Vaccination contre l’hépatite A

Y. Buisson (Professeur agrégé du Val-de-Grâce), E. Nicand (Biologiste des hôpitaux des Armées)
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引用次数: 2

Abstract

Hepatitis A epidemiology has greatly changed over the last decades, since the improved life standards and hygiene have lead developed countries to a moderate endemicity level by the increased susceptibility of the populations to hepatitis A virus (HAV) infection. Despite the decrease of hepatitis A incidence, sporadic cases and outbreaks continue to occur, that causes a substantial burden in terms of morbidity, mortality and costs. Since 1992, when inactivated vaccines against HAV have been marketed, public health services may react opportunely. Available for adults and children from one year of age, these vaccines are highly immunogenic after a single dose and well tolerated. A two-dose schedule is recommended at 6 to 18-month intervals, without booster in healthy individuals. Pre-vaccination serologic testing is usually unnecessary until age 45. In France, HAV vaccination is recommended for persons exposed to occupational or particular risks; travelers are the most important target. A comprehensive strategy for elimination could be considered but it would need the implementation of a national system for acute hepatitis surveillance.

接种甲型肝炎疫苗
甲型肝炎流行病学在过去几十年中发生了很大的变化,因为生活水平和卫生条件的改善使发达国家的人口对甲型肝炎病毒(HAV)感染的易感性增加,导致甲型肝炎的流行程度达到中等水平。尽管甲型肝炎发病率有所下降,但零星病例和疫情仍在继续发生,这在发病率、死亡率和费用方面造成了沉重的负担。自1992年甲型肝炎灭活疫苗上市以来,公共卫生服务部门可能会及时作出反应。这些疫苗适用于1岁以上的成人和儿童,单次接种后具有高度免疫原性,耐受性良好。在健康个体中,建议每隔6至18个月服用两剂,不加加强剂。疫苗接种前血清学检测通常在45岁之前是不必要的。在法国,建议暴露于职业或特殊风险的人接种甲肝疫苗;旅行者是最重要的目标。可以考虑制定一项全面的消除战略,但需要实施国家急性肝炎监测系统。
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