山东省聊城市慢性丙型肝炎感染者接种乙型肝炎疫苗效果评价  

Immunogenicity of hepatitis B vaccination of chronic hepatitis C patients in Liaocheng city of Shandong province

作　　者：刘婷婷[1] 刘淑霞[1] 张永霞 梁伟[1] 侯怡哲[1] 袁慧[1] Liu Tingting;Liu Shuxia;Zhang Yongxia;Liang Wei;Hou Yizhe;Yuan Hui(Liaocheng Municipal Center for Disease Control and Prevention, Liaocheng 252000, Shandong, China;Dongchangfu District Center for Disease Control and Prevention, Liaocheng 252000, Shandong , China)

机构地区：[1]聊城市疾病预防控制中心,山东聊城252000 [2]东昌府区疾病预防控制中心,山东聊城252000

出　　处：《中国疫苗和免疫》2018年第3期285-288,共4页Chinese Journal of Vaccines and Immunization

基　　金：国家“十二五”科技重大专项(2012ZX10002001;2013ZX10004902)

摘　　要：目的评价慢性丙型肝炎（丙肝）感染者接种乙型肝炎（乙肝）疫苗（Hep B）的效果。方法通过以社区为基础的筛选方法选择聊城东昌府区18-59岁的慢性丙肝病例,且血清乙肝病毒（HBV）表面抗原（HBs Ag）、抗HBs Ag抗体（Anti-HBs）、抗HBV核心抗原抗体（Anti-HBc）均阴性,抗丙肝病毒（HCV）抗体和HCV RNA阳性者为病例组;按照1∶2配比选择以上五项指标均为阴性的人群对照组。采用0-1-6月程序为所有研究对象接种3剂次Hep B,比较两组人群免疫后1个月Anti-HBs免疫应答率和几何平均浓度（GMC）。结果病例组、对照组Anti-HBs阳转率分别为100%（17/17）、100%（34/34）;低应答率分别为23.53%、2.94%（χ2=5.43,P=0.02）;正常应答率分别为29.41%、41.18%（χ2=0.67,P=0.41）;高应答率分别为47.06%、55.88%（χ2=0.35,P=0.55）;GMC分别为563.46m IU/ml、1 270.70m IU/ml（t=1.50,P=0.15）。Logistic回归分析显示,慢性丙肝感染是Hep B免疫应答的危险因素。结论慢性丙肝感染者接种Hep B后免疫应答弱于健康人群;需增加接种剂量或剂次以提高其免疫应答。Objective To evaluate the immunogenicity of hepatitis B vaccine for chronic hepatitis C patients in Liaocheng city. Methods We used community-based screening to select as cases 18-59 year old hepatitis C patients from Dongchangfu district of Liaocheng who were negative for hepatitis B virus（ HBV） surface antigen（ HBs Ag）,antibody to HBs Ag（ Anti-HBs）,and antibody to HBV core antigen（ Anti-HBc）,but who were positive for antibody to hepatitis C virus（ Anti-HCV） and HCV RNA. We used a 1∶ 2 match to select controls who were negative for the above indicators. All participants received3 doses of hepatitis B vaccine（ Hep B） on a 0-1-6-month schedule. One month after the third dose of vaccine,we compared cases and controls on Anti-HBs sero-positivity and geometric mean concentration（ GMC） of Anti-HBs. Results The Anti-HBs seroconversion rate was 100%（ 17/17） in the case group and 100%（ 34/34） in the control group. Low-response Anti-HBs levels were seen in 23. 53% and2. 94%（ χ2= 5. 43,P = 0. 02） of cases and controls,respectively; normal-response levels were seen in29. 41% and 41. 18%（ χ2= 0. 67,P = 0. 41） of cases and controls,respectively; and high-response levels were seen in 47. 06% and 55. 88%（ χ2= 0. 35,P = 0. 55） of cases and controls,respectively.GMCs were 563. 46 m IU/ml in cases and 1 270. 70 m IU/ml in controls（ t = 1. 50,P = 0. 15）. Logistic regression showed that chronic HCV infection was a risk factor for lower Hep B immune response. Conclusions The immune response to Hep B was weaker among chronic hepatitis C patients than among a healthy population. Hep B dosage or number of doses should be increased to improve the immune response to Hep B among chronic hepatitis C patients.

关 键 词：慢性丙型肝炎 乙型肝炎疫苗 免疫效果 

分 类 号：R186[医药卫生—流行病学]