervention of administering HBV with the vitamin K injection and erythromycin eye ointment at DUH had a marked impact. Continued multi-disciplinary efforts to improve HBV vaccination in the newborn nursery at both hospitals will optimize the care of newborn infants in prevention of HBV.

Assessing the Impact of Electronic Health Record Interventions on Hepatitis B Screening and Vaccination.

Hepatitis B virus (HBV) infection is a major health disparity between Asian Americans, Native Hawaiians, and Pacific Islanders compared with other racial/ethnic groups in the U.S. Our aims were to determine the effectiveness of an electronic health record (EHR) data-driven clinical intervention to improve HBV screening and vaccination rates at a community health center primarily serving Asian American patients. Using a community-engaged approach, we conducted a study to compare the differences in screening and vaccination rates for 6,429 patient encounters before and after implementation of the EHR intervention. A multivariable logistic regression analysis was conducted to estimate the effect of the intervention. Analyses indicated that patients who visited the clinic after implementing the EHR intervention were more likely to be screened (OR=1.8, p&lt;.001) and vaccinated (OR=2.8, p&lt;.001) for hepatitis B. Electronic health record interventions implemented using a community-engaged approach may improve delivery of appropriate care to patients at risk for hepatitis B in a community health setting.

Efficacy of a community-based participatory and multilevel intervention to enhance hepatitis B virus screening and vaccination in underserved Korean Americans.

The primary objective of the current study was to evaluate the efficacy of a community-based participatory intervention program in improving hepatitis B virus (HBV) screening and vaccination among Korean Americans who were not previously screened. A cluster randomized trial involving 32 Korean church-based community organizations (1834 participants) was conducted. Sixteen churches were randomly assigned to an HBV screening and vaccination multicomponent intervention condition (972 participants) and 16 were assigned to a general cancer education control condition (862 participants). The main components of the intervention program included interactive group education; patient navigation; and the engagement of health care providers, church leadership, and church members in the medical field. The application of community-based participatory research principles was monitored and evaluated. HBV screening and vaccination rates (self-reported and medical record verification) were assessed at 6-month and 12-month follow-ups, respectively. The results of the current study demonstrated significant efficacy in the HBV screening rate (92.5% in the intervention group vs 5.5% in the control group), 3-series HBV vaccination completion rate (84% in the intervention group vs 17.6% in the control group), and overall screening and vaccination compliance rate (87% in the intervention group vs 3.8% in the control group). Participants in the intervention group were significantly more likely to receive HBV screening (92.5%) compared with those in the control group (5.5%). In multivariate mixed-effect logistic regression analysis, the odds ratio for an intervention effect on HBV screening was 512.3 after adjusting for cluster effect and other demographic variables. With regard to vaccination rates, of the 332 participants who were screened with no immunity in the intervention group, 308 (92.8%) received at least 1 HBV vaccination, 300 (90.4%) received at least 2 shots, and 279 participants (84%) received all 3 shots. A combination of community-based participatory research and a multilevel approach may produce the most optimal results and be essential in producing a considerable effect for enhancing HBV screening and vaccination, particularly for Korean American populations with limited language proficiency and insurance coverage. Cancer 2018;124:973-82. © 2017 American Cancer Society.

Abstract 5288: Perception of barriers and facilitators to hepatitis B virus screening, vaccination, and treatment care among Asian American physicians

Abstract Objective: To examine practices and factors affecting Hepatitis B Virus (HBV) screening, vaccination, and treatment among Asian-American physicians in New York City. Methods: Members of the Chinese American Independent Practice Association (CAIPA) will be recruited to participate in a comprehensive survey, developed based on prior research, to assess physicians’ practice in HBV screening, vaccination and treatment. This study will also examinebarriers/facilitators toward HBV prevention and treatment in knowledge, familiarity or awareness of guidelines, perception, attitude/behaviors, self-efficacy, motivation, patient factors, cultural, and environmental factors. A bivariate analysis and multivariate regressions will be conducted to evaluate factors that predict study outcomes. Results: We hypothesize that Asian American physicians are more likely to screen for HBV, but are experiencing many barriers unique to the Asian American physicians that are leading them improperly perceive certain patients not at risk for HBV infection. Furthermore, we anticipate finding significant key barriers and facilitators among Asian American physicians for HBV screening and vaccination and treatment towards Asian patients. Preliminary findings will be presented at the conference. Conclusions &amp; Implications: Asian/Pacific Islanders (APIs) are disproportionally affected by chronic hepatitis B. Therefore, identifying chronically infected persons and linking them to care is crucial. As a result of the reverence of the doctors, a cultural norm prevalence within the Asian community, physicians are uniquely positioned to improve HBV screening and vaccination rates and if necessary, recommend linkage to care. This study will fill in an important gap in creating a culturally-relevant, physician-focused intervention to improve HBV care and reduce the burden of HBV infection within the Asian community. Citation Format: Patricia Estrella, Ming Chin Yeh, Yin Tan, Carolyn Y. Fang, Sarit A. Golub, Grace X. Ma. Perception of barriers and facilitators to hepatitis B virus screening, vaccination, and treatment care among Asian American physicians [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 5288. doi:10.1158/1538-7445.AM2017-5288

Hepatitis B Virus Infection in Preconception Period Among Women of Reproductive Age in Rural China - A Nationwide Study.

Hepatitis B virus (HBV) infection during pregnancy is associated with perinatal complications and poor maternal and fetal outcomes. There is a lack of reports on HBV infection screening, prophylaxis, and/or treatment in preconception period among women planning a pregnancy. This study is to investigate the prevalence and demographic characteristics of HBV infection among rural women of reproductive age planning pregnancy within 6 months, in different geographical regions of China. A population-based, cross-sectional, sero-survey of HBV infection among women intending to get pregnant within 6 months was carried out as a part of the National Free Preconception Health Examination Project covering 31 provinces in mainland China between 2010-12. General information (age, residence status, race, education, and occupation), HBV infection and vaccination history was collected. Results of HBV serological test panel were recorded for analysis. Of 2 120 131 women, 2 028 361 (95.7%) samples of HBV serology were available for analysis. Participating women were of young age (median 28.1 years), mostly engaged in agricultural activities (78.1%), and had high school education or lower (89.6%). The overall prevalence of HBsAg sero-positivity was 4.9%, which corresponds to an intermediate epidemic, with a wide geographical variation that ranged from 1.1% in Shanxi to 13.0% in Tibet. 90.1% women were susceptible to HBV with a 24.5% self-reported HBV vaccination rate. Significant regional differences in HBV prevalence, and a vast majority of women of childbearing age being susceptible to HBV, calls for a targeted HBV screening and vaccination strategy for women and their offspring in rural China.

Occult Hepatitis B Virus Infection in Hyperlipidemia Patients.

Chronic hepatitis B virus (HBV) infection is associated with lower prevalence of hyperlipidemia (HLP). However, occult HBV infection (OBI) in HLP patients has not yet been explored. OBI is defined as the presence of detectable HBV DNA in serum or liver tissue but undetectable HBV surface antigen in serum. In this study, 1,036 HLP patients and 1,134 replacement blood donor controls were recruited. Among them, 252 HLP patients and 255 blood donors with antibody to HBV core positive were selected and analyzed. HBV DNA was confirmed by nucleic acid testing assays, and nucleotide mutations were analyzed. OBI was detected in 9.5% (24/252) of HLP patients and 2.4% (6/255) of blood donors, respectively (P < 0.001). In HLP population, 41.7% of OBI and 13.6% of non-OBI carriers were associated with daily alcohol consuming > 30 g/day (P < 0.01), while in control population those rates were not statistically different between OBI and non-OBI carriers (P > 0.05). Viral load of OBI in HLP patients was higher than that of OBI in blood donors (P < 0.05), which was a positive correlation between total cholesterol and HBV viral load levels (r = 0.474 P = 0.019). HBV vaccination rate was found significantly lower in OBI HLP patients than that in non-OBI HLP patients (P < 0.01). Importantly, mutations were found in basic core promoter region of HBV among OBI HLP patients. In conclusion, the frequency of OBI is significantly higher in HLP patients, especially those patients with heavy daily alcohol consumption.