Ingerslev J, Mortensen E, Rasmussen K, Jørgensen J, Skinhøj P
Department of Clinical Chemistry, Aarhus Kommunehospital, Denmark.
Scand J Clin Lab Invest. 1988 Jun;48(4):333-6. doi: 10.3109/00365518809167504.
The present investigation was initiated to assess the demand for vaccination against hepatitis-B in a department of clinical chemistry. One hundred and twenty-eight employees enrolled for the test programme consisting primarily of screening for hepatitis-B antigen (HBsAg) and antibody to hepatitis-B surface antigen (anti-HBs). Surprisingly it was found, that 8 persons out of 58 who had also participated in a screening survey in 1978 had developed anti-HBs. These persons, who had no history of hepatitis, were also positive for antibodies towards the core antigen of hepatitis-B (anti-HBc). A seroconversion rate of 1,53/100/year for this material was calculated. Six persons who had contracted hepatitis-B during an epidemic 14 years previously, presented with very weak anti-HBs reactivity, but were positive for anti-HBc indicating, that anti-HBc was the more stable indicator of past HBV infection. The cost-effectiveness of vaccination against HBV seems disputable compared with other protective measures. The high incidence of silent seroconversion indicates a chronic exposure to virus among the laboratory personnel. Therefore, safety precautions against virus exposure are highly recommended.
本次调查旨在评估临床化学科室对乙肝疫苗接种的需求。128名员工报名参加了主要包括乙肝抗原(HBsAg)筛查和乙肝表面抗原抗体(抗-HBs)检测的测试项目。令人惊讶的是,在1978年也参加过一次筛查调查的58人中,有8人产生了抗-HBs。这些无肝炎病史的人,乙肝核心抗原抗体(抗-HBc)也呈阳性。据此计算出该群体的血清转化率为每年1.53/100。14年前在一次疫情中感染乙肝的6人,抗-HBs反应非常微弱,但抗-HBc呈阳性,这表明抗-HBc是过去乙肝病毒感染更稳定的指标。与其他防护措施相比,乙肝疫苗接种的成本效益似乎存在争议。隐性血清转化的高发生率表明实验室人员长期接触病毒。因此,强烈建议采取预防病毒暴露的安全措施。