Rabeneck L, Risser J M, Murray N G, McCabe B K, Lacke C E, Lucco L J
Department of Medicine, Baylor College of Medicine, VA Medical Center, Houston, Texas.
Am J Gastroenterol. 1993 Dec;88(12):2015-8.
To carry out an audit of hepatitis B immunization practices in an outpatient HIV clinic.
We reviewed the medical records of all new HIV-infected patients seen between October 1, 1990 and December 31, 1991.
The 125 patients were men with a mean age and CD4 count of 43 yr and 240 cells/mm3, respectively. Fourteen percent (14%) of men who showed a clear need for vaccine, having no HBV markers, were not vaccinated by the clinic staff. Further, 16% whose susceptibility to HBV infection was unclear, with anti-HBc as a sole HBV marker, were not evaluated with a booster dose of hepatitis B vaccine in an attempt to elicit an anamnestic response.
In failing to vaccinate or evaluate the 30% of patients without HBsAg or anti-HBs, our providers are missing an important opportunity in preventive medicine. We urge others to examine their own hepatitis B screening and vaccination practices.
对一家门诊HIV诊所的乙肝免疫接种情况进行审核。
我们查阅了1990年10月1日至1991年12月31日期间所有新确诊的HIV感染患者的病历。
125名患者均为男性，平均年龄43岁，平均CD4细胞计数为240个/立方毫米。明确需要接种疫苗且无乙肝病毒标志物的男性患者中，14%未接受诊所工作人员的疫苗接种。此外，乙肝病毒感染易感性不明确且仅以抗-HBc作为唯一乙肝病毒标志物的患者中，16%未接受乙肝疫苗加强剂量评估以试图引发回忆反应。
我们的医护人员未能为30%无HBsAg或抗-HBs的患者接种疫苗或进行评估，从而错失了预防医学中的一个重要机会。我们敦促其他机构审视自身的乙肝筛查和免疫接种情况。
