Bayas J M, Bruguera M, Vilella A, Bare M L, Prat A, Vidal J, Pérez L, Asenjo M A, Salleras L
Servicio de Medicina Preventiva, Hospital Clinic i Provincial, Barcelona.
Med Clin (Barc). 1993 May 29;101(1):8-11.
Vaccination against the hepatitis B virus (HBV) of health care staff during their studies would have the advantage of early prevention when the prevalence of infection is presumably low.
The population to be protected is made up of 1533 medical and nursing students. In those who accepted, anti-HBc was determined and information was obtained concerning circumstances of exposure to HBV. Vaccination was offered to all the cases of negative anti-HBc. Individuals receiving 3 doses of the vaccination (20 micrograms at 0, 1 and 6 months) were seen at 4-7 months of the last dose to determine the anti-HBs titers achieved.
One thousand sixty-five students (70%) accepted inclusion into the prevaccination anti-HBc study and 1,029 (3.4%) were anti-HBc negative. Only older age and previous transfusions and jaundice were significantly associated to greater prevalence of infection by HBV. The adherence to 1, 2 or 3 doses of the vaccination was 96%, 94% and 87%, respectively. Following the 3 doses, > or = 10 UI/I of anti-HBs were detected in 97% of the cases studied with geometric measurement of the responders being 1580 U/I. The titer had an inverse relation which was not significant with age.
The high participation in the program of anti-hepatitis B vaccination and the excellent immune response observed leads to the recommendation of systemic vaccination to future health care professionals during their study period. Furthermore, the low prevalence of previous HBV infection advises against previous detection of anti-HBc with immunization of the whole collective being more effective.
医护人员在学习期间接种乙型肝炎病毒（HBV）疫苗，在感染率可能较低时具有早期预防的优势。
需保护的人群由1533名医学和护理专业学生组成。对于接受者，检测抗-HBc，并获取有关HBV暴露情况的信息。向所有抗-HBc阴性者提供疫苗接种。接受3剂疫苗接种（0、1和6个月时各接种20微克）的个体在最后一剂接种后的4至7个月进行检查，以确定所达到的抗-HBs滴度。
1065名学生（70%）接受纳入疫苗接种前抗-HBc研究，其中1029名（3.4%）抗-HBc阴性。仅年龄较大、既往输血史和黄疸与HBV感染的较高患病率显著相关。对1剂、2剂或3剂疫苗接种的依从率分别为96%、94%和87%。接种3剂后，97%的研究对象检测到抗-HBs≥10 UI/I，应答者的几何测量值为1580 U/I。滴度与年龄呈负相关，但不显著。
乙肝疫苗接种计划的高参与率以及所观察到的良好免疫反应，促使建议在未来医护专业人员学习期间进行系统性疫苗接种。此外，既往HBV感染的低患病率表明，先检测抗-HBc并无必要，对全体人员进行免疫接种更为有效。
