成人乙肝疫苗免疫无应答影响因素及60μg重组疫苗复种效果评价  

An evaluation on immunization effect and the influencing factors after revaccination with 60 μg hepatitis B vaccine among non-response adults

作　　者：陈胜玉[1,2] 余运贤[1] 王学才[2] 董晓莲[2] 唐智峰[2] 陈颖峰[2] 王晓丽[2] 

机构地区：[1]浙江大学公共卫生学院,浙江杭州310058 [2]德清县疾病预防控制中心

出　　处：《预防医学》2016年第8期762-765,共4页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：国家"十二五"科技重大专项(2011ZX10004-901)

摘　　要：目的：探讨成人初次接种乙肝疫苗免疫无应答的影响因素，评价复种60μg重组乙肝疫苗对无应答人群的免疫效果。方法选择乙肝表面抗原（HBsAg）和乙肝表面抗体（抗－HBs）均为阴性的成人689人，在完成3剂次乙肝疫苗初次常规免疫1个月后，对接种无应答（抗－HBs滴度＜10.00 mIU／mL）者复种1剂次60μg重组乙肝疫苗，并于1个月后检测抗－HBs。结果成人初次接种乙肝疫苗后无应答率为17.71％（122／689）。多因素非条件Logistic回归分析显示，0－1－12月免疫程序（OR＝2.09，90％ CI：1.37～3.19）和单项乙肝核心抗体（抗－HBc）阳性（OR＝1.73，90％ CI：1.16～2.59）是初次常规免疫无应答的危险因素。89名初次免疫无应答者复种1剂次60μg重组乙肝疫苗后，抗－HBs阳转率达95.51％，抗－HBs几何平均滴度为585.39 mIU／mL。结论成人初次接种乙肝疫苗可获得较好的免疫应答，抗－HBc单阳者初次接种乙肝疫苗免疫应答水平低于抗－HBc阴性人群；无应答者复种1剂次60μg重组乙肝疫苗，可获得良好的免疫效果。Objective To explore vaccine immune effects of 60μg hepatitis B on adults who have no response to hepatitis B vaccination.Methods A Total of 689 healthy adults who were HBsAg and anti -HBs negative were selected,and they were received 3 doses of hepatitis B vaccine at dosage 10 μg.Those with anti-HBs〈10 IU/L detected after full series vaccination were given 1 dose of hepatitis B vaccine at dosage 60 μg.One month later,anti-HBs detection was conducted for them.Results The non -responsiveness rate was 17.71% after primary hepatitis B vaccination.The multivariate logistic regression analysis showed that risk factors for primary non-responsiveness were the history of surgical operation, immunization schedule and ＂anti-HBc alone＂.The anti-HBs positive rate was 95.5 1% in 89 re-vaccinated people, and the geometric mean titers of anti -HBs（GMT）was 585.39 IU/L.Conclusion Re -immunization of hepatitis B vaccine at dosage 60 μg has good immunogenicity in people who have no response to primary vaccination,and weight control may improve the effect of hepatitis B re-immunization.

关 键 词：乙型肝炎疫苗 无应答 免疫效果 影响因素 

分 类 号：R186[医药卫生—流行病学]