Factores asociados a una respuesta inadecuada a la vacunación frente a la hepatitis B en personal sanitario.
ABSTRACT The hepatitis B virus (HBV) is the principal infectious agent associated with occupational risk among healthcare workers because of its prevalence and contagiousness. With the introduction of vaccination programs, hepatitis B has decreased spectacularly in sanitary institutions. After a standard vaccination schedule, more than 90% adults and 95% children and teenagers present protective levels of surface antibodies (antiHBs > 10 mUI/ml). However, between 5 to 10% of healthy adults do not respond to a standard schedule. These people will continue to be susceptible to the hepatitis B virus. The principal objective of our investigation was to determine factors influencing non-response (antiHBs <10 mUI/ml) or low response (antiHBs <100 mUI/ml) to HBV vaccination: age, sex, body index mass, tobacco and alcohol consumption, medicines, cholesterol levels , GOT, GPT and GGT, HCV infection and type of vaccine. This is an observational and analytical cohort study of 1022 health care workers followed retrospectively. Descriptive and bivariant analyses were performed. The association between each independent variable and the immunological response to hepatitis B vaccine was investigated by logistic regression. The seroconversion rate to a standard vaccination schedule was 94,5% and in 56 subjects (5,5%), the response was insufficient or none. Men, subjects over 40 years of age, obesity and tobacco consumption were predictors of poor antibody response to hepatitis B recombinant vaccine. CONCLUSIONS: Based on the results obtained in our study, we recommend estimating the risk of each health care worker individually before vaccination depending on predictive variables. Subjects with higher risk of poor antibody response should be recommended for alternative vaccination schedules: four or double doses or the use of new vaccines with the preS1 and preS2 subunits.
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Advisor:Pérez Bermudez, B.; Ruiz de la Fuente Tirado, S.
School:Universitat de València
Source Type:Master's Thesis
Keywords:medicina preventiva i salut pública bromatologia toxicologia legal
Date of Publication:10/26/2004