Objective: To estimate validity of self-reports of prior hepatitis B virus (HBV) infection and hepatitis B vaccination among youth in a high-drug-use urban community.
Methods: 461 youths (18-24 years) in Bushwick, New York City were recruited through multi-stage household probability sampling (n=306), and through street-based targeted sampling of drug users (n=155) from the same neighborhood; asked whether they had ever been told by a doctor or nurse that they had hepatitis B, and whether they had ever received the hepatitis B vaccine (HepB); and tested for HBV infection (HBsAg, anti-HBc, and anti-HBs). Given their young ages, most HepB vaccinations might have been relatively recent and thus the observed anti-HBs prevalence may be a reasonable estimate of actual vaccination levels in the population. Specificity and sensitivity were determined through comparing self-reports of HBV infection and vaccination with respective seromarkers.
Results: Past or present HBV infection was 3.7% by self-reports and 5.9% by seromarkers (HBsAg+ or anti-HBc+). Only two people were HBsAg+. While 36.8% reported that they had received HepB vaccine, only 23.1% were anti-HBs+. Of 104 subjects with sero-evidence of vaccination (anti-HBs+), 50% said they had not been vaccinated; 6% said they "did not know."
|
Seromarker |
N |
Self-report |
Serology |
Specificity |
Sensitivity |
kappa |
|
HBsAg+ or anti-HBc+ |
460 |
17 |
27 |
0.98 |
0.26 |
0.29 |
|
anti-HBs+ |
451 |
166 |
104 |
0.65 |
0.44 |
0.08 |
Conclusions: Self-reports of HBV exposure were specific, but not sensitive. Specificity is moderate and sensitivity low for self-reports of vaccination. Researchers and health care providers should be cautious in using such self-reports.
Learning Objectives: 1.Evaluate a method of sampling inner-city youths and collecting data on hepatitis B. 2.Identify the extent of past HBV infection and immunization among inner-city youth. 3. Recognize the limitations of both self-report data on and seromarkers of HBV infection and immunization
Keywords: Hepatitis B, Youth
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.