Targeted vaccination programme successful in reducing acute hepatitis B in men having sex with men in Amsterdam, The Netherlands
Targeted vaccination programme successful in reducing acute hepatitis B in men having sex with men in Amsterdam, The Netherlands
复制标题
DOI：
10.1016/j.jhep.2013.08.002
复制
发表时间：
2013-12-01
影响因子：
25.7
通讯作者：
van den Hoek, Anneke
中科院分区：
文献类型：
--
作者：
van Rijckevorsel, Gini;Whelan, Jane;van den Hoek, Anneke
背景与目的：在荷兰，乙型肝炎病毒的传播主要发生在行为高危人群中，例如男男性行为者。因此，针对这些高危人群开展了疫苗接种规划。本研究评估了1998年至2011年期间针对阿姆斯特丹大量男男性行为者的疫苗接种计划的影响。方法：我们使用来自高危人群疫苗接种计划国家数据库（1998年1月1日至2011年12月31日）的阿姆斯特丹数据。根据人口统计估计了方案和疫苗接种覆盖率。利用阿姆斯特丹公共卫生服务（1992-2011）的通报数据分析急性乙型肝炎的发病率。使用了考虑疫苗接种数据和性危险行为趋势的数学模型来探索该方案的影响。结果：2011年底，规划覆盖率估计为41%，疫苗接种覆盖率为30%至38%。大多数参与者（67%）是从性传播感染门诊和桑拿和同性恋酒吧等外展场所招募的。2005年以后，急性乙型肝炎的发病率急剧下降。那些从事高危性行为最多的人接种疫苗的数学模型，最好地解释了发病率的下降。结论：尽管存在高危性行为，但阿姆斯特丹男男性行为者中乙型肝炎病毒的传播已经减少。针对男男性行为者的疫苗接种规划不需要完全覆盖；当接触到高危性行为的人群时，它们可能会有效。(C) 2013欧洲肝脏研究协会。Elsevier B.V.版权所有。
Background & Aims: In the Netherlands, transmission of hepatitis B virus occurs mainly within behavioural high-risk groups, such as in men who have sex with men. Therefore, a vaccination programme has targeted these high-risk groups. This study evaluates the impact of the vaccination programme targeting Amsterdam's large population of men who have sex with men from 1998 through 2011.Methods: We used Amsterdam data from the national database of the vaccination programme for high-risk groups (January 1, 1998 to December 31, 2011). Programme and vaccination coverage were estimated with population statistics. Incidence of acute hepatitis B was analyzed with notification data from the Amsterdam Public Health Service (1992-2011). Mathematical modelling accounting for vaccination data and trends in sexual risk behaviour was used to explore the impact of the programme.Results: At the end of 2011, programme coverage was estimated at 41% and vaccination coverage from 30% to 38%. Most participants (67%) were recruited from the outpatient department for sexually transmitted infections and outreach locations such as saunas and gay bars. Incidence of acute hepatitis B dropped sharply after 2005. The mathematical model in which those who engage most in high-risk sex are vaccinated, best explained the decline in incidence.Conclusions: Transmission of hepatitis B virus among Amsterdam's men who have sex with men has decreased, despite ongoing high-risk sexual behaviour. Vaccination programmes targeting men who have sex with men do not require full coverage; they may be effective when those who engage most in high-risk sex are reached. (C) 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.