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Background: A two-dose preoperative vaccination schedule against HBV has been the widely accepted policy in Poland. However, its effectiveness has not yet been assessed.Objective: To evaluate a two-dose preoperative HBV vaccination policy by an assessment of the proportion of patients who don't present a protective level of anti-HBs (<10.0 mIU/ml).Methods: Consecutive patients from surgical/gynecologic wards of 12 randomly selected hospitals in West Pomerania, Poland, hospitalized between 2010 and 2013, vaccinated against HBV with a two-dose regimen, were asked to complete an anonymous questionnaire. Serum samples were assayed for anti-HBs with the use of third-generation testing methods. To compare sensitivity versus specificity across a range of values for the ability to predict a dichotomous outcome (a protection against HBV infection) a Receiver operating characteristic (ROC) curve was determined.Results: There were 193 patients, 58.5% women, median age 52 years. Almost a half (46.0%) of the patients were operated on within 0-60 days of taking the second vaccine dose, 16.2% - 61-180 days after, 37.8% >180 days after. Anti-HBs titer was below a protective level in 49.2% of participants (0.0 mIU/ml in 17.8%, 0.1-9.9 mIU/ml in 31.4%); none of them were aware of this fact. Age ≤ 52 years (OR = 1.89) and having surgery more than 37.5 days after HBV vaccination (OR = 2.70) were associated with greater odds of being protected against HBV infection through vaccination. For the time frame between the second dose implementation and surgery 23 days, a sensitivity of 84% and specificity of 22% for obtaining protection against HBV infection was found, for the time frame >37.5 days - sensitivity remained high (80%), while specificity increased (41%); there was an apparent peek on the ROC curve between 38 and 60 day. In the group vaccinated 0-37.5 days before surgery, less patients had the protective level of anti-HBs titer than in vaccinated 38-60 days before surgery (32.3% vs 60.0%; p = 0.03).Conclusions: The success rate in achieving adequate immune protection with two dose HBV vaccination schedule in preoperatively vaccinated patients is relatively low, especially among those vaccinated less than five weeks prior to surgery. In more than a third of cases the standard three-dose regimen could have been implemented, as participants had time to complete a third dose. Current recommendations regarding a preoperative policy with a 2-dose vaccination schedule in Poland should be revised; the best time to perform surgery after the implementation of the second dose of vaccine in the context of patient protection against HBV infection would be between 38 and 60 days. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B is a significant health burden in Poland with nosocomial transmission being the main source of infection. Therefore, HBV vaccination is widely recommended for those not covered by the national immunisation program.Objective: To assess the coverage and influencing determinants of HBV vaccination among adult patients attending GP clinics as well as to establish serological status in terms of HBV infection.Methods: Patients who were seen consecutively in March 2013 at four randomly selected GP practices located in Zgorzelec county, in south-western part of Poland, were invited to participate and complete questionnaires on socio-demographic data and other factors related to vaccination. A pilot study was done in one urban GP practice in the city of Gryfino (Gryfino county), the results have been included in the study. Patients' immunisation status was assessed basing on vaccination cards and anti-HBs titer with the use of third-generation testing methods. In addition, serum samples were assayed for anti-HBc total.Results: Response rate: 99.3 %. Of 410 participants (66.1 % females, median age 56 years), 55.4 % (95%CI:50.5-60.1 %) were previously vaccinated; in those 11.5 % took 2 doses, 66.1 % - 3 doses,18.1 % - 4 doses. Elective surgery was the main reason (57.7 %) for HBV immunization, 4.8 % - were vaccinated due to recommendations by GPs. The multivariable logistic regression model revealed that living in a city (OR 2.11), and having a surgery in the past (OR 2.73) were each associated with greater odds of being vaccinated. Anti-HBc total prevalence among those unvaccinated was 13.6 % (95%CI:9.3 %-19,5 %), and 7.2 % (95%CI:4.4-11.8 %) among those vaccinated.Conclusions: Low HBV immunization coverage among adult patients from GP clinics and the presence of serological markers of HBV infection among both - those unvaccinated and vaccinated call for comprehensive preventative measures against infection, including greater involvement of family doctors. Although interventions should cover the whole population, inhabitants living in the rural areas should be a group of special interest. Preoperative immunization for HBV seems to be an efficient public health tool to increase the vaccination uptake. [ABSTRACT FROM AUTHOR]

Although voluntary HIV testing is still more dominant than the mandatory form, in accordance with the Joint United Nations Programme on HIV/AIDS (UNAIDS) and Centers for Disease Control recommendations, there are still millions of people who are mandatorily tested before marriage. This article presents policies toward mandatory premarital HIV testing (PHT) in selected Arabian Peninsula countries, focusing on details of the testing as experienced by high-school students, who were participants of a recent research study conducted in the United Arab Emirates. With a high acceptance for mandatory premarital and periodical marital HIV testing among young Emirates, showing a feeling of vulnerability to contracting the infection, possible explanations for such feelings is also discussed. The advantages and disadvantages of PHT are presented with a focus on Arabian Peninsula countries. The author concludes that while a positive PHT result may be socially isolating, the challenge in Arab countries is to stimulate efforts into shifting social norms toward a destigmatization of disease, acceptance, and support of HIV-infected persons with reference to religion and compassion. Recommendations, which consider the specific nature of Arab countries, predominately governed by Islamic laws are formulated. A PHT program could benefit from adequate legislation acts followed by education and counseling based on government policy, religious body support, and an involvement of NGOs and international agencies. [ABSTRACT FROM AUTHOR]