939 - Immunity to Hepatitis A and/or Hepatitis B Viruses Among Inmates Living with HIV

Background: Hepatitis A (HAV) and B viruses (HBV) are vaccine-preventable diseases where screening upon entry into prison provides an ideal public health opportunity to assess vaccination status and administer vaccination while incarcerated.

Methods:

A retrospective, electronic medical record review evaluated incarcerated adults receiving human immunodeficiency virus (HIV) telemedicine care in 26 prisons in Illinois, USA, from 01/01/19 through 12/31/19. Included subjects were living with HIV, incarcerated in the Illinois Department of Corrections (IDOC), and had available data for HAV/HBV serologies, viral load, and CD4 count during incarceration. The primary objective was to assess rates of HAV and/or HBV immunity in individuals with HIV. The secondary objective was to assess factors associated with vaccination status. Statistical analysis included Chi-squared testing and descriptive statistics.

Results: Among the 524 patients analyzed, the majority were Black men (75%) with an average age of 44 years. 429 patients had existing data for HAV vaccination where 79% had documented immunity. 397 patients had existing data for HBV vaccination where 5% had HBV infection, 1.4% had an equivocal HBV surface antibody and negative HBV surface antigen, and 70% had documented immunity. In total, 387 patients had existing data for HAV and HBV vaccination status where 213 (55%) were immune to both HAV and HBV while (7%) had no immunity to both HAV and HBV. Immunity did not vary based on CD4 count, age, gender, or race (p > 0.05).

Conclusion: Assessing serologies and providing Hepatitis A and B vaccinations while incarcerated, where indicated, can increase immunity to these vaccine-preventable viruses and thereby reduce transmission of HAV and HBV. This is of particular importance for patients living with HIV as this is an indication for vaccination.  Based on these findings, the telemedicine study team has been able to assess serologies and advocate for vaccination for inmates living with HIV entering the IDOC. Over time, we expect our interventions to result in further improvements in rates of immunity.