Public Health Service Amsterdam, Department of Infectious Diseases, Nieuwe Achtergracht 100, 1018 WT Amsterdam, The Netherlands.
J Hepatol. 2013 Dec;59(6):1177-83. doi: 10.1016/j.jhep.2013.08.002. Epub 2013 Aug 13.
BACKGROUND & AIMS: In the Netherlands, transmission of hepatitis B virus occurs mainly within behavioural high-risk groups, such as in men who have sex with men. Therefore, a vaccination programme has targeted these high-risk groups. This study evaluates the impact of the vaccination programme targeting Amsterdam's large population of men who have sex with men from 1998 through 2011.
We used Amsterdam data from the national database of the vaccination programme for high-risk groups (January 1, 1998 to December 31, 2011). Programme and vaccination coverage were estimated with population statistics. Incidence of acute hepatitis B was analyzed with notification data from the Amsterdam Public Health Service (1992-2011). Mathematical modelling accounting for vaccination data and trends in sexual risk behaviour was used to explore the impact of the programme.
At the end of 2011, programme coverage was estimated at 41% and vaccination coverage from 30% to 38%. Most participants (67%) were recruited from the outpatient department for sexually transmitted infections and outreach locations such as saunas and gay bars. Incidence of acute hepatitis B dropped sharply after 2005. The mathematical model in which those who engage most in high-risk sex are vaccinated, best explained the decline in incidence.
Transmission of hepatitis B virus among Amsterdam's men who have sex with men has decreased, despite ongoing high-risk sexual behaviour. Vaccination programmes targeting men who have sex with men do not require full coverage; they may be effective when those who engage most in high-risk sex are reached.
在荷兰，乙型肝炎病毒的传播主要发生在行为高危人群中，例如男男性行为者。因此，已经针对这些高危人群开展了疫苗接种计划。本研究评估了针对阿姆斯特丹大量男男性行为者的疫苗接种计划在 1998 年至 2011 年间的影响。
我们使用了国家高危人群疫苗接种计划的阿姆斯特丹数据库中的数据（1998 年 1 月 1 日至 2011 年 12 月 31 日）。使用人口统计数据估计了计划和疫苗接种的覆盖率。使用来自阿姆斯特丹公共卫生服务部门的急性乙型肝炎通报数据（1992-2011 年）分析了发病率。使用考虑疫苗接种数据和性行为风险趋势的数学模型来探索该计划的影响。
2011 年底，计划覆盖率估计为 41%，疫苗接种覆盖率为 30%至 38%。大多数参与者（67%）是从性传播感染门诊和桑拿浴室和同性恋酒吧等外展地点招募的。2005 年后，急性乙型肝炎的发病率急剧下降。在那些最常发生高危性行为的人接种疫苗的数学模型中，发病率下降得到了最佳解释。
尽管持续存在高危性行为，但阿姆斯特丹男男性行为者中的乙型肝炎病毒传播已经减少。针对男男性行为者的疫苗接种计划不需要全覆盖；当接触到那些最常发生高危性行为的人时，它们可能是有效的。
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