| HIV Clinical
Performance Measure: # 6 |
| Stated
Performance Measure: Percentage
of clients with HIV infection who had been
screened for Hepatitis B virus infection
status |
| Numerator: |
Number
of clients with HIV infection who:
- were seen within the measurement
year, and
- had Hepatitis B infection status
documented in their medical record
|
| Denominator:
|
Number of
clients with HIV infection who were seen
within the measurement year |
| Data
Sources: |
- Electronic Medical Record/Electronic
Health Record
- CAREWare, Lab Tracker, or other electronic
data base
- HIVQUAL reports on this measure for
grantee under review
- Medical record data abstraction by
grantee of a sample of records that
is negotiated with the OPR Review Team
|
| National Goals, Targets,
or Benchmarks for Comparison |
None available
at this time. |
| Basis
for Selection: |
Hepatitis
B virus (HBV) is the leading cause of
chronic liver disease worldwide. In developed
countries, HBV is transmitted primarily
through sexual contact and injection-drug
use. Even though risk factors are similar,
HBV is transmitted more efficiently than
HIV-1. Although up to 90% of HIV-1–infected
persons have at least one serum marker
of previous exposure to HBV, only approximately
10% have chronic hepatitis B, as evidenced
by the detection of hepatitis B surface
antigen (HBsAg) in the serum persisting
for a minimum of 6 months.[1]
HIV-1 infection is associated with an
increased risk for the development of
chronic hepatitis B after HBV exposure.
Limited data indicate that co-infected
patients with chronic hepatitis B infection
have higher HBV DNA levels and are more
likely to have detectable hepatitis B
e antigen (HBeAg), accelerated loss of
protective hepatitis B surface antibody
(anti-HBs), and increased risk for liver-related
mortality and morbidity.[2],[3]
Co-infection with HIV and HBV can complicate
the care and treatment of HIV, and guide
the selection of medications for HAART.
|
| US Public
Health Guidelines: |
| “It is
not clear that treatment of hepatitis B
virus (HBV) improves the course of HIV,
nor is there evidence that treatment of
HIV alters the course of HBV. However several
liver-associated complications that are
ascribed to flares in HBV activity or toxicity
of antiretroviral agents can affect the
treatment of HIV in patients with HBV coinfection.
Therefore, providers should know the HBV
status of all patients with HIV. This also
will guide the choice of medications for
HIV treatment in the context of any possible
HBV treatment. For patients who are HBV
negative, prophylaxis is recommended. This
consists [of] 3 doses of vaccine for “all
susceptible patients (i.e., antihepatitis
B core antigen-negative).”2,3 (6/14/02) |
| References/Notes: |
1
Centers for Disease
Control and Prevention. Treating opportunistic
infections among HIV-infected adults and
adolescents: recommendations from CDC, the
National Institutes of Health, and the HIV
Medicine Association/Infectious Diseases
Society of America. MMWR 2004;53(No. RR-15).
(http://aidsinfo.nih.gov/ContentFiles/TreatmentofOI_AA.pdf)
2 Guidelines
for the Use of Antiretroviral Agents in
HIV-1-Infected Adults and Adolescents (http://aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf)
3 Centers
for Disease Control and Prevention. Guidelines
for Preventing Opportunistic Infections
Among HIV-Infected Persons — 2002
Recommendations of the U.S. Public Health
Service and the Infectious Diseases Society
of America. MMWR 2002;51(No. RR-8) (http://www.cdc.gov/mmwr/PDF/rr/rr5108.pdf
or http://aidsinfo.nih.gov/ContentFiles/OIpreventionGL.pdf) |
