Rahmani Alborz, Montecucco Alfredo, Kusznir Vitturi Bruno, Debarbieri Nicoletta, Dini Guglielmo, Durando Paolo
Department of Health Sciences, University of Genoa, 16132 Genoa, Italy.
Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy.
Vaccines (Basel). 2022 Oct 30;10(11):1841. doi: 10.3390/vaccines10111841.
Hepatitis B virus represents an important global health problem. In highly developed countries, mass vaccination campaigns of newborns in recent decades have drastically reduced the proportion of carriers. However, workers exposed to blood and body fluids, including healthcare students, can be at risk of exposure. In order to assess the proportion of susceptible individuals in the specific population of healthcare students in highly developed countries, a systematic review and meta-analysis was performed to summarize the evidence on the persistence of humoral immune protection induced by the primary cycle of hepatitis B vaccination, as well as the proportion of true non-responders. Forty-six studies were included in the final analysis (52,749 participants). Overall, the seroprotection prevalence at the pre-exposure assessment was equal to 73.8% (95% CI 69.1-78.0); the prevalence of anamnestic response following the administration of a challenge dose was 90.9% (95% CI 87.7-93.3), demonstrating a high proportion of persistence of vaccination-induced immunity. Among those without evidence of anamnestic response, 5.0% (95% CI 2.1-11.5) were non-responders following the completion of a secondary immunization cycle. These findings demonstrate that the majority of healthcare students vaccinated with the complete HBV primary cycle maintain an effective humoral immunity against this pathogen for over two decades.
乙型肝炎病毒是一个重要的全球健康问题。在高度发达国家，近几十年来针对新生儿的大规模疫苗接种运动大幅降低了携带者的比例。然而，包括医学生在内的接触血液和体液的工作人员可能面临接触风险。为了评估高度发达国家医学生这一特定人群中易感个体的比例，进行了一项系统综述和荟萃分析，以总结关于乙肝疫苗初次接种周期诱导的体液免疫保护持续性以及真正无应答者比例的证据。最终分析纳入了46项研究（52749名参与者）。总体而言，暴露前评估时的血清保护率为73.8%（95%可信区间69.1 - 78.0）；给予激发剂量后回忆应答的发生率为90.9%（95%可信区间87.7 - 93.3），表明疫苗诱导的免疫力有很高比例的持续性。在没有回忆应答证据的人群中，二次免疫接种周期完成后无应答者占5.0%（95%可信区间2.1 - 11.5）。这些发现表明，大多数完成乙肝疫苗初次完整接种周期的医学生对这种病原体保持有效的体液免疫长达二十多年。
