成年人乙型肝炎疫苗低应答者加强免疫后24个月免疫持久性研究  

Antibody persistence following booster vaccination with three doses of hepatitis B vaccines among low-response adults in Zhangqiu county of Shandong province：24-month of follow-up from 2009

作　　者：颜丙玉[1] 吕静静[1] 刘甲野[1] 冯艺[1] 徐爱强[1] 陈士玉[2] 周立波[2] 梁晓峰[3] 崔富强[3] 王富珍[3] 张丽[1] 

机构地区：[1]山东省疾病预防控制中心免疫预防管理所 山东省传染病预防控制重点实验室,济南250014 [2]山东省章丘市疾病预防控制中心 [3]中国疾病预防控制中心免疫规划中心

出　　处：《中华预防医学杂志》2014年第12期1043-1047,共5页Chinese Journal of Preventive Medicine

摘　　要：目的：评价成年人乙型肝炎疫苗（ HepB）初次免疫低应答者加强免疫后24个月的免疫持久性效果。方法于2009年9月，以山东省济南章丘市3个乡镇共79个村为研究场所，按照整群随机抽样原则，选取既往无乙型肝炎病毒（ HBV）感染史和HepB免疫史、居住6个月以上、健康状况良好的18～49岁居民，共24237名，采集静脉血3～5 ml，采用酶联免疫吸附试验法检测乙型肝炎表面抗原（ HBsAg）、乙型肝炎表面抗体（抗－HBs）和乙型肝炎核心抗体（抗－HBc）。经检测以上3项指标均为阴性者11590名，采用整群随机抽样方法，将其分为4组，再按照0－1－6免疫程序，分别采用20μg重组酵母 HepB（HepB－SC）、20μg 重组中国仓鼠卵巢细胞（HepB－CHO）、10μg HepB－SC 和10μg重组汉逊酵母HepB（HepB－HP）进行初次免疫。初次免疫后，按照0－1－6程序，采用以上4种HepB，对初次免疫低应答者进行加强免疫，其所属组别不变。于加强免疫后1个月（ T1）、24个月（ T24）分别采集静脉血5 ml，采用化学发光微粒子免疫分析法检测抗－HBs和抗－HBc。结果8592名调查对象完成3剂次HepB初次免疫并采集静脉血，其初次免疫低应答率为15．20％（1306／8592），完成加强免疫并于T1、T24时采集静脉血的调查对象占54．98％（718／1306），其中，20μg HepB－SC组、20μgHepB－CHO组、10μg HepB－SC组和10μg HepB－HP组分别占32．3％（232／718）、25．8％（185／718）、19．3％（139／718）、22．6％（162／718）。 T1时，低应答者的抗体阳性率为77．6％（557／718），高于T24时[35．6％（256／718）；χ2＝256．87，P＜0．01]。 T24时，20μg HepB－SC 组、20μg HepB－CHO 组、10μg HepB－SC组和10μg HepB－HP组的抗－HBs阳性率分别为38．8％（90／177）、39．5％（73／185）、25．2％（35／139）和35．8％（58／162）（χ2＝8．81，P＝0．032）。 T1时�Objective To assess the 24-month efficacy after booster vaccination with 3 doses of hepatitis B vaccine among low-response adults in Zhangqiu county of Shandong province.Methods A total of 24 237 adults aged 18-49 years old, never received HepB vaccination,without HBV infection history,and had been living at 3 towns of Zhangqiu county in Shandong province for more than half a year in september, 2009,were collected blood samples of 3-5 ml.A total of 11 590 adults who were negative for hepatitis B virus （HBV）surface antigen（HBsAg）,antibody to HBsAg（Anti-HBs）and antibody to HBV core antigen（Anti-HBc）,were divided into four groups randomly and were vaccinated following the schedule of 0-1-6 with 20 μg hepatitis B vaccine made by recombinant deoxyribonucleic acid techniques in Saccharomyces cerevisiae （ HepB-SC） , 20μg hepatitis B vaccine made by Chinese hamster ovary cell （ HepB-CHO） , 10μg HepB-SC and 10 μg hepatitis B vaccine made by recombinant deoxyribonucleic acid techniques in Hansenula Polymorpha （ HepB-HP ） , respectively. The adults who were low-response to the primary hepatitis B vaccination （ 10 mU/ml≤anti-HBs ＆lt;100 mU/ml ） were divided into four groups by cluster random sampling.These groups were revaccinated with 3-dose of above-mentioned four kinds of HepB respectively.Blood samples were drawn from 1month（ T1 ） and 24 month（ T24 ） after the 3 dose revaccination, respectively.Anti-HBs and anti-HBc was detected by Chemiluminescence Microparticle Imunoassay（ CMIA） . Results Out of the 8 592 adults who have accepted the primary vaccination of hepatitis B and been collected the blood samples,1 306 subjects showed low-response.A total of 718 low-response subjects were collected blood samples after T1 and T24 following 3 doses of booster vaccination.The proportion of the four groups was 32.3% （ 232/718 ） , 25.8% （ 185/718 ） , 19.3% （ 139/718 ） , 22.6% （ 162/718 ） , respectively.The average proportion of anti-HBs≥100 mIU/ml were decreased f

关 键 词：成年人 肝炎疫苗 乙型 免疫接种 加强 低应答者 免疫持久性 

分 类 号：R186[医药卫生—流行病学]