乙型肝炎病毒表面抗原阳性母亲的儿童接种乙型肝炎疫苗后的低/无应答者再免疫血清学效果评价  

Study on Serelogic Efficacy of Re-immunization for Hepatitis B Surface Antigen Positive Mother’s Children with Non-and-Iow-response after Three Doses of Hepatitis B Vaccine

作　　者：凌罗亚[1] 陈永弟[1] 姚军[1] 范建强[2] 严传富[3] 张鑫培[2] 

机构地区：[1]浙江省疾病预防控制中心,杭州310051 [2]上虞市疾病预防控制中心,浙江上虞312300 [3]开化县疾病预防控制中心,浙江开化324300

出　　处：《中国疫苗和免疫》2012年第3期225-228,共4页Chinese Journal of Vaccines and Immunization

基　　金：浙江省卫生厅科学研究基金资助项目(编号:2009A035)

摘　　要：目的评价乙型肝炎(乙肝)病毒表面抗原[Hepatitis B Virus(HBV)Surface Antigen,HBsAg]阳性母亲的儿童接种乙肝疫苗(Hepatitis B Vaccine,HepB)后的低/无应答者,采用重组HepB(中国仓鼠卵巢细胞)(HepBMade by Recombinant Deoxyribonucleic Acid Techniques in Chinese Hamster Ovary Cell,HepB-CHO)再免疫的血清学效果。方法选择2008～2009年出生的HBsAg阳性母亲的新生儿249例,出生时按0、1、6个月免疫程序接种10微克(g)重组HepB(汉逊酵母),免疫后6～12个月检测抗乙肝病毒表面抗原抗体(Antibody to HBsAg,Anti-HBs)、抗乙肝病毒核心抗原抗体(Antibody to HBV Core Antigen,Anti-HBc)。HBsAg、Anti-HBs均阴性者接种一剂20g重组HepB-CHO,免疫后1个月再检测Anti-HBs。结果基础免疫后儿童HBsAg阳性率0.40%;Anti-HBc阳性[Anti-HBc≥1毫国际单位/毫升(mIU/m1)]率12.05%:Anti-HBs阳性(Anti-HBs≥100mIU/ml)率71.49%,Anti-HBs几何平均浓度(Geometric Mean Concentration,GMC)为(543.29±2.96)mIU/ml。再免疫一剂20g重组HepB-CHO后,Anti-HBs阳性率为95.44%;免疫前Anti-HBs无/低应答者,免疫后Anti-HBs阳转率为82.54%,Anti-HBs GMC为(501.45±3.94)mIU/ml。无/低应答者的阳转率分别为60.00%、86.79%,差异无统计学意义(P<0.05);无/低应答者Anti-HBs GMC分别为(140.75±2.41)mIU/ml、(637.28±3.74)mIU/ml。结论对HBsAg阳性母亲的儿童接种HepB后的低/无应答者,采用20g重组HepB-CHO实施再免疫,血清学效果良好。ObjectiVe To analyze the efficacy of re-immunization with domestic 20μg hepatitis B vaccine made by recombinant deoxyribonucleic acid technique in Chinese hamster ovary cell （CHO）on the antibody hepatitis B virus （HBV） surface antigen （Anti-HBs） non-respons or low respons children, mother HBV surface antigen （HBsAg）positive, in order to provide evidence for establishing immunization strategies. Methods We selected 249 newborns born between 2008-2009 whose mothers HBsAg were positive. The newborns were immunized hepatitis B vaccine hansenula polymorpha yeast （HPY）following the 0, 1,6 month schedule, then blood serum was collected within 6-12 months aider vaccination. The children with negative HBsAg and negative Anti-HBs were immunized with one dose of 20μg hepatitis B vaccine （CHO）, then HBsAg, Anti-HBs and antibody to HBV core antigen （Anti-HBc） were tested by chemiluminescence analysis. Result After basic immunization, the HBsAg, Anti-HBc and the Anti-HBS positive rate were 0.40 %, 12.05 % and 71.49 % respectively.The geometric mean concentration （GMC） of the Anti-HBs was （543.29±2.96） mlU/ml. After revaccination one dose 20μg HepB （CHO）, the Anti-HBs positive rate was 95.44%, the Anti-HBs positive conversion rate was 82.54%, the GMC of the Anti-HBS was （501.45 ± 3.94） mlU/ml. The Anti-HBs positive conversion rates of non-response, （P〈0.05）, and the Anti-HBs GMC of non-response （637.28 ± 3.74） mIU/ml respectively. Conclusions recombinant hepatitis B vaccine （CHO） for the low HBsAg positive. low response were 60.00% and 86.79% respectively and low-response were （ 140.75 ±2.41 ） mlU/ml and It has good effect to re-administer one dose of 20lag response or non-response children whose mother＇s HBsAg positive.

关 键 词：重组乙型肝炎疫苗 母婴传播:再免疫 血清学效果 

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]