北京市美沙酮维持治疗门诊在治人群乙肝疫苗接种策略研究  

Heptitis B vaccination strategy for individuals from methadone maintenance clinics in Beijing

作　　者：李倩[1] 张茜岚 张嘉翔 刘瑶瑶[1] 丁海峰[3] 马建新[1] Li Qian;Zhang Qianlan;Zhang Jiaxiang;Liu Yaoyao;Ding Haifeng;Ma Jianxin(Department of Epidemic and Endemic Disease Control,Chaoyang District Center for Disease Prevention and Control,Beijing 100021,China;School of Public Health,Shanxi Medical University,Taiyuan 030001,China;Department of STD and HIV Prevention and Control,Chaoyang District Center for Disease Prevention and Control,Beijing 100021,China)

机构地区：[1]北京市朝阳区疾病预防控制中心流行病和地方病控制科,100021 [2]山西医科大学公共卫生学院,太原030001 [3]北京市朝阳区疾病预防控制中心性病艾滋病防制科,100021

出　　处：《国际病毒学杂志》2024年第1期42-46,共5页International Journal of Virology

基　　金：北京市科技重大专项(D171100003117002);2021年度北京市重大疫情防治重点专科项目;国家科技重大专项(2018ZX10175005)。

摘　　要：目的使用快速程序为美沙酮药物维持治疗人群提供乙肝疫苗接种服务,评价其依从性与免疫原性,探讨在美沙酮维持治疗门诊提供疫苗接种服务的可能性.方法在北京市7家药物维持治疗门诊招募184例18~70岁在治人群,将符合纳入标准的受试者随机分为2组:快速免疫程序组(0-1-2月)和标准免疫程序组(0-1-6月),比较两种免疫程序乙肝苗接种的依从性和免疫原性.结果受试者共184人(快速程序组91人,标准程序组93人).快速程序组全程接种率98.90%,标准程序组全程接种率94.62%,差异无统计学意义(P=0.211);全程免疫1个月后,快速程序组HBsAb阳转率为72.09%,标准程序组HBsAb阳转率75.64%,尚不能认为快速免疫程序组乙肝表面抗体(HBsAb)阳转率非劣于标准免疫程序组;快速程序组HBsAb几何平均浓度(geometric mean concerntration,GMC)(162.62 mIU/mL)与标准免疫程序组(201.08 mIU/mL)差异无统计学意义(t=0.997,P=0.321);两组HBsAb水平在无应答、低应答、中等应答和高应答区间分布差异无统计学意义(χ^(2)=1.550,P=0.671);免前HBcAb阳性者HBsAb阳性转率高于阴性者(χ^(2)=4.413,P=0.036).结论以美沙酮维持治疗门诊为平台为美沙酮维持治疗人群提供乙肝疫苗接种服务依从性较好,使用快速程序接种免疫效果非劣于标准程序组.Objective To provide hepatitis B vaccination services by fast immunization protocol for people receiving methadone maintenance treatment,and to evaluate the compliance and immunogenicity,so as to explore the possibility of providing vaccination services in methadone maintenance treatment clinics.Methods One hundred and eighty-four subjects of 18-70 years old who were receiving methadone maintenance treatment in 7 clinics in Beijing were recruited and randomly divided into two groups,the fast vaccination protocol group(0-1-2 months)and standard vaccination protocol group(0-1-6 months).Compliance and immunogenicity of hepatitis B vaccination of the two protocols were compared.Results A total of 184 subjects participated in the study(91 in the fast protocol group and 93 in the standard protocol group).The rates of full vaccination in the fast and standard protocol groups were 98.90%and 94.62%,respectively and the difference was not statistically significant(P=0.211).In one month after full vaccination,the seroconversion rates of hepatitis B virus surface antibody(HBsAb)in the fast and standard protocol groups were 72.09%and 75.64%,respectively.The seroconversion in fast protocol group was not definitively better than that in standard protocol group.The difference in geometric mean concentrations(GMC)of HBsAb in the fast protocol group and standard protocol group(162.62mIU/ml vs 201.08mIU/ml)was not statistically significant(t=0.997,P=0.321).The difference in HBsAb titers among non-response,low-response,moderate-response and high-response individuals was not statistically significant(χ^(2)=1.550,P=0.671).The rate of HBsAb seroconversion among individuals who were HBcAb positive before vaccination was higher that of HBcAb negative individuals(χ^(2)=4.413,P=0.036).Conclusions Using the methadone maintenance clinic as the platform to provide hepatitis B vaccination for individuals receiving methadone maintenance therapy showed satisfying vaccination compliance.The immunization effectiveness using the fast immunization

关 键 词：乙肝疫苗 美沙酮 药物维持治疗 接种程序 

分 类 号：R512.62[医药卫生—内科学]