摘要
目的评价我国新生儿乙型肝炎（乙肝）疫苗免疫后的长期保护效果，为乙肝防控和乙肝疫苗HepB免疫策略提供参考。方法用横断面调查和分层整群抽样的方法，在乙肝疫苗免疫效果观察监测点收集1987--1996年出生（13～22岁）、全程接种乙肝血源疫苗的人群，以及1997—2008年出生（1～12岁）、全程接种乙肝重组酵母疫苗人群的血清样本和资料；用微粒子酶免疫法检测HBV感染指标，结合本底资料和乙肝疫苗免疫史进行分析。结果在河北正定、广西隆安、上海黄浦、青海同德和湖南湘潭5个监测点共收集1～12岁重组酵母疫苗免疫人群样本8133例，13～22岁血源疫苗免疫人群样本4848例，5个监测点的HBsAg平均阳性率均显著低于本底值，疫苗总体保护效果分别为86．04％～96．14％；河北正定、青海同德和湖南湘潭的年龄分布差异无统计学意义，广西隆安和上海黄浦的结果显示19～22岁人群HBsAg阳性率偏高；Anti-HBs阳性率随免疫年龄增长而下降，重组疫苗免疫人群从1～2岁组的86．84％下降至11～12岁组的46．40％，17～18岁组的Anti．HBs阳性率处于较低水平，而19～22岁组出现升高；几何平均浓度（GMC）〈10mIU／ml（Anti．HBs阴性）的比例随着年龄增长逐渐升高，100～999．99mlU／ml和≥1000mlU／ml的比例随着年龄的增长呈现下降趋势。结论血源疫苗免疫后13—22年、重组酵母疫苗免疫后1～12年的总体保护效果良好；不必开展加强免疫，建议加强监测18岁以上人群的Anti-HBs水平，对GMC〈10mlU／ml者开展加强免疫。
Objective To evaluate the long-term efficacy and duration of hepatitis B vaccine （HepB） after vaccinated to newborns and to provide information for HBV control and prevention. Methods A cross-sectional investigation was carried out in 5 HepB surveillance sites to collect blood samples and vac- cination history information of participants who were born in 1987-1996 and received plasma derived HepB （HepB-P） as newborns, and who were born in 1997-2008 and received recombinant saccharomyces cerevisiae yeast HepB （HepB-SCY）as newborns. The serum samples were taken to test HBV infective markers by the method of microparticle enzyme immunoassay（MEIA）. The data was analyzed combined with vaccination in- formation and baseline data. Results Four thousand eight hundred and forty-eight participants who were immunized with HepB-P as newborns and 8133 participants with HepB-SCY were enrolled in 5 sites inclu- ding Hebei-Zhengding, Guangxi-Longan, Shanghai-Huangpu, Qinghai-Tongde and Hunan-Xiangtan. The average HBV surface antigen （HBsAg） prevalence rates of 5 sites were all significantly lower than their base-line data. The overall vaccine protective efficacy is between 86.04% -96.14%. The age distributions of HB- sag prevalence showed differences in 5 sites. Participants aged 19 to 22 had a relatively high prevalence in Guangxi-Longan and Shanghai-Huangpu, while there was no statistic differences showed in Hebei-Zheng- ding, Qinghai-Tongde and Hunan-Xiangtan. The positive rate of antibody to HBsAg（Anti-HBs） decreased with immune duration, whose average rate was 54.34%. The Anti-HBs positive rate decrease by the trend of after vaccinated by HepB-SCY from 1 year to 12 years and vaccinated by HepB-P, which of 17-18 age group was low but enhanced at 19-22 age group. Conclusion It shows that the effectiveness of HepB-P and HepB-SCY are fine and stable after HepB-P being used for 22 years and HepB-SCY for 12 years. It is sug- gested not to carry out large scale booster immunization in people younger than 18 years old, but it is sugges- ted to monitor the GMC of Anti-HBs and give booster for those people whose GMC is lower than 10 mlU/ml.
出处
《中华微生物学和免疫学杂志》
CAS
CSCD
北大核心
2013年第1期6-10,共5页
Chinese Journal of Microbiology and Immunology
关键词
乙型肝炎病毒
乙型肝炎血源疫苗
乙型肝炎重组酵母疫苗
免疫效果
Hepatitis B virus
Plasma derived hepatitis B vaccine
Recombinant Saccharomyces cerevisiae yeast-derived hepatitis B vaccine
Long-term efficacy
