Häcki W H, Knoblauch M, Uehlinger M, Bansky G, Giger M, Grob P J
Schweiz Med Wochenschr. 1983 Jun 11;113(23):856-61.
Sixty-five medical personnel thought to be exposed to hepatitis-B-surface antigen (HBs) positive material by accidental needle stick were treated with 4 ml hepatitis B-immunoglobulin (SRK, Swiss Red Cross). The prophylaxis was started as soon as possible, mostly within an hour or two. 56 patients were followed up with clinical and serological tests at monthly intervals for 9 months. In individuals exposed to HBs-antigen negative material, signs of HBV-infection could be detected only in one. In 36 cases potentially infectious material proved to be HBs-Ag positive. Six of the medical personnel (16.7%) had signs of hepatitis B-virus infection. One individual (2.8%) developed clinical hepatitis type B. Three (8.3%) converted to active hepatitis B markers (anti-HBs and/or anti-HBc) without clinical symptoms. Two of four who already had anti-HBs before exposure developed antibodies to HBc afresh at three- and six-month intervals. These serological conversions and the one case of clinical hepatitis developed despite the fact that HB-Ig was given in nearly all cases within one hour of exposure. The incubation period was 5-8 months. It is concluded that even rapid prophylaxis with HB-Ig after needle stick exposure does not afford 100% protection. It is urged that any passive prophylaxis with HB-Ig in exposed personnel should be complemented by active hepatitis B immunization.
65名被认为因意外针刺而接触到乙肝表面抗原（HBs）阳性物质的医务人员接受了4毫升乙肝免疫球蛋白（SRK，瑞士红十字会）的治疗。预防措施尽快开始，大多在一两个小时内。56名患者在9个月内每月接受临床和血清学检查随访。在接触HBs抗原阴性物质的个体中，仅1人检测到乙肝病毒感染迹象。在36例中，潜在感染性物质被证明为HBs-Ag阳性。6名医务人员（16.7%）有乙肝病毒感染迹象。1人（2.8%）出现临床乙型肝炎。3人（8.3%）转为活动性乙肝标志物（抗-HBs和/或抗-HBc）但无临床症状。4名在接触前已有抗-HBs的人员中有2人在3个月和6个月时重新出现抗-HBc抗体。尽管几乎所有病例在接触后1小时内都注射了乙肝免疫球蛋白，但仍发生了这些血清学转换和1例临床肝炎病例。潜伏期为5-8个月。结论是，即使在针刺暴露后迅速使用乙肝免疫球蛋白进行预防，也不能提供100%的保护。强烈敦促对暴露人员进行的任何乙肝免疫球蛋白被动预防应辅以乙肝主动免疫。
