Shah Dimpy P, Grimes Carolyn Z, Nguyen Anh T, Lai Dejian, Hwang Lu-Yu
Dimpy P. Shah, Carolyn Z. Grimes, Anh T. Nguyen, and Lu-Yu Hwang are with the Center for Infectious Diseases, Division of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas School of Public Health, Houston. Dejian Lai is with the Division of Biostatistics, The University of Texas School of Public Health.
Am J Public Health. 2015 Jun;105(6):e36-43. doi: 10.2105/AJPH.2014.302487. Epub 2015 Apr 16.
We demonstrated the effectiveness of an accelerated hepatitis B vaccination schedule in drug users.
We compared the long-term effectiveness of accelerated (0-1-2 months) and standard (0-1-6 months) hepatitis B vaccination schedules in preventing hepatitis B virus (HBV) infections and anti-hepatitis B (anti-HBs) antibody loss during 2-year follow-up in 707 drug users (HIV and HBV negative at enrollment and completed 3 vaccine doses) from February 2004 to October 2009.
Drug users in the accelerated schedule group had significantly lower HBV infection rates, but had a similar rate of anti-HBs antibody loss compared with the standard schedule group over 2 years of follow-up. No chronic HBV infections were observed. Hepatitis C positivity at enrollment and age younger than 40 years were independent risk factors for HBV infection and antibody loss, respectively.
An accelerated vaccination schedule was more preferable than a standard vaccination schedule in preventing HBV infections in drug users. To overcome the disadvantages of a standard vaccination schedule, an accelerated vaccination schedule should be considered in drug users with low adherence. Our study should be repeated in different cohorts to validate our findings and establish the role of an accelerated schedule in hepatitis B vaccination guidelines for drug users.
我们证明了加速乙肝疫苗接种方案在吸毒者中的有效性。
我们比较了加速(0-1-2月)和标准(0-1-6月)乙肝疫苗接种方案在2004年2月至2009年10月期间对707名吸毒者(入组时HIV和HBV阴性且完成3剂疫苗接种)进行2年随访时预防乙肝病毒(HBV)感染和乙肝抗体(抗-HBs)消失的长期有效性。
在2年的随访中,加速接种方案组的吸毒者HBV感染率显著较低,但抗-HBs抗体消失率与标准接种方案组相似。未观察到慢性HBV感染。入组时丙肝阳性和年龄小于40岁分别是HBV感染和抗体消失的独立危险因素。
在预防吸毒者HBV感染方面,加速接种方案比标准接种方案更可取。为克服标准接种方案的缺点,对于依从性低的吸毒者应考虑采用加速接种方案。我们的研究应在不同队列中重复进行,以验证我们的发现,并确定加速接种方案在吸毒者乙肝疫苗接种指南中的作用。