接种乙型肝炎疫苗无应答健康成人再免疫效果的Meta分析  

The effect of re-vaccination with hepatitis B vaccine among non-responding healthy adults: a meta-analysis

作　　者：葛申[1] 马建新[1] 刘瑶瑶[1] 李倩[1] 张政[1] Ge Shen;Ma Jianxin;Liu Yaoyao;Li Qian;Zhang Zheng(Chaoyang District Center for Disease Control and Prevention,Beijing 100021,China)

机构地区：[1]北京市朝阳区疾病预防控制中心

出　　处：《中国疫苗和免疫》2019年第5期598-604,共7页Chinese Journal of Vaccines and Immunization

基　　金：艾滋病和病毒性肝炎等重大传染病防治科技重大专项(2018ZX10715-005)

摘　　要：目的评价中国大陆地区常规接种乙型肝炎(乙肝)疫苗(Hepatitis B vaccine,HepB)后无应答健康成人的再免疫效果。方法检索2000年1月-2018年4月发表的相关研究文献,对无应答健康成人HepB再免疫后的抗乙肝表面抗原抗体(HBsAb)阳转率进行Meta分析。结果本研究共纳入18篇文献。Meta分析显示,无应答健康成人HepB再免疫后的合并HBsAb阳转率为78.84%(95%CI:72.69%-84.99%);采用10μg 0-1-6月程序、20μg 0-1-2月程序、20μg 0-1-6月程序、60μg 1剂次程序人群的抗体阳转率分别为59.09%(95%CI:38.62%-79.57%)、86.37%(95%CI:78.21%-94.53%)、87.08%(95%CI:82.85%-91.31%)、91.69%(95%CI:87.96%-95.41%)。结论无应答健康成人HepB再免疫的效果以60μg 1剂次程序最好,20μg 0-1-2月程序和0-1-6月程序次之,10μg 0-1-6月程序较差。Objective To evaluate the effect of re-vaccination with hepatitis B vaccine(HepB)among healthy adults of China’s mainland who had not responded to routine HepB vaccination.Methods We searched relevant literatures published from January 2004 to April 2018 and conducted a meta-analysis of seroconversion rates of hepatitis B surface antibody(HBsAb)af ter HepB re-vaccination of non-responding healthy adults.Results A total of 18 articles were included.Our meta-analysis showed that the overall HBsAb seroconversion rate was 78.84%(95%CI:72.69%-84.99%)among non-responding healthy adults,with 59.09%(95%C I:38.62%-79.57%),86.37%(95%C I:78.21%-94.53%),87.08%(95%CI:82.85%-91.31%),and 91.69%(95%CI:87.96%-95.41%)responding af ter re-vaccination with a 0-1-6-month schedule with 10μg,a 0-1-2-month schedule with 20μg,a 0-1-6-month schedule with 20μg,and a 1-dose schedule with 60μg,respectively.Conclusions The 1-dose schedule with 60μg HepB had the best re-vaccination effect among non-response healthy adults.A 0-1-2-month or 0-1-6-month schedule with 20μg had a better effect than did a 0-1-6-month schedule with 10μg of antigen.

关 键 词：乙型肝炎疫苗 再免疫 无应答 成人 META分析 

分 类 号：R512.62[医药卫生—内科学] R186[医药卫生—临床医学]