Stroffolini Tommaso, Stroffolini Giacomo
Department of Tropical and Infectious Diseases, Policlinico Umberto I, 00161 Rome, Italy.
Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A. Sempreboni, 5, Negrar, 37024 Verona, Italy.
Vaccines (Basel). 2023 Sep 27;11(10):1531. doi: 10.3390/vaccines11101531.
In Italy, the vaccination campaign against hepatitis B virus has been characterized by two phases. In the first phase (1984-1991), vaccination with plasma-derived vaccines was first recommended for the high-risk group. In the second phase (1991-nowadays), recombinant vaccine targeted, by law, infants 2 months old and teenagers 12 years old (limited to the first 12 years of campaign); screening for HBsAg became compulsory for all pregnant women during the third trimester of pregnancy. Successful achievements have been attained: No acute HBV case has been observed in the age group targeted by vaccination, the pool of chronic HBsAg carriers is strongly reduced, perinatal HBV transmission is under control, and acute delta virus hepatitis cases are nearly eliminated. The key point of this success has been the peculiar vaccination policy adopted. The combined vaccination of teenagers has generated an early immune cohort of youths, who are no longer at risk of acquiring HBV infection by sources of exposure (i.e., drug use and unsafe sex practices) typical of the young adults. Vaccination of household contacts with HBsAg-positive subjects represents an area of improvement; providing migrants and refugees access to healthcare services is also a focal point. In 2020, Italy became the first country in Europe to achieve the WHO's regional hepatitis targets.
在意大利，针对乙型肝炎病毒的疫苗接种运动分为两个阶段。在第一阶段（1984年至1991年），首先建议高危人群接种血浆源性疫苗。在第二阶段（1991年至今），法律规定重组疫苗的接种对象为2个月大的婴儿和12岁的青少年（仅限于运动开展的前12年）；所有孕妇在妊娠晚期必须进行HBsAg筛查。已取得了成功：在疫苗接种目标年龄组中未观察到急性乙肝病例，慢性HBsAg携带者群体大幅减少，围产期乙肝传播得到控制，急性丁型病毒性肝炎病例几乎消除。这一成功的关键在于所采取的特殊疫苗接种政策。青少年联合接种疫苗产生了一个早期免疫群体，这些年轻人不再有通过典型的年轻成年人接触源（即吸毒和不安全的性行为）感染乙肝病毒的风险。对HBsAg阳性受试者的家庭接触者进行疫苗接种是一个有待改进的领域；为移民和难民提供医疗服务也是一个重点。2020年，意大利成为欧洲首个实现世界卫生组织区域肝炎目标的国家。
