Wisconsin Division of Public Health, Madison, WI, USA.
Division of Infectious Disease, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.
Public Health Rep. 2019 Nov/Dec;134(6):651-659. doi: 10.1177/0033354919874088. Epub 2019 Sep 20.
Despite recommendations for vaccination against hepatitis A virus (HAV) and hepatitis B virus (HBV) for all adults at increased risk of infection, several US states have reported increases in HAV and HBV infections among persons who inject drugs. We investigated hepatitis A and hepatitis B vaccination coverage among a sample of persons who reported injecting drugs and had evidence of hepatitis C virus (HCV) infection.
We searched the Wisconsin Immunization Registry for the vaccination records of persons who underwent HCV testing at syringe services programs from January 1 through August 31, 2018, and were reported to the Wisconsin Division of Public Health as having positive HCV antibody test results and a history of injection drug use. We calculated the percentage of persons who were vaccinated according to national recommendations.
Of 215 persons reported, 204 (94.9%) had a client record in the Wisconsin Immunization Registry. Of these 204 persons, 66 (32.4%) had received ≥1 dose of hepatitis A vaccine, 46 (22.5%) had received 2 doses of hepatitis A vaccine, and 115 (56.4%) had received 3 doses of hepatitis B vaccine. Hepatitis B vaccine coverage decreased with increasing age, from 88.0% (22 of 25) among adults aged 20-24 to 30.3% (10 of 33) among adults aged 35-39.
These findings suggest that most persons who inject drugs in Wisconsin are susceptible to HAV infection and that most persons aged ≥35 who inject drugs are susceptible to HBV infection. In addition to routine vaccination of children, targeted hepatitis vaccination programs should focus on adults who inject drugs to help prevent future infections.
尽管有建议为所有感染风险增加的成年人接种甲型肝炎病毒（HAV）和乙型肝炎病毒（HBV）疫苗，但美国几个州报告称，在注射毒品的人群中，HAV 和 HBV 感染有所增加。我们调查了在注射毒品且有丙型肝炎病毒（HCV）感染证据的人群中甲型肝炎和乙型肝炎疫苗接种情况。
我们在 2018 年 1 月 1 日至 8 月 31 日期间，通过威斯康星州注射器服务计划（syringe services programs）对接受 HCV 检测的人员进行了搜索，这些人员的疫苗接种记录被报告给威斯康星州公共卫生部，并且他们的 HCV 抗体检测结果呈阳性，且有注射毒品史。我们根据国家建议计算了疫苗接种率。
报告了 215 名人员，其中 204 名（94.9%）在威斯康星州免疫登记处有客户记录。在这 204 名人员中，66 名（32.4%）接受了≥1 剂甲型肝炎疫苗，46 名（22.5%）接受了 2 剂甲型肝炎疫苗，115 名（56.4%）接受了 3 剂乙型肝炎疫苗。乙型肝炎疫苗接种率随着年龄的增加而降低，从 20-24 岁的成年人的 88.0%（22 名）到 35-39 岁的成年人的 30.3%（10 名）。
这些发现表明，威斯康星州的大多数注射毒品者容易感染 HAV，大多数年龄≥35 岁的注射毒品者容易感染 HBV。除了对儿童进行常规疫苗接种外，有针对性的肝炎疫苗接种计划应重点关注注射毒品的成年人，以帮助预防未来的感染。
