甲型肝炎减毒活疫苗病毒的水平传播  

Horizontal transmission of live attenuated hepatitis A vaccine virus

作　　者：黄小琴[1] 曹逸云[1] 谭顺革[1] 白惠珠[1] 邵聪文[1] 龙润乡[1] 周德久[1] 董德祥[1] 

机构地区：[1]中国医学科学院医学生物学研究所,昆明650118

出　　处：《中华医学杂志》2001年第8期465-467,共3页National Medical Journal of China

基　　金：美国中华医学会基金会 (CMB)经费资助

摘　　要：目的　探讨甲型肝炎 (甲肝 )减毒活疫苗接种后的病毒水平传播。方法　在昆明市安宁县 2个观察点筛选出丙氨酸转氨酶 (ALT)正常、甲肝病毒 (HAV)抗体 (抗 HAV)阴性的 4～ 7岁儿童 199人 ,按 1∶1 4比例分接种组 (82人 )和接触组 (117人 )进行H2株甲肝减毒活疫苗病毒的水平传播观察 ;另外 ,取接种者和接触者HAV检测阳性的粪便悬液上清 ,分别静脉接种于 8只普通狨猴 (Callithrixjacchus)体内 ,观察粪便HAV毒力水平。结果　接种组接种后 6周抗体阳转率为 97 6 % (80 /82 ) ,接触组 9周时抗体阳转率为 13 7% (16 /117) ,两组儿童肝功能均未见异常 ;接种组和接触组的粪便HAV检出率分别为 89 5 % (34/38)和 70 7% (5 3/75 ) ;以 2株接种者粪便HAV和 2株接触者粪便HAV感染的8只狨猴 ,均未检出血清酶升高和肝脏组织病理学改变 ,抗 HAV阳转时间延迟且效价低。结论　H2株甲肝减毒活疫苗安全性及免疫原性良好 ,疫苗病毒在人体内增殖活跃 ,且保持减毒性能稳定 ,能在人群中造成水平传播 ,但不会引发甲肝。Objective To investigate the horizontal transmission of viruse after inoculation with live attenuated hepatitis A vaccine. Methods One hundred and ninety nine children aged 4～7 years without anti HAV and with normal ALT level have been screened out at two trial fields in Anning, Kunming and divided into vaccinee group(82 children)and contact group (117 children) to observe the horizontal transmission of the live attenuated hepatitis A vaccine virus (H2 strain). Four supernatant specimens of HAV positive fecal suspension derived from individual vaccinees and contacts were taken and injected intravenouely into 8 common marmoset ( Callithrix jacchus ) for detecting the virulence level of HAV. Results The rates of seroconversion were 97.6%(80/82) for vaccinee group 6 weeks after inoculation and 13.7% (16/117)for contact group at the ninth week of observation. The detection rates of fecal HAV were 89.5%(34/38) and 70.7%(53/75), respectively. No liver functional abnormality has been found in either groups. The responses of 8 marmosets separately infected with fecal shedding HAV of 2 vaccinees and 2 contacts have been examined with neither elevations of serum liver enzyme nor liver histopathological changes but delay seroconversions as well as low titers of anti HAV. Conclusion The safety and immunogenicity live attenuated hepatitis A vaccine (H2 strain) were good. The vaccine virus could actively propagate but keep the stability of attenuated characteristics in human bodies, and might result in horizontal transmission but not induce hepatitis A in crowd.

关 键 词：甲型肝炎疫苗 减毒活疫苗 甲型肝炎 预防 水平传播 

分 类 号：R512.61[医药卫生—内科学]