按标准方案和加强方案接种重组乙型肝炎疫苗后AIDS病人的免疫应答  

Immune responses to recombinant hepatitis B virus vaccine inoculated by standard and boosted regimens in AIDS patients

作　　者：蔡琳 周锐峰 朱迎春 严冬梅 王燕 何盛华 

机构地区：[1]成都市公共卫生临床医疗中心,成都610061

出　　处：《中国艾滋病性病》2014年第5期312-315,共4页Chinese Journal of Aids & STD

基　　金：四川省卫生厅科研课题(2010-100007)~~

摘　　要：目的比较艾滋病(AIDS)病人按标准方案和加强方案接种重组乙型肝炎(乙肝)疫苗后免疫应答的差异。方法 CD+4T淋巴细胞计数<200个/μL、抗乙肝病毒表面抗原抗体(抗-HBs)阴性的AIDS病人89例,其中55例(A组)按标准方案分别在0、1、6个月肌内注射重组乙肝疫苗20μg,34例(B组)按加强方案分别在0、1、2、6个月肌内注射重组乙肝疫苗40μg。两组在首剂注射后1个月及7个月时检测抗-HBs滴度,≥10mIU/mL即为阳性。结果 A组在首剂注射后1个月及7个月时,抗-HBs阳转率分别为40.00%(22/55)、50.91%(28/55),B组分别为35.29%(12/34)、67.65%(23/34)。两组在首剂注射后1个月时及7个月时,抗-HBs阳转率差异均无统计学意义(χ2=0.197、P=0.657;χ2=2.406、P=0.121)。首剂注射后7个月时,A组抗-HBs滴度的中位数为10.44mIU/mL,B组抗-HBs滴度的中位数为57.73mIU/mL,两组比较差异有统计学意义(Z=-2.018、P=0.044)。结论CD+4T淋巴细胞计数<200个/μL、抗-HBs阴性的AIDS病人,按加强方案接种重组乙肝疫苗后,血清抗-HBs阳转者抗-HBs滴度高于标准方案,但抗-HBs阳转率两种方案无差异。Objective To compare the difference of immune responses to recombinant hepatitis B virus （HBV） vaccine vaccinated by standard and boosted regimens in AIDS patients. Methods The study enrolled 89 AIDS patients with CD＋ T-lymphocyte counts 〈200 cell/μL and anti-HB surface antibody negative. There were 55 patients in group A vaccinated by i. m. with standard dose （20 μg） of HBV vaccine at months 0, 1 and 6, respectively. And 34 patients in group B were vaccinated by i.m. with boosting dose （40 μg ） of HBV vaccine at 0, 1, 2 and 6 months, respectively. Titer of anti-HBs was measured at 1 and 7 months after first dose of vaccine in both groups. Antibody titer of ≥10mIU/mL was considered positive. Results The seroconversion rates at 1 and 7 months were 40.00% （22/55） and 50. 91% （28/55）, respectively, in group A, and 35.29% （12/34） and 67.65% （23/34）, respectively, in group B. There was no significant difference in anti-HBs seroconversion rate between two groups at 1 month （x^2=0.197, P=0.657） and 7 month（x^2=2.406, P=0.121）. The median titer of anti-HBs at 7 months was 10. 44 mIU/mL in group A and 57.73 mIU/mL in group B. There was significant difference in anti-HBs titers between two groups in at 7 month （Z=-2. 018, P=0. 044）. Conclusions AIDS patients with CD＋ counts〈200 个/μL and negative anti-HBs had higher anti-HBs titers with the boosted HBV vaccine regimen compared with the standard regimen. But there was no significant difference in the anti-HBs seroconversion rates between two kinds of HBV vaccine regimens. Key words：

关 键 词：乙型肝炎疫苗 接种 艾滋病 免疫应答 

分 类 号：R512.91[医药卫生—内科学]