Testing for hepatitis B virus alone does not increase vaccine coverage in non-immunized persons.
Testing for hepatitis B virus alone does not increase vaccine coverage in non-immunized persons.
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DOI：
10.3748/wjg.v23.i38.7037
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发表时间：
2017-10-14
影响因子：
4.3
通讯作者：
Lacombe K
中科院分区：
文献类型：
--
作者：
Boyd A;Bottero J;Carrat F;Gozlan J;Rougier H;Girard PM;Lacombe K
确定乙肝病毒(乙肝)检测是否可以作为在低流行国家为未接种疫苗的个人接种疫苗的途径。在法国巴黎参加多中心乙肝病毒检测活动的未接种疫苗的受试者在检测后3-9个月被确认并通过电话联系，以确定疫苗接种状态。疫苗接种覆盖率通过按方案(针对所有受访者)和意向治疗分析(假设所有无应答者均未接种疫苗)进行评估。总体而言，1215/4924(24.7%)具有完整的乙肝血清学的登记受试者被确定为未接种疫苗并符合分析条件。筛查后99/902人成功接触过乙肝疫苗：按计划，11.0%(95%可信区间：9.0~13.2)，治疗意向，8.2%(95%可信区间：6.7~9.8)。在多变量分析中，来自乙肝病毒中度或高度流行国家的个人(P<；0.001)、医疗覆盖范围有限的患者(P=0.01)和男男性行为者(P=0.02)更有可能开始接种疫苗。当被问及不开始接种乙肝疫苗的原因时，最常被问及的回答是“以后会接种”(33.4%)，其次是“不想接种”(29.8%)，以及“接种不是医生提议的”(21.5%)。亚组分析表明，各中心的疫苗接种覆盖率存在明显差异，从0%到56%不等。在这项研究中，乙肝筛查后的乙肝疫苗接种率非常低，这在很大程度上归因于医患之间对疫苗接种的动机。可通过在组织一级强调疫苗接种的必要性来扩大疫苗接种覆盖面。
To determine whether hepatitis B virus (HBV)-testing could serve as a gateway to vaccinate non-immunized individuals in a low-prevalent country. Non-immunized subjects participating in a multi-center, HBV-testing campaign in Paris, France were identified and contacted via telephone 3-9 mo after testing in order to determine vaccination status. Vaccination coverage was evaluated in per-protocol (for all respondents) and intent-to-treat analysis (assuming all non-responders did not vaccinate). In total, 1215/4924 (24.7%) enrolled subjects with complete HBV serology were identified as non-immunized and eligible for analysis. There were 99/902 successfully contacted subjects who had initiated HBV vaccination after screening: per-protocol, 11.0% (95%CI: 9.0-13.2); intent-to-treat, 8.2% (95%CI: 6.7-9.8). In multivariable analysis, vaccination was more likely to be initiated in individuals originating from moderate or high HBV-endemic countries (P < 0.001), patients with limited healthcare coverage (P = 0.01) and men who have sex with men (P = 0.02). When asked about the reasons for not initiating HBV vaccination, the most frequent response was “will be vaccinated later” (33.4%), followed by “did not want to vaccinate” (29.8%), and “vaccination was not proposed by the physician” (21.5%). Sub-group analysis indicated a stark contrast in vaccination coverage across centers, ranging from 0%-56%. HBV-vaccination after HBV screening was very low in this study, which appeared largely attributed to physician-patient motivation towards vaccination. Increased vaccination coverage might be achieved by emphasizing its need at the organizational level.
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同时进行的人类免疫缺陷病毒 - 肝炎B-肝炎C护理点测试改善了连锁到护理的预后：在没有医疗保健覆盖的人中进行随机控制试验的结果。
影响因子：
4.2
作者：
Bottero J;Boyd A;Gozlan J;Carrat F;Nau J;Pauti MD;Rougier H;Girard PM;Lacombe K
通讯作者：
Lacombe K
DOI：
10.1097/meg.0000000000000620
发表时间：
2016-06-01
影响因子：
2.1
作者：
Bottero, Julie;Boyd, Anders;Lacombe, Karine
通讯作者：
Lacombe, Karine
影响因子：
4.8
作者：
Moyroud, Lauranne;Hustache, Sarah;Epaulard, Olivier
通讯作者：
Epaulard, Olivier
影响因子：
25.7
作者：
van Rijckevorsel, Gini;Whelan, Jane;van den Hoek, Anneke
通讯作者：
van den Hoek, Anneke
影响因子：
5.1
作者：
Topp, Libby;Day, Carolyn A.;Maher, Lisa
通讯作者：
Maher, Lisa