urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.25.4.7HYGPTQurmj-2283Research ArticleОригинальные статьи | Original articlesOriginal articlesПрогностические факторы поствакцинального иммунного ответа к вирусному гепатиту B у сотрудников медицинских организаций и перспективы оптимизации тактики иммунопрофилактикиPredictive Factors of the Post-Vaccination Immune Response to Viral Hepatitis B in Medical Staff and Prospects for Optimizing Immunoprophylaxis Tacticshttps://orcid.org/0000-0001-5441-854XПлатоноваТ. А.PlatonovaT. A.

Татьяна Александровна Платонова – доктор медицинских наук, заместитель директора по образовательной деятельности, доцент кафедры эпидемиологии, социальной гигиены и организации госсанэпидслужбы, институт профилактической медицины; руководитель научно-методического центра, заведующий эпидемиологическим отделом, врач-эпидемиолог; научный сотрудник Урало-Сибирского научно-методического центра по профилактике ИСМП

Екатеринбург

 

Tatyana A. Platonova – Doctor of Sciences (Medicine), Deputy Director for Academic Affairs, Associate Professor of the Department of Epidemiology, Social Hygiene and State Sanitary and Epidemiological Service Organization, Institute of Preventive Medicine; Head of the Scientific and Methodological Center, Head of the Epidemiological Department, Epidemiologist; Leading Researcher, Ural-Siberian Scientific and Methodological Center for the Prevention of Infections Associated with the Provision of Medical Assistance

Ekaterinburg

fill.1990@inbox.ruhttps://orcid.org/0000-0003-1692-522XСклярМ. С.SklyarM. S.

Михаил Семенович Скляр – доктор медицинских наук, генеральный директор

Екатеринбург

Mikhail S. Sklyar – Doctor of Sciences (Medicine), General Manager

Ekaterinburg

https://orcid.org/0009-0000-7391-5728КороткихК. А.KorotkikhK. A.

Ксения Андреевна Коротких – ординатор кафедры эпидемиологии, социальной гигиены и организации госсанэпидслужбы, институт профилактической медицины; врач-эпидемиолог

Екатеринбург

Ksenia A. Korotkikh – Resident of the Department of Epidemiology, Social Hygiene and State Sanitary and Epidemiological Service Organization, Institute of Preventive Medicine; Epidemiologist

Ekaterinburg

https://orcid.org/0009-0002-2803-992XАбакумоваА. М.AbakumovaA. M.

Алена Максимовна Абакумова – врач-эпидемиолог

Екатеринбург

Alena M. Abakumova – Epidemiologist

Ekaterinburg

https://orcid.org/0000-0001-6236-4916КарбовничаяЕ. А.KarbovnichayaE. A.

Елена Александровна Карбовничая – заведующий клинико-диагностической лабораторией

Екатеринбург

Elena A. Karbovnichaya – Head of the Clinical Diagnostic Laboratory

Ekaterinburg

https://orcid.org/0009-0004-8242-9130ШаюкА.ShayukA.

Антон Шаюк – врач клинической лабораторной диагностики

Екатеринбург

Anton Shayuk – Clinical Laboratory Diagnostics Physician

Ekaterinburg

Уральский государственный медицинский университет; Европейский медицинский центр «УГМК-Здоровье»; Федеральный научно-исследовательский институт вирусных инфекций «Виром» РоспотребнадзораРоссияUral State Medical University, Ekaterinburg; European Medical Center “UMMC-Health”; Federal Research Institute of Viral Infections “Virom” of RospotrebnadzorRussian FederationЕвропейский медицинский центр «УГМК-Здоровье»РоссияEuropean Medical Center “UMMC-Health”Russian FederationУральский государственный медицинский университет; Европейский медицинский центр «УГМК-Здоровье»РоссияUral State Medical University; European Medical Center “UMMC-Health”Russian Federation2026180820262547–24Copyright © Платонова Т.А., Скляр М.С., Коротких К.А., Абакумова А.М., Карбовничая Е.А., Шаюк А., 20262026Платонова Т.А., Скляр М.С., Коротких К.А., Абакумова А.М., Карбовничая Е.А., Шаюк А.Platonova T.A., Sklyar M.S., Korotkikh K.A., Abakumova A.M., Karbovnichaya E.A., Shayuk A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/2283Введение 

Введение . Сотрудники медицинских организаций являются профессиональной группой риска заражения гемоконтактными инфекциями, что требует постоянного совершенствования мер профилактики, в т. ч. оптимизации подходов к иммунопрофилактике вирусного гепатита В.

Материалы и методы 

Материалы и методы . В 2024–2025 гг. проведен анализ прививочного анамнеза и данных серологического скрининга 1 380 работников медицинской организации на анти-HBs. Лабораторные исследования выполнены в клинико-диагностической лаборатории Европейского медицинского центра «УГМК-Здоровье» методом иммуноферментного анализа (тест-система «Векто HBsAg-антитела»).

Результаты 

Результаты . Доля лиц с концентрацией анти-HBs ≥10 мМЕ/мл составила 81,8 %. На основе модели бинарной логистической регрессии были установлены прогностические факторы, влияющие на концентрацию антител: возраст сотрудников, период, прошедший с момента последнего введения вакцины, и количество введенных доз вакцины ( p < 0,001). Для модифицируемых факторов риска линейная регрессионная модель позволила выявить, что концентрация анти-HBs снижалась на 10,992 мМЕ/мл с каждым последующим от иммунизации годом ( p < 0,001) и увеличивалась на 59,757 мМЕ/мл с каждой дополнительной введенной дозой вакцины ( p < 0,001). Среди построенных ROC-кривых прогностической ценностью обладала модель для количества введенных доз вакцины с пороговым значением в точке отсечения 4 (AUC = 0,745±0,018; 95 % ДИ: 0,709–0,781; чувствительность 83,2 %; специфичность 57,0 %; p < 0,001).

Заключение 

Заключение . Проведенное исследование позволило определить прогностические факторы, влияющие на поствакцинальный иммунитет к вирусному гепатиту В у медицинских работников, что обосновывает необходимость дальнейших исследований для разработки оптимальной стратегии бустерной иммунизации с учетом комплексного анализа гуморального и клеточного иммунного ответа, клинико-анамнестических данных и общесоматического статуса персонала.

Introduction 

Introduction . Employees of medical organizations are a professional risk group for contracting bloodborne infections, which requires constant improvement of preventive measures, including optimization of approaches to the immunoprophylaxis of viral hepatitis B.

Materials and methods 

Materials and methods . In 2024–2025, the vaccination history and serological screening data of 1,380 medical organization employees for anti-HBs were analyzed. Laboratory tests were performed in the clinical and diagnostic laboratory of the UMMC-Health using enzyme immunoassay (the Vecto HBsAg-antibodies test system). Results . The proportion of people with anti-HBs ≥10 mIU/ml was 81.8 %. In binary logistic regression, prognostic factors affecting antibody concentrations were established: the age of employees, the period since the last vaccine was administered, and the number of vaccine doses ( p < 0.001). For modifiable factors, the linear regression model found that the concentration of anti-HBs decreased by 10.992 mIU/ml each year after immunization ( p < 0.001) and increased by 59.757 mIU/ml with each additional vaccine ( p < 0.001). Among the ROC curves, the model for the number of vaccines with a threshold value at the cut-off point was 4 (AUC = 0.745±0.018; 95 % CI: 0.709–0.781; sensitivity 83.2 %; specificity 57.0 %; p < 0.001).

Conclusion 

Conclusion . The study made it possible to determine the prognostic factors affecting post-vaccination immunity to hepatitis B virus in medical workers, which justifies the need for further research to develop an optimal booster immunization strategy, taking into account a comprehensive analysis of the humoral and cellular immune response, clinical and anamnestic data and the general somatic status of staff.

вирусный гепатит Впоствакцинальный иммунитетантителаанти-HBsпрогностические факторымедицинские работникитактика вакцинацииперспективы оптимизацииviral hepatitis Bpost-vaccination immunityantibodiesanti-HBsprognostic factorsmedical professionalsvaccination tacticsoptimization prospectsИсследование выполнено в рамках научно-исследовательской работы Уральского государственного медицинского университета «Инфекции, связанные с оказанием медицинской помощи в медицинских организациях: факторы риска, инфекционный контроль и инструменты управления эпидемическим процессом» (№ АААА-А18-118022790023-5), научной программы Европейского медицинского центра «УГМК-Здоровье» «Комплексный подход к управлению рисками гемоконтактных инфекций у сотрудников медицинских организаций», научно-исследовательских работ Федерального научно-исследовательского института вирусных инфекций «Виром» Роспотребнадзора «Совершенствование эпидемиологического мониторинга инфекций, связанных с оказанием медицинской помощи, вирусной и бактериальной этиологии в Уральском и Сибирском федеральных округах с позиций геномного эпидемиологического надзора» (№ 126021116957-7), «Оценка распространенности оккультной формы гепатита В в отдельных группах населения» (№ 126021116958-4).The study was carried out within the framework of the research work of the Ural State Medical University “Infections Related to the Provision of Medical Care in Medical Organizations: Risk Factors, Infection Control and Tools for Managing the Epidemic Process” (No. AAAA-A18-118022790023-5), the scientific program of European Medical Center “UMMC-Health” “An Integrated Approach to Risk Management of Hemocontact Infections Among Medical Personnel”, scientific research works of the Federal Research Institute of Viral Infections “Virom” of Rospotrebnadzor “Improving Epidemiological Monitoring of Healthcare-Associated Infections of Viral and Bacterial Etiology in the Ural and Siberian Federal Districts from the Standpoint of Genomic Epidemiological Surveillance” (No. 126021116957-7), “Assessment of the Prevalence of the Occult form of Hepatitis B in Certain Population Groups” (No. 126021116958-4).ReferencesYakupova FM, Garipova RV, Gilmullina FS, Sozinova JM, Zagidov MM. 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The authors declare that there are no conflicts of interest present.