乙肝疫苗接种无弱应答与遗传关系的研究

STUDY ON THE ASSOCIATION OF GENETIC FACTOR AND NON-AND-HYPORESPONSIVENESS TO HEPATITIS B VACCINE

乙肝疫苗接种后约有５％～１０％的人出现无或弱应答（简称无弱应答）其危害在于易发生ＨＢＶ感染，甚至形成慢性ＨＢｓＡｇ携带。无弱应答发生的原因很复杂，可能存在遗传因素。虽然分子遗传学的研究表明，弱反应与人类白细胞抗原（ＨＬＡ）有关，但尚需要群体遗传学方面的研究证据。本研究为从群体遗传学角度探讨遗传因素的作用。在严格确诊无弱应答的前提下，用配对方法精选强应答作为对照，首先调查分析两组一级亲属各项有关指标均均衡可比，再对两组一级亲属检测ＨＢＶ感染三项指标并接种乙肝疫苗。从ＨＢＶ感染率上，无弱应答一级亲属高于强应答；在抗－ＨＢｓ检出率上则反之，无弱应答低于强应答。在一级亲属接种疫苗应答率和抗－ＨＢｓＧＭＴ上，无弱应答组均低于强应答。提示。

After the initial vaccination schedule of hepatitis B vaccine, about 5%-10% of the vaccinees turned out to be non-and-hyporesponders. They were susceptible to HBV infection and even became chronic HBV carriers. The cause of the non-and-hyporesponsiveness was complicated and there may exist a genetic factor. Although molecular genetics studies had indicated that the poor response was associated with human leucocyte antigen (HLA),more evidences from population genetics studies were still needed. In the present study, the population genetics survey was adopted to investigate the involvement of genetic factor. The non-and-hyporesponders were strictly diagnosed,relevant normal responder controls were paired and then their first degree relatives were recruited and investigated. The background factors of the two group relatives were proved to be comparable, both of them were tested for three HBV serological markers and further vaccinated three 10 μg doses of hepatitis B vaccine.The results showed that the HBV infection rate of the poor responder relatives was higher than that of normal responder relatives, while anti-HBs positive rate was lower than normal responder relatives. Moreover, in the poor responder relatives, both the vaccine response rate and anti-HBs GMT were lower than in normal responder relatives. It suggested an association of genetic factor with the non-and-hyporesponsiveness to hepatitis B vaccine.