Batra Vishal, Goswami Amitava, Dadhich Sunil, Kothari Dinesh, Bhargava Narendra
Department of Medicine (Vishal Batra, Dinesh Kothari), Dr Sampurnanand Medical College, Jodhpur, India.
Department of Gastroenterology (Amitava Goswami, Sunil Dadhich, Narendra Bhargava), Dr Sampurnanand Medical College, Jodhpur, India.
Ann Gastroenterol. 2015 Apr-Jun;28(2):276-280.
Healthcare workers (HCWs) are at high risk for hepatitis B virus (HBV) infection. The aim of the study was to evaluate HBV immunization status and anti-HBs titer among HCWs.
AntiHBs titer was prospectively examined in all vaccinated of the 464 HCWs enrolled. A comparison was done between two groups who had received vaccination within or beyond 5 years (Group A >5 years, Group B <5 years) and also between those who received a booster dose, Group I (<1 year) and Group II (>1 year).
49.6% HCWs were vaccinated, 46.1% were unvaccinated, and 4.3% were partially vaccinated. Among HCWs, doctors had the highest vaccination rate of 92.5%, followed by medical students (62.4%), nursing staff (41.6%), technical staff (24.2%), administrative staff (12.1%), nursing students (8.5%), and grade IV/laundry staff (0%). Of the vaccinated HCWs, 30% had anti-HBs titer <10 mIU/mL, 10.8% between 10-100 mIU/mL, and 59.2% >100 mIU/mL. Mean anti-HBs titer between groups A and B was 334.8 and 649.2 mIU/mL, respectively (P<0.05); mean anti-HBs titer between groups I and II was 1742.7 and 629.2 mIU, respectively (P<0.002).
A significant proportion of HCWs is unvaccinated. A fair proportion of fully vaccinated HCWs can have low titers to protect them against HBV infection. Measuring anti-HBs titer, administering a booster dose, and offering general screening for HBs antigen should be made compulsory for HCWs.
医护人员感染乙型肝炎病毒（HBV）的风险很高。本研究的目的是评估医护人员的HBV免疫状况和抗-HBs滴度。
对纳入研究的464名医护人员中所有接种过疫苗的人员进行前瞻性抗-HBs滴度检测。比较了两组接种疫苗时间在5年以内或超过5年的人员（A组>5年，B组<5年），以及接种过加强剂量的两组人员，即I组（<1年）和II组（>1年）。
49.6%的医护人员接种过疫苗，46.1%未接种，4.3%部分接种。在医护人员中，医生的接种率最高，为92.5%，其次是医学生（62.4%）、护理人员（41.6%）、技术人员（24.2%）、行政人员（12.1%）、护理专业学生（8.5%）和四级/洗衣房工作人员（0%）。在接种过疫苗的医护人员中，30%的抗-HBs滴度<10 mIU/mL，10.8%在10-100 mIU/mL之间，59.2%>100 mIU/mL。A组和B组的平均抗-HBs滴度分别为334.8和649.2 mIU/mL（P<0.05）；I组和II组的平均抗-HBs滴度分别为1742.7和629.2 mIU（P<0.002）。
相当一部分医护人员未接种疫苗。相当一部分完全接种疫苗的医护人员可能抗-HBs滴度较低，无法有效预防HBV感染。应对医护人员强制检测抗-HBs滴度、接种加强剂量疫苗并进行HBs抗原常规筛查。
