接种HBV疫苗的HIV感染者血清抗-HBs 5年阳性率及影响因素  

Seroprevalence and the influencing factors of anti-HBs antibody after five-year hepatitis B vaccination in HIV-infected persons

作　　者：唐仁海 李畅 王继宝 叶润华 杨锦 段星 王译葵 高洁 项丽芬 杨跃诚 丁盈盈[2] 何纳[2] 段松 TANG Renhai;LI Chang;WANG Jibao;YE Runhua;YANG Jin;DUAN Xing;WANG Yikui;GAO Jie;XIANG Lifen;YANG Yuecheng;DING Yingying;HE Na;DUAN Song(Dehong Prefecture Center for Disease Control and Prevention,AIDS STD Prevention and Control Division,Mangshi 678400,China;Department of Epidemiology,School of Public Health,Fudan University,Shanghai 200032)

机构地区：[1]德宏傣族景颇族自治州疾病预防控制中心艾滋病性病防制科,云南芒市678400 [2]复旦大学公共卫生学院流行病学教研室公共卫生安全教育部重点实验室,上海200032

出　　处：《中国艾滋病性病》2022年第6期652-657,共6页Chinese Journal of Aids & STD

基　　金：国家自然科学基金项目(81773485)。

摘　　要：目的分析HIV感染者接种乙型肝炎(简称乙肝)疫苗后5年血清乙肝表面抗体(抗-HBs)阳性率及其影响因素,为优化HIV感染者乙肝疫苗免疫策略提供科学依据。方法以云南省德宏州HBV五项检测均为阴性并完成5年随访的761例HIV感染者为研究对象。在首针接种后5年时检测抗-HBs,分析HIV感染者乙肝疫苗接种后的长期免疫效果及其影响因素。结果761例HIV感染者中359例(47.2%)完成乙肝疫苗接种。5年抗体阳性率为12.2%(93/761),接种组为21.2%(76/359),未接种组为4.2%(17/402);多因素分析结果显示,接种乙肝疫苗、女性感染者5年血清抗-HBs阳性率较高,较大年龄、病毒载量≥200 copies/mL则较低。进一步对接种疫苗的359例HIV感染者进行多因素分析,结果显示,女性感染者(OR=2.38,95%CI:1.29~4.39)在接种乙肝疫苗5年后血清抗-HBs阳性率水平显著高于男性感染者;而较大年龄(40~49岁:OR=0.38,95%CI:0.17~0.85;≥50岁:OR=0.21,95%CI:0.07~0.65)的感染者则显著低于15~29岁的感染者。结论HIV感染者注射乙肝疫苗5年后抗-HBs水平仍显著高于未接种者,但男性、大龄及病毒载量较高者接种后免疫持久性较差,应予以关注。Objective To investigate the prevalence and associated factors of serum hepatitis B surface antibody(anti-HBs)and 5 years after completion of first hepatitis B vaccination among HIV-infected persons.Methods A total of 761 HIV-infected persons in Dehong prefecture of Yunnan province who were both negative for hepatitis B and completed 5-year follow-up were included.Anti-HBs was measured 5 years after the first vaccination.Results Hepatitis B vaccination was completed in 359(47.2%)of 761 HIV-infected patients.The 5-year prevalence of anti-HBs was 12.2%(93/761),with a prevalence of 21.2%(76/359)and 4.2%(17/402)in the vaccinated and unvaccinated group respectively.Multivariate analysis showed that serum anti-HBs among all participants was higher in women infected with hepatitis B vaccine for 5 years,but lower in people with older age and viral load≥200 copies/mL.Multivariate analysis of 359 HIVinfected persons who were vaccinated,the female(OR=2.38,95%CI:1.29-4.39)were associated with increased serum anti-HBs prevalence.The older age(40~49 years:OR=0.38,95%CI:0.17-0.85;≥50 years:OR=0.21,95%CI:0.07-0.65)were associated with reduced serum anti-HBs prevalence.Conclusions Seroprevalence of anti-HBs antibody among HIV-infected persons after 5 years of HBV vaccination is still significantly higher than those unvaccinated.However,the sustainability of anti-HBs antibody is relatively lower among vaccinated HIVinfected persons who are male and older with higher viral load,which calls for particular attentions.

关 键 词：艾滋病病毒感染者 乙型肝炎疫苗 乙型肝炎病毒表面抗体阳性率 接种 

分 类 号：R373.9[医药卫生—病原生物学] R512.6[医药卫生—基础医学]