Drug Health Service, Sydney South West Area Health Service, Sydney, Australia.
Addiction. 2010 Feb;105(2):329-34. doi: 10.1111/j.1360-0443.2009.02765.x.
Injecting drug users are a high-risk population for hepatitis B (HBV), but are difficult to engage in vaccination programmes. This study examines the completion rates of a HBV vaccination schedule and seroconversion in a group of patients in methadone maintenance treatment.
Patients at a public methadone maintenance programme in Sydney, Australia, were screened for viral hepatitis (hepatitis A, B and C) and offered a rapid HBV vaccination schedule (0, 1 and 2 months). Hepatitis B surface antibody (antiHBs) was retested on completion of the vaccination schedule.
A total of 143 patients [71.3% male, mean age 33.1 (standard deviation +/- 8.3)] enrolled in the project. Forty-nine per cent of patients were HAV antibody (Ab) positive, 81.1% hepatitis C virus (HCV) antibody (Ab) positive and 38.9% antiHBs positive. Exposure to multiple hepatitis viruses was common, with 24.5% testing positive for all three viruses. Seventy-three (83%) of the 88 antiHBs negative patients completed the vaccination schedule. Post-vaccination serology indicated a seroconversion rate of 75.4% (55 of 73) of completors, or 62.5% of eligible participants (55 of 88).
While there was a high rate of completion of the rapid vaccination schedule in this population, a moderate seroconversion rate was achieved. Further work is required to identify an optimal vaccination schedule in opioid substitution patients.
注射吸毒者是乙型肝炎（HBV）的高危人群，但难以参与疫苗接种计划。本研究旨在检查一组美沙酮维持治疗患者完成乙型肝炎疫苗接种计划和血清转换的情况。
在澳大利亚悉尼的一个公共美沙酮维持治疗计划中，对患者进行病毒性肝炎（甲型、乙型和丙型肝炎）筛查，并提供快速乙型肝炎疫苗接种计划（0、1 和 2 个月）。在接种计划完成后，重新检测乙型肝炎表面抗体（抗-HBs）。
共有 143 名患者[71.3%为男性，平均年龄 33.1（标准差 +/- 8.3）]入组该项目。49%的患者甲型肝炎抗体（Ab）阳性，81.1%丙型肝炎病毒（HCV）抗体（Ab）阳性，38.9%抗-HBs 阳性。同时感染多种肝炎病毒的情况很常见，24.5%的患者三种病毒均呈阳性。在 88 名抗-HBs 阴性的患者中，有 73 名（83%）完成了疫苗接种计划。接种后血清学检测表明，75.4%（55/73）的完成者和 62.5%（55/88）的合格参与者发生了血清转换。
尽管该人群快速疫苗接种计划的完成率较高，但血清转换率适中。需要进一步研究以确定阿片类药物替代患者的最佳疫苗接种计划。
