HIV感染者乙型肝炎疫苗不同接种方案效果比较  

Immunogenicity of different hepatitis B vaccination programs for HIV-infected patients

作　　者：冯永亮[1,2] 姚添 卢晓晓 石璟[1,2] 蓝光华[3] 鲁鸿燕[3] 向绍密 王富珍[5] 王素萍[1,2] FENG Yongliang;YAO Tian;LU Xiaoxiao;SHI Jing;LAN Guanghua;LU Hongyan;XIANG Shaomi;WANG Fuzhen;WANG Suping(School of Public Health,Shanxi Medical University,Taiyuan 030001,Shanxi,China;Center of Clinical Epidemiology and Evidence-Based Medicine,Shanxi Medical University,Taiyuan 030001,Shanxi,China;Guangxi Center for Disease Prevention and Control,Nanning 530028,Guangxi;Ningming Center for Disease Prevention and Control,Ningming 532500,Guangxi;Chinese Center for Disease Control and Prevention,Beijing 102206)

机构地区：[1]山西医科大学公共卫生学院,太原030001 [2]山西医科大学临床流行病学与循证医学中心,太原030001 [3]广西壮族自治区疾病预防控制中心,南宁530028 [4]广西宁明县疾病预防控制中心,广西宁明532500 [5]中国疾病预防控制中心,北京102206

出　　处：《中国艾滋病性病》2022年第1期37-41,共5页Chinese Journal of Aids & STD

基　　金：国家科技重大专项(2012ZX10002001,2018ZX10721202)。

摘　　要：目的探讨HIV感染者短程接种高剂量乙肝疫苗的免疫效果、依从性和安全性。方法以广西两所疾病预防控制中心管理的182名HIV感染者为对象,随机分组后接受0-1-6月20μg(IM20*3组)或0-1月60μg(IM60*2组)乙肝疫苗接种,随访检测两组第二针接种后5个月与IM20*3组接种后6个月的抗-HBs,分析比较抗-HBs几何平均浓度(GMC)、(强)阳性率、接种完成情况和安全性。结果IM60*2组和IM20*3组抗-HBs GMC、阳性率和强阳性率接近,分别为148.90 mIU/mL vs.264.40 mIU/mL、78.31%(65/83)vs.73.53%(50/68)、34.94%(29/83)vs.38.24%(26/68)(P>0.05);IM60*2组接种完成率(96.70%,88/91)略高于IM20*3组(92.31%,84/91)(P=0.19);两组不良反应发生率分别为7.95%(7/88)和9.09%(8/88)(P=0.79),均为轻度不良反应。结论HIV感染者短程接种高剂量乙肝疫苗与常规方案的免疫效果相当,安全性、依从性均较好。Objective To explore the immunogenicity,compliance,and safety of high-dose short-course(60μg with 0,1 month intervals)hepatitis B vaccine in HIV-infected adults.Methods We conducted a randomized,controlled trial including 182 HIV-infected adults who were centrally randomized in a ratio of 1∶1 to receive a 20μg or 60μg hepatitis B vaccine at months 0,1,and 6.We focused on the comparison of the anti-HBs geometric mean concentration(GMC),positive rate(anti-HBs≥10 mIU/mL),strong positive rate(anti-HBs≥100 mIU/mL),safety,and completion rate of the 60μg group at 5 months after two doses(IM60*2 group)and the 20μg group at 6 months after complete inoculation(IM20*3 group).Results For the IM60*2 group and the IM20*3 group,GMC,positive rate and strong positive rate of anti-HBs were 148.90 mIU/mL vs.264.40 mIU/mL,78.31%(65/83)vs.73.53%(50/68),34.94%(29/83)vs.38.24%(26/68),and the difference of immunogenicity was not statistically significant(P>0.05).The vaccination completion rate of the IM60*2 group(96.70%,88/91)was slightly higher than that of the IM20*3 group(92.31%,84/91)(P=0.19).The incidence of adverse reactions in the two groups was 7.95%(7/88)and 9.09%(8/88)(P=0.79),both of which were mild adverse reactions.Conclusion The immunogenicity of the short-course high-dose hepatitis B vaccine for HIV-infected adults may be comparable to that of the conventional regimen,and the safety and compliance are good.

关 键 词：艾滋病病毒感染者 乙型肝炎疫苗 免疫效果 安全性 依从性 

分 类 号：R186[医药卫生—流行病学] R373.9[医药卫生—公共卫生与预防医学]