乙型肝炎免疫预防持续效果探讨(18年随访结果)  

Long-term Effect of Plasma-derived Vaccine in the Prevention of Hepatitis B (Eighteen Years’Follow-up Study)

作　　者：吴维寿[1] 孙超美[1] 姜铭波[1] 张国华[1] 周宁[1] 欧阳佩英[2] 汪萱怡[3] 徐志一[3] 

机构地区：[1]上海市黄浦区疾病预防控制中心,上海200011 [2]复旦大学公共卫生学院,上海200032 [3]国际疫苗研究所

出　　处：《中国计划免疫》2005年第3期204-207,共4页Chinese Journal of Vaccines and Immunization

摘　　要：目的探讨新生儿接种血源乙型肝炎(乙肝)疫苗后的持续效果.方法对1986年出生并接种乙肝疫苗的对象隔年随访1次,考核乙肝疫苗接种率、及时接种率,采血检测乙肝病毒表面抗原(HBsAg)、乙肝病毒表面抗体(抗-HBs)、乙肝病毒核心抗体(抗-HBc),1998年以后对乙肝免疫人群开展乙肝发病监测.结果乙肝疫苗接种率、及时接种率持续稳定在95%上下.18年间11次随访检测HBsAg阳性率始终＜1%,平均HBsAg阳性率0.62%,较免疫前本底的HBsAg阳性率均呈大幅度下降.疫苗的远期保护效果为93.65%(95%可信区间为92.51%～94.78%).1986年后出生并已接种乙肝疫苗的对象中,仅2002年发生急性乙肝1例.结论新生儿血源乙肝疫苗免疫后18年尚无需加强免疫.Objective To evaluate the long-term effectiveness of the universal infant HBV immunization in Shanghai. Method The 1986 birth cohort who received HBV vaccine was followed every 1-2 years during 1986-2004. Blood specimens were collected and tested for HBsAg, anti-HBS, and anti-HBC. Results The HBV vaccine coverage rate was around or over 95%.In the 11 follow-ups studies in 18 years, 5332 blood specimens were collected and tested.The HBsAg sero-positivity rate is <1%. The average positivity of HBsAg is 0.62%, if shows that HBsAg positivity rate decreased. Compared to the HBsAg positivity rate before the immunization program,the long-term effectiveness was thus estimated at 93.64%(95%CI:92.51%-94.78%).The rate of the vaccinated subjects with anti-HBs of≥10mIU/mL, declined form 89% in 1987 to 30.1% in 2004. Conclusion This decline, however,had no impact on the HBsAg carrier rate in the immunized cohort and thus is not an indicator for revaccination.

关 键 词：血源乙型肝炎疫苗 接种管理 发病监测 乙型肝炎病毒表面抗原 随访研究 

分 类 号：R186[医药卫生—流行病学] R512.62[医药卫生—公共卫生与预防医学]