Anaes practice guidelines for vaccination against hepatitis B virus: impact on general practitioners

In September 2003, Agency for Accreditation and Evaluation in Health (ANAES) published its consensus recommendations for vaccination practices against hepatitis B virus (HBV), one objective of which was to decrease the risk of HBV transmission to those in the environments of patients who are carriers of the HBs antigen. The aim of our survey was to measure the awareness and application of these recommendations among general practitioners (GPs) in the Loiret region.

This retrospective survey analysed the decisions, using a semi-directed interview, made by all consenting GPs who, in 2004, had referred newly diagnosed HBs antigen-positive patients to the liver unit of the hospital of Orleans.

Of the contacted GPs, 83% agreed to participate. Although only one-third of them were familiar with the recommendations, all identified the sexual partners and people living under the same roof as the patient targets for screening and/or vaccination. Also, 75% of the GPs had a consultation with some or all of the identified at-risk individuals in their patient's environment, but only 58% succeeded in vaccinating these at-risk people. Among the interviewed GPs, 71% were in favour of mass vaccination practices against HBV and all were in favour of vaccination targeting the at-risk individuals.

Dissemination of the ANAES recommendations needs to be improved, even though the majority of the GPs included in the present study were in favour of mass vaccination against HBV and all were in favour of vaccination of at-risk individuals. However, one-third of the identified at-risk individuals eluded screening and/or vaccination, indicating the need for a specific organized program to make contact with these prone populations.