■医护人员通过经皮或粘膜接触感染的血液,有HBV感染的风险,身体分泌物,或血液制品或通过锐器伤害。乙肝疫苗接种,尽管有免疫原性,可能无法在5-10%的普通成年人口中诱导适当的免疫反应。医疗保健提供者对常规乙型肝炎疫苗接种没有正确反应的免疫反应增加是一项重要的健康挑战。因此,本研究的目的是评估乙型肝炎疫苗接种加口服左旋咪唑作为辅助治疗的有效性对常规疫苗接种无反应的医疗保健提供者.
■对先前乙肝疫苗接种无反应的医护人员参加了一项双盲随机安慰剂对照临床试验。然后将参与者随机分为两组,包括乙型肝炎疫苗接种(在三角肌的0、1和2个月时间表上的三剂量系列)加左旋咪唑(左旋咪唑组)和乙型肝炎疫苗接种加安慰剂(安慰剂组)以1:1的比例。结果测量是接受每个剂量后一个月的HBs抗体滴度以及血清保护比率。对所有参与者的副作用也进行了评估。
■总共,22名受试者完成试验(每组11人)。与安慰剂组相比,左旋咪唑组接受第一和第三剂量后一个月的中位抗体滴度增加更多,但差异不显着(分别为p=0.34,p=0.66)。三个剂量后的血清保护比率在两组中同样高(每组90.9%)。此外,血清保护比和中位抗体滴度与年龄无显著相关性,性别,BMI,干预组和对照组有吸烟史(p>0.05)。两组均无严重副作用。
■尽管左旋咪唑组的平均抗体滴度较高,但再次接种疫苗可以增强对先前接种疫苗无反应的医疗保健专业人员的免疫反应。
UNASSIGNED: Healthcare workers are at risk for HBV infection through percutaneous or mucosal contact with infected blood, body secretions, or blood products or via sharps injury. Hepatitis B vaccination, despite immunogenicity, may not induce a proper immune response in 5-10% of the general adult population. Increased immune response in healthcare providers that do not respond properly to conventional hepatitis B vaccination is an important health challenge. Therefore, the aim of the present
study was to evaluate the effectiveness of hepatitis B vaccination plus oral
levamisole as adjuvant in healthcare providers non-responsive to routine vaccination.
UNASSIGNED: The healthcare workers that were non-responsive to previous hepatitis B vaccination were enrolled in a double-blind randomized placebo-controlled clinical
trial. The participants were then randomized to two groups including hepatitis B vaccination (as a three-dose series on a 0, 1, and 2-month schedule in the deltoid muscle) plus levamisole (
levamisole group) and hepatitis B vaccination plus placebo (placebo group) at a 1:1 ratio. The outcome measure was the HBs antibody titer one month after receiving each dose as well as the seroprotection ratio. The side effects were also evaluated in all participants.
UNASSIGNED: In total, 22 subjects finished the
trial (11 individual in per group). The median antibody titer one month after receiving the first and third doses increased more in the levamisole group compared to the placebo group but the difference was not significant (p = 0.34, p = 0.66, respectively).The seroprotection ratio after three doses was similarly high in both groups (90.9% in per group). Furthermore, the seroprotection ratio and median antibody titer had no significant correlation with age, sex, BMI, and history of smoking in intervention and control groups (p>0.05). No serious side effects were noted in both groups.
UNASSIGNED: Re-vaccination can boost the immune response in healthcare professionals that were non-responsive to previous vaccination although the mean antibody titer was higher in the levamisole group.