母亲乙型肝炎病毒e抗原阳性对婴儿接种乙型肝炎疫苗的影响  

Influence of positive maternal hepatitis B virus e antigen on the antibody response to hepatitis B vaccination in infants

作　　者：冯静[1] 黄红玉[2] 陈洁[1] 戴毅敏[1] 胡娅莉[1] 周乙华[2] 张昭萍 Feng Jing;Huang Hongyu;Chen Jie;Dai Yimin;Hu Yali;Zhou Yihua;Zhang Zhaoping(Department of Obstetrics and Gynecology,Nanjing Drum Tower Hospital,Nanjing University Medical School,Nanjing 210008,China;Department of Laboratory Medicine,Nanjing Drum Tower Hospital,Nanjing University Medical School,Nanjing 210008,China;Department of Infectious Diseases,Nanjing Drum Tower Hospital,Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属南京鼓楼医院妇产科,210008 [2]南京大学医学院附属南京鼓楼医院科研部,210008 [3]南京大学医学院附属南京鼓楼医院感染科,210008

出　　处：《国际流行病学传染病学杂志》2021年第6期451-455,共5页International Journal of Epidemiology and Infectious Disease

基　　金：江苏省临床医学中心(创新平台)项目(YXZXB2016004)。

摘　　要：目的探讨母亲HBeAg阳性对婴儿接种乙型肝炎疫苗的影响。方法2012年4月至2015年3月在南京鼓楼医院分娩的265例HBsAg阳性单胎母亲中,根据母亲HBeAg情况分为2组,HBeAg阳性母亲及其婴儿组(脐血HBeAg阳性组,124例)和HBeAg阴性母亲及其婴儿组(脐血HBeAg阴性组,141例)。两组婴儿均在出生后12 h内接种100 U乙型肝炎免疫球蛋白,并于0、1、6月接种3针乙型肝炎疫苗。对两组婴儿在出生后7~12月龄随访乙型肝炎血清学标志物,并进行对比分析。结果脐血HBeAg阳性组和阴性组婴儿抗-HBs阳性率分别为97.6%(121/124)和97.9%(138/141),差异无统计学意义(χ^(2)=0.025,P>0.05)。脐血HBeAg阳性组婴儿抗-HBs几何平均浓度高于脐血HBeAg阴性组(351.70vs.293.12 mIU/mL;Z=-1.294,P<0.05)。两组婴儿不同抗-HBs水平分布比较差异无统计学意义(P均>0.05)。脐血HBeAg阳性组中HBeAg水平滴度≥1.39 lg S/CO和<1.39 lg S/CO的婴儿抗-HBs水平分布差异无统计学意义(χ^(2)=0.932,P>0.05)。结论母亲HBeAg阳性不影响婴儿对乙型肝炎疫苗的免疫应答,提示宫内暴露HBeAg胎儿不会导致对HBV产生免疫耐受。Objective To investigate the effect of HBeAg-positive pregnant women on antibody response to hepatitis B vaccine in their infants.Methods HBsAg-positive women in singletons who delivered at Nanjing Drum Tower Hospital from April 2012 to March 2015 were divided into two groups based on the statue of HBeAg.HBeAg-positive group was composed of 124 HBeAg-positive mothers and their infants,and HBeAg-negative group was composed of 141 HBeAg-negative mothers and their infants.All infants received 100 U hepatitis B immunoglobulin within 12 hour after birth and hepatitis B vaccine at 0,1 and 6 months,respectively.HBV serological markers were quantitatively determined and compared in infants at 7-12 months of age.Results The positive rates of anti-HBs were 97.6%(121/124)and 97.9%(138/141)in HBeAg-positive and negative groups,with no significant difference(χ^(2)=0.025,P>0.05).The geometric mean concentration of anti-HBs in HBeAg-positive group was higher than that in HBeAg-negative group(351.70 vs.293.12 mIU/mL;Z=-1.294,P<0.05).There was no significant difference in distributions of anti-HBs levels between the two groups(P>0.05).The distributions of anti-HBs levels had no significant difference between HBeAg-positive infants with HBeAg≥1.39 lg S/CO and<1.39 lg S/CO(χ^(2)=0.932,P>0.05).Conclusions Maternally transplacental HBeAg in infants does not inhibit the antibody response to hepatitis B vaccine,which suggests that fetal HBeAg exposure does not induce immunotolerance to HBV.

关 键 词：肝炎病毒 乙型 乙型肝炎E抗原 乙型肝炎疫苗 抗体应答 婴儿 对照研究 

分 类 号：R186[医药卫生—流行病学]