Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA. email@example.com.
Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Comprehensive Access and Delivery Research & Evaluation (CADRE) at the Iowa City Iowa City VA Healthcare System, Iowa City, IA, USA.
College of Pharmacy, University of Iowa, Iowa City, IA, USA.
Department of Pharmacy, Iowa City VA Healthcare System, Iowa City, IA, USA.
Department of Internal Medicine, Iowa City VA Healthcare System, Iowa City, IA, USA.
The objective of this study was to examine Hepatitis A (HAV) and Hepatitis B (HBV) screening, and the risk of HBV reactivation during Hepatitis C (HCV) therapy with direct-acting antivirals (DAAs). A retrospective chart review was performed of patients treated with second generation DAA therapy from January 2014 to September 2016 at the Iowa City VA Healthcare System. In total 409 patients initiated HCV treatment, 308 (75%) and 241 (59%) were HAV and HBV vaccine eligible, respectively. Among those, 24 (8%) received a HAV vaccine, while only 20 (8%) received a HBV vaccine. Of these, 7 patients initiating an immunization in the clinic had record of completing the series. Further, 101 patients had a reactive Hepatitis B core Antibody indicating previous HBV infection, and 3 of these were tested for HBV reactivation during HCV therapy. Overall, the assessment found low rates of HAV and HBV vaccine administration, indicating missed opportunities for preventative care during HCV therapy. With the known risk of HBV reactivation with DAAs, the need for HAV and HBV screening is essential.