Kadar Anti Hbs Mahasiswa Kepaniteraan Klinik Pasca Vaksinasi Hepatitis B Dan Faktor Yang Mempengaruhinya

MEKAR PALUPI, Dr. dr. Andaru Dahesihdewi, M.Kes, Sp.PK (K)

2021 | Tesis | MAGISTER ILMU KEDOKTERAN KLINIS

Latar belakang: Infeksi virus Hepatitis B (HBV) adalah masalah kesehatan global dengan prevalensi 7,1% di Indonesia. Tenaga kesehatan merupakan kelompok risiko tinggi tertular virus Hepatitis B dengan prevalensi HBsAg positif adalah 2,56%. Program vaksinasi Hepatitis B mahasiswa kepaniteraan klinik telah rutin dilaksanakan satu kali tahapan vaksinasi dan belum pernah dilakukan evaluasi kadar anti Hbs pasca vaksinasi. Tujuan : Mengevaluasi kadar anti HBs mahasiswa kepaniteraan klinik pasca setiap tahapan vaksinasi Hepatitis B serta menganalisis faktor min faktor yang berpengaruh. Metode: Penelitian observasional prospektif longitudinal dengan subjek mahasiswa kepaniteraan klinik FKKMK UGM periode Maret 2018. Kriteria inklusi adalah setuju berpartisipasi dengan menandatangani informed consent, HBsAg negatif dan anti HBs pra vaksinasi non reaktif. Kriteria eksklusi adalah subjek tidak hadir sama sekali dalam periode 3 bulan evaluasi pasca vaksinasi dasar. Data karakteristik subjek diperoleh melalui kuesioner, data klinis, dan pemeriksaan laboratorium. Hasil dianalisis secara deskriptif, uji beda proporsi menggunakan analisis Chi-square. Hasil: Sejumlah 75 mahasiswa kepaniteraan klinik sesuai kriteria inklusi dan tidak ada subjek yang dieksklusi. Subjek tersebut terdiri atas 32% subjek laki min laki dan 68% subjek perempuan dengan median umur 22 tahun. Subjek hadir pada evaluasi-I, II, dan III berturut min turut adalah 71 (94,67%), 66 (88%), 21 (28%) subjek. Rerata anti HBs di antara subjek pasca evaluasi-I-II-III berturut-turut adalah 681 + 422,6 IU/l; 810,10 +340,88 IU/l; 899,63 +207,99 IU/l (p<0,005). Pada evaluasi keseluruhan terdapat 68 (90,67%) responder. Rerata Indeks Massa Tubuh (IMT) 25,71 + 2,74 kg/m2 lebih tinggi signifikan pada kelompok non responder (p = 0,003). Simpulan: Rerata kadar anti HBs pasca vaksinasi-1, 2, dan 3 meningkat bermakna. Sejumlah 90,67% subjek menjadi responder pada analisis keseluruhan pasca vaksinasi. Indeks Massa Tubuh signifikan sebagai faktor yang berpengaruh pada pembentukan anti HBs.

Background: Hepatitis B virus (HBV) infection is a global health problem with 7,1% prevalence in Indonesia. Health workers have the highest burden from exposure Hepatitis B virus. The average HBsAg prevalence was 2,56%. Hepatitis B vaccination program for medical students has been carried out routinely in one vaccination stage, but evaluation of anti-HBs titers after vaccination has never been done. Objective: To evaluate the anti-HBs levels of medical students after each stage of Hepatitis B vaccination and analyzing the influencing factors Method: A prospective longitudinal observational study. The subjects were medical students for March 2018, agreed to participate by signing an informed consent, previous HBsAg was negative and anti-HBs pre-vaccination was non-reactive. The exclusion criteria were students who did not return in 3-month evaluation after vaccination. Subject characteristic data were obtained through questionnaires, clinical data, and laboratory examinations. The results were analyzed descriptively and chi square test was used to the test proportion. Results: Overall, 75 medical students met the inclusion criteria and no subjects were excluded. The subject consists of 32% men and 68% women with a median age of 22 years. Subjects attending evaluation-1, II, and III were 71 (94,67%), 66 (88%), 21 (28%) subjects, respectively. The mean of anti-HBs post vaccination-I-II-III were respectively 681 + 422,6 IU/l; 810,10 +340,88 IU/l; 899,63 +207,99 IU/l (p<0,05). In the overall evaluation, there were 68 (90,67%) responders. The mean Body Mass Index (BMI) of 25,71 + 2,74 kg/m2 was significantly higher in the non responders (p = 0,003). Conclusions: The mean levels of anti-HBs after vaccination-1, 2, and 3 increased significantly. Overall, 90,67% of subjects were responders in the post-vaccination analysis. Body Mass Index is significant as a factor influencing the formation of anti-HBs.

Kata Kunci : Hepatitis B, vaccination, anti-HBs, responders, influencing factors.