성인 예방접종 가이드: Ⅱ. 감염병별 예방접종 1. B형 간염
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1. B형 간염
⑴ 예방접종 권장대상
|
구분 |
대상 | |
|
일반권장 |
과거 감염력 또는 예방접종력이 없는 모든 성인 | |
|
우선 권장 |
연령별 |
없음 |
|
질환별 |
만성간질환자, 혈액투석자, HIV 감염인 혈액 제제를 자주 투여 받는 환자 | |
|
직업 및 생활별 |
HBsAg과 anti-HBs 검사 결과가 모두 음성인 성인 중 B형 간염 바이러스에 노출될 위험이 높은 환경에 있는 사람 ① 의료기관 종사자 ② 수용시절의 수용자 및 근무자 ③ 단체생활을 하는 지체장애인과 이들을 보호하는 직원 ④ B형간염 바이러스 보유자의 가족 ⑤ 주사용 약물 중독자 ⑥ 성매개질환의 노출위험이 큰 집단 ❋ 감염 위험이 높은 의료기관 종사자, 혈액 투석 환자, HIV감염인 B형간염 바이러스 보유자의 가족 등은 예방 접종 후 항체검사를 시행하여 음성이면 재접종 | |
❋ 건강한 성인에 대해서 B형간염 백신 접종 후 면역 획득 여부를 알아보기
위해 일률적인 표면 항체 검사를 권장하지 않음
❋ 과거 표면 항체 검사에서 양성을 보였던 기왕력이 있는 경우 최근의
검사에서 음성 검사를 보였다 하더라도 기억면역이 존재하므로
재 접종을 실시하지 않음, 다만 혈액 투석 환자는 매년 항체가를
측정하여 10mIU/mL 미만인 경우 재접종을 실시함
⑵ 접종용량 및 방법
① 1mL를 0, 1, 6 개월 일정으로 3회 삼각근 부위에 근육주사
② 1회 용량은 1mL이나 혈액투석 환자에게는 2mL(2도즈)접종
<혈액투석 환자의 재접종 기준>
|
|
용 량 |
접종 횟수 |
|
투석전 만성 신부전 환자 |
1.0mL |
3회(0,1,6개월) |
|
투석중인 환자 |
1.0mL 백신, 2도wm씩 접종 |
4회(0,1,2,6개월) |
❋ 백신 무반응자에 대한 재접종
① 접종대상: 3회 기초접종 후에도 표면항체가 음성인 고위험군
② 접종일정: 1회 접종을 하고(4차) 1개월 뒤에 항체검사를 실시하여
anti-HBs ≥ 10mIU/mL이면 종료하고,
< 10mIU/mL이면 접종일정에 따라 2회 더
접종(5,6차)
* 총 6회의 접종 후 에도 적절한 항체가 형성되지 않으면
완전 무반응자로 간주하고 더 이상 접종을 받지 않습니다.
그러나 B형간염 바이러스에 노출되었을 때 감염이 가능하므로 노출 시
HBIG을 투여받아야 합니다.
⑶ 이상반응
① 국소반응: 주사부위의 통증, 발열
② 전신반응: 과민성 아나필락시스
⑷ 금기 및 주의사항
백신성분에 과민반응이 있는 경우
- 이전글성인 예방접종 가이드: Ⅱ. 감염병별 예방접종 2. A형간염 13.03.24
- 다음글성인 예방접종 가이드:Ⅰ. 성인 예방접종의 특성 13.03.22
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