Matthew W McGarrity, Ryan Lisk, Paul MacPherson, David Knox, Kevin S Woodward, Jeffrey Reinhart, John MacLeod, Isaac I Bogoch, Deanna Clatworthy, Mia J Biondi, Sean T Sullivan, Alan T W Li, Garfield Durrant, Andrew Schonbe, Fanta Ongoiba, Janet Raboud, Ann N Burchell, Darrell H S Tan
{"title":"艾滋病毒暴露前预防以及接种甲型肝炎病毒、乙型肝炎病毒和人类乳头瘤病毒疫苗的机会：安大略省 PrEP 队列研究分析。","authors":"Matthew W McGarrity, Ryan Lisk, Paul MacPherson, David Knox, Kevin S Woodward, Jeffrey Reinhart, John MacLeod, Isaac I Bogoch, Deanna Clatworthy, Mia J Biondi, Sean T Sullivan, Alan T W Li, Garfield Durrant, Andrew Schonbe, Fanta Ongoiba, Janet Raboud, Ann N Burchell, Darrell H S Tan","doi":"10.1136/sextrans-2023-055961","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Populations who seek HIV pre-exposure prophylaxis (PrEP) are disproportionately affected by hepatitis A virus (HAV), hepatitis B virus (HBV) and human papillomavirus (HPV). We examined immunity/vaccination against these infections among participants in the Ontario PrEP cohort study (ON-PrEP).</p><p><strong>Methods: </strong>ON-PrEP is a prospective cohort of HIV-negative PrEP users from 10 Ontario clinics. We descriptively analysed baseline immunity/vaccination against HAV (IgG reactive), HBV (hepatitis B surface antibody >10) and HPV (self-reported three-dose vaccination). We further performed multivariable logistic regression to identify characteristics associated with baseline immunity/vaccination. We used cumulative incidence functions to describe vaccine uptake among participants non-immune at baseline.</p><p><strong>Results: </strong>Of 633 eligible participants, 59.1% were white, 85.8% were male and 79.6% were gay. We found baseline evidence of immunity/vaccination against HAV, HBV and HPV in 69.2%, 81.2% and 16.8% of PrEP-experienced participants and 58.9%, 70.3% and 10.4% of PrEP-naïve participants, respectively. Characteristics associated with baseline HAV immunity were greater PrEP duration (adjusted OR (aOR) 1.41/year, 95% CI 1.09 to 1.84), frequent sexually transmitted and bloodborne infection (STBBI) testing (aOR 2.38, 95% CI 1.15 to 4.92) and HBV immunity (aOR 3.53, 95% CI 2.09 to 5.98). Characteristics associated with baseline HBV immunity were living in Toronto (aOR 3.54, 95% CI 1.87 to 6.70) or Ottawa (aOR 2.76, 95% CI 1.41 to 5.40), self-identifying as racialised (aOR 2.23, 95% CI 1.19 to 4.18), greater PrEP duration (aOR 1.39/year, 95% CI 1.02 to 1.90) and HAV immunity (aOR 3.75, 95% CI 2.19 to 6.41). Characteristics associated with baseline HPV vaccination were being aged ≤26 years (aOR 9.28, 95% CI 2.11 to 40.77), annual income between CAD$60 000 and CAD$119 000 (aOR 3.42, 95% CI 1.40 to 8.34), frequent STBBI testing (aOR 7.00, 95% CI 1.38 to 35.46) and HAV immunity (aOR 6.96, 95% CI 2.00 to 24.25). Among those non-immune at baseline, overall cumulative probability of immunity/vaccination was 0.70, 0.60 and 0.53 among PrEP-experienced participants and 0.93, 0.80 and 0.70 among PrEP-naïve participants for HAV, HBV and HPV, respectively.</p><p><strong>Conclusions: </strong>Baseline immunity to HAV/HBV was common, and a sizeable proportion of non-immune participants were vaccinated during follow-up. However, HPV vaccination was uncommon. Continued efforts should be made to remove barriers to HPV vaccination such as cost, inclusion in clinical guidelines and provider recommendation.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11287645/pdf/","citationCount":"0","resultStr":"{\"title\":\"HIV pre-exposure prophylaxis and opportunities for vaccination against hepatitis A virus, hepatitis B virus and human papillomavirus: an analysis of the Ontario PrEP cohort study.\",\"authors\":\"Matthew W McGarrity, Ryan Lisk, Paul MacPherson, David Knox, Kevin S Woodward, Jeffrey Reinhart, John MacLeod, Isaac I Bogoch, Deanna Clatworthy, Mia J Biondi, Sean T Sullivan, Alan T W Li, Garfield Durrant, Andrew Schonbe, Fanta Ongoiba, Janet Raboud, Ann N Burchell, Darrell H S Tan\",\"doi\":\"10.1136/sextrans-2023-055961\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Populations who seek HIV pre-exposure prophylaxis (PrEP) are disproportionately affected by hepatitis A virus (HAV), hepatitis B virus (HBV) and human papillomavirus (HPV). We examined immunity/vaccination against these infections among participants in the Ontario PrEP cohort study (ON-PrEP).</p><p><strong>Methods: </strong>ON-PrEP is a prospective cohort of HIV-negative PrEP users from 10 Ontario clinics. We descriptively analysed baseline immunity/vaccination against HAV (IgG reactive), HBV (hepatitis B surface antibody >10) and HPV (self-reported three-dose vaccination). We further performed multivariable logistic regression to identify characteristics associated with baseline immunity/vaccination. We used cumulative incidence functions to describe vaccine uptake among participants non-immune at baseline.</p><p><strong>Results: </strong>Of 633 eligible participants, 59.1% were white, 85.8% were male and 79.6% were gay. We found baseline evidence of immunity/vaccination against HAV, HBV and HPV in 69.2%, 81.2% and 16.8% of PrEP-experienced participants and 58.9%, 70.3% and 10.4% of PrEP-naïve participants, respectively. Characteristics associated with baseline HAV immunity were greater PrEP duration (adjusted OR (aOR) 1.41/year, 95% CI 1.09 to 1.84), frequent sexually transmitted and bloodborne infection (STBBI) testing (aOR 2.38, 95% CI 1.15 to 4.92) and HBV immunity (aOR 3.53, 95% CI 2.09 to 5.98). Characteristics associated with baseline HBV immunity were living in Toronto (aOR 3.54, 95% CI 1.87 to 6.70) or Ottawa (aOR 2.76, 95% CI 1.41 to 5.40), self-identifying as racialised (aOR 2.23, 95% CI 1.19 to 4.18), greater PrEP duration (aOR 1.39/year, 95% CI 1.02 to 1.90) and HAV immunity (aOR 3.75, 95% CI 2.19 to 6.41). Characteristics associated with baseline HPV vaccination were being aged ≤26 years (aOR 9.28, 95% CI 2.11 to 40.77), annual income between CAD$60 000 and CAD$119 000 (aOR 3.42, 95% CI 1.40 to 8.34), frequent STBBI testing (aOR 7.00, 95% CI 1.38 to 35.46) and HAV immunity (aOR 6.96, 95% CI 2.00 to 24.25). Among those non-immune at baseline, overall cumulative probability of immunity/vaccination was 0.70, 0.60 and 0.53 among PrEP-experienced participants and 0.93, 0.80 and 0.70 among PrEP-naïve participants for HAV, HBV and HPV, respectively.</p><p><strong>Conclusions: </strong>Baseline immunity to HAV/HBV was common, and a sizeable proportion of non-immune participants were vaccinated during follow-up. However, HPV vaccination was uncommon. Continued efforts should be made to remove barriers to HPV vaccination such as cost, inclusion in clinical guidelines and provider recommendation.</p>\",\"PeriodicalId\":21624,\"journal\":{\"name\":\"Sexually Transmitted Infections\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2024-07-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11287645/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sexually Transmitted Infections\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/sextrans-2023-055961\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sexually Transmitted Infections","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/sextrans-2023-055961","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
摘要
目标：寻求艾滋病暴露前预防疗法（PrEP）的人群受到甲型肝炎病毒（HAV）、乙型肝炎病毒（HBV）和人类乳头瘤病毒（HPV）的影响尤为严重。我们研究了安大略省 PrEP 队列研究（ON-PrEP）参与者对这些感染的免疫/疫苗接种情况：方法：ON-PrEP 是一项前瞻性队列研究，研究对象是来自安大略省 10 家诊所的 HIV 阴性 PrEP 用户。我们对 HAV（IgG 反应性）、HBV（乙肝表面抗体 >10）和 HPV（自我报告的三剂疫苗接种）的基线免疫/疫苗接种情况进行了描述性分析。我们进一步进行了多变量逻辑回归，以确定与基线免疫/疫苗接种相关的特征。我们使用累积发生率函数来描述基线无免疫力参与者的疫苗接种情况：在 633 名符合条件的参与者中，59.1% 为白人，85.8% 为男性，79.6% 为同性恋。我们发现分别有69.2%、81.2%和16.8%的PrEP体验者和58.9%、70.3%和10.4%的PrEP未体验者基线免疫/接种HAV、HBV和HPV疫苗。与基线 HAV 免疫力相关的特征有：较长的 PrEP 持续时间（调整 OR (aOR) 1.41/年，95% CI 1.09 至 1.84）、频繁的性传播和血液传播感染 (STBBI) 检测（aOR 2.38，95% CI 1.15 至 4.92）和 HBV 免疫力（aOR 3.53，95% CI 2.09 至 5.98）。与基线 HBV 免疫相关的特征有：居住在多伦多（aOR 3.54，95% CI 1.87 至 6.70）或渥太华（aOR 2.76，95% CI 1.41 至 5.40）、自我认同为种族化（aOR 2.23，95% CI 1.19 至 4.18）、PrEP 持续时间较长（aOR 1.39/年，95% CI 1.02 至 1.90）和 HAV 免疫（aOR 3.75，95% CI 2.19 至 6.41）。与基线接种 HPV 疫苗相关的特征有：年龄小于 26 岁（aOR 9.28，95% CI 2.11 至 40.77）、年收入在 60 000 至 119 000 加元之间（aOR 3.42，95% CI 1.40 至 8.34）、经常进行 STBBI 检测（aOR 7.00，95% CI 1.38 至 35.46）和 HAV 免疫（aOR 6.96，95% CI 2.00 至 24.25）。在基线无免疫力的人群中，对于HAV、HBV和HPV，有PrEP经验的参与者免疫力/接种疫苗的总体累积概率分别为0.70、0.60和0.53，而对于PrEP无经验的参与者，免疫力/接种疫苗的总体累积概率分别为0.93、0.80和0.70：结论：对 HAV/HBV 的基线免疫很普遍，相当一部分无免疫力的参与者在随访期间接种了疫苗。然而，HPV 疫苗接种并不常见。应继续努力消除 HPV 疫苗接种的障碍，如成本、纳入临床指南和提供者推荐等。
HIV pre-exposure prophylaxis and opportunities for vaccination against hepatitis A virus, hepatitis B virus and human papillomavirus: an analysis of the Ontario PrEP cohort study.
Objectives: Populations who seek HIV pre-exposure prophylaxis (PrEP) are disproportionately affected by hepatitis A virus (HAV), hepatitis B virus (HBV) and human papillomavirus (HPV). We examined immunity/vaccination against these infections among participants in the Ontario PrEP cohort study (ON-PrEP).
Methods: ON-PrEP is a prospective cohort of HIV-negative PrEP users from 10 Ontario clinics. We descriptively analysed baseline immunity/vaccination against HAV (IgG reactive), HBV (hepatitis B surface antibody >10) and HPV (self-reported three-dose vaccination). We further performed multivariable logistic regression to identify characteristics associated with baseline immunity/vaccination. We used cumulative incidence functions to describe vaccine uptake among participants non-immune at baseline.
Results: Of 633 eligible participants, 59.1% were white, 85.8% were male and 79.6% were gay. We found baseline evidence of immunity/vaccination against HAV, HBV and HPV in 69.2%, 81.2% and 16.8% of PrEP-experienced participants and 58.9%, 70.3% and 10.4% of PrEP-naïve participants, respectively. Characteristics associated with baseline HAV immunity were greater PrEP duration (adjusted OR (aOR) 1.41/year, 95% CI 1.09 to 1.84), frequent sexually transmitted and bloodborne infection (STBBI) testing (aOR 2.38, 95% CI 1.15 to 4.92) and HBV immunity (aOR 3.53, 95% CI 2.09 to 5.98). Characteristics associated with baseline HBV immunity were living in Toronto (aOR 3.54, 95% CI 1.87 to 6.70) or Ottawa (aOR 2.76, 95% CI 1.41 to 5.40), self-identifying as racialised (aOR 2.23, 95% CI 1.19 to 4.18), greater PrEP duration (aOR 1.39/year, 95% CI 1.02 to 1.90) and HAV immunity (aOR 3.75, 95% CI 2.19 to 6.41). Characteristics associated with baseline HPV vaccination were being aged ≤26 years (aOR 9.28, 95% CI 2.11 to 40.77), annual income between CAD$60 000 and CAD$119 000 (aOR 3.42, 95% CI 1.40 to 8.34), frequent STBBI testing (aOR 7.00, 95% CI 1.38 to 35.46) and HAV immunity (aOR 6.96, 95% CI 2.00 to 24.25). Among those non-immune at baseline, overall cumulative probability of immunity/vaccination was 0.70, 0.60 and 0.53 among PrEP-experienced participants and 0.93, 0.80 and 0.70 among PrEP-naïve participants for HAV, HBV and HPV, respectively.
Conclusions: Baseline immunity to HAV/HBV was common, and a sizeable proportion of non-immune participants were vaccinated during follow-up. However, HPV vaccination was uncommon. Continued efforts should be made to remove barriers to HPV vaccination such as cost, inclusion in clinical guidelines and provider recommendation.
期刊介绍：
Sexually Transmitted Infections is the world’s longest running international journal on sexual health. It aims to keep practitioners, trainees and researchers up to date in the prevention, diagnosis and treatment of all STIs and HIV. The journal publishes original research, descriptive epidemiology, evidence-based reviews and comment on the clinical, public health, sociological and laboratory aspects of sexual health from around the world. We also publish educational articles, letters and other material of interest to readers, along with podcasts and other online material. STI provides a high quality editorial service from submission to publication.
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