Reynolds-Cortez Valeria, Criado-Álvarez Juan-José, Martinez-Vizcaino Vicente, Pascual-Morena Carlos, Salinas-Vilca Ana, Sequí-Domínguez Irene
Health and Social Research Centre, Universidad de Castilla-La Mancha, 16002 Cuenca, Spain.
Preventive Medicine, Hospital Virgen de la Luz, 16002 Cuenca, Spain.
Vaccines (Basel). 2024 Sep 8;12(9):1026. doi: 10.3390/vaccines12091026.
Hepatitis B virus (HBV) vaccination has been available for over four decades. However, a synthesis of the evidence regarding the effectiveness of this strategy on preventing hepatitis B infection in people who use drugs (PWUD) is lacking. A systematic search of the MEDLINE (via PubMed), SCOPUS, Web of Science, and Cochrane Library databases was conducted up to June 2024. Eight studies reported on the effectiveness of HBV vaccination, defined as a positive result for HBsAg or anti-Hbc in vaccinated versus non-vaccinated PWUD, with a pooled effect size of 52% (95% CI: 28.2-67.9) for HBsAg and 31.89% (95% CI: 14.8-45.5) for anti-Hbc. For sero-immunity, defined as the proportion of vaccinated PWUD with levels of anti-HBs ≥ 10 mIU/mL, we found that 66.2% (95% CI: 0.61-0.71; I2 = 94%) had protective levels of anti-HBs. The results of this meta-analysis indicate that the incidence of HBV infection is lower in vaccinated PWUD than in those who did not receive the vaccine. However, the effectiveness is lower than that observed in the general population. This highlights the need for a thorough review of the factors influencing the prevention of HBV infection in PWUD.
乙肝疫苗已经问世四十多年了。然而，目前缺乏关于该策略在预防吸毒者（PWUD）感染乙肝方面有效性的证据综合分析。截至2024年6月，我们对MEDLINE（通过PubMed）、SCOPUS、科学引文索引和考克兰图书馆数据库进行了系统检索。八项研究报告了乙肝疫苗接种的有效性，定义为接种疫苗与未接种疫苗的吸毒者中乙肝表面抗原（HBsAg）或乙肝核心抗体（抗-Hbc）呈阳性结果，HBsAg的合并效应量为52%（95%置信区间：28.2-67.9），抗-Hbc为31.89%（95%置信区间：14.8-45.5）。对于血清免疫，定义为抗-HBs水平≥10 mIU/mL的接种疫苗吸毒者的比例，我们发现66.2%（95%置信区间：0.61-0.71；I2 = 94%）具有抗-HBs的保护水平。这项荟萃分析的结果表明，接种疫苗的吸毒者中乙肝感染的发生率低于未接种疫苗的吸毒者。然而，其有效性低于在普通人群中观察到的有效性。这凸显了对影响吸毒者预防乙肝感染的因素进行全面审查的必要性。
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