Grady G F
Sex Transm Dis. 1981 Oct-Dec;8(4 suppl):344-8.
In industrialized western nations where sexual contact is a predominant mechanism of transmitting hepatitis B, benefit:cost models can be developed to indicate when testing of immunity (for susceptibility) would be worthwhile in order to target immunization to high-risk groups and extend the supplies of vaccine. Promiscuous male homosexuals illustrate one end of the spectrum in priority for immunization and screening tests. They are at high risk and at least 50% will be found seropositive for a marker of prior infection and thus do not need immunization. At the other end of the spectrum are populations of typical volunteer blood donors with neither sufficient risk to justify immunization nor a high enough prevalence of seropositive individuals ( less than 10%) to justify screening. An intermediate group, requiring screening tests for selective immunization, would be promiscuous heterosexuals attending venereal disease clinics. Aggressive immunization of sexually promiscuous adults will have major impact in western nations, whereas the newborn must remain the focus of immunization progrmas in areas of the world where hepatitis B virus is endemic.
在性接触是乙型肝炎主要传播途径的西方工业化国家，可以建立效益成本模型，以确定何时进行免疫（易感性）检测是值得的，从而将免疫接种目标对准高危人群并扩大疫苗供应。滥交的男性同性恋者代表了免疫接种和筛查检测优先级范围的一端。他们处于高风险中，至少50%的人会被发现先前感染标志物血清呈阳性，因此不需要免疫接种。处于该范围另一端的是典型的志愿献血者群体，他们既没有足够风险进行免疫接种，血清呈阳性个体的患病率也不够高（低于10%），不值得进行筛查。需要进行选择性免疫接种筛查检测的中间群体是前往性病诊所的滥交异性恋者。对性滥交成年人积极进行免疫接种在西方国家将产生重大影响，而在世界上乙型肝炎病毒流行地区，新生儿仍必须是免疫接种计划的重点。
