甲型肝炎减毒活疫苗与灭活疫苗不同免疫程序免疫后7年血清学效果观察

Comparison of Antibody Persistence Between Live Attenuated and Inactivated Hepatitis A Vaccines

目的观察甲型肝炎(甲肝)减毒活疫苗(Hepatitis A Attenuated Live Vaccine,HepA-L)不同免疫程序免疫后7年的抗体持久性,并与甲肝灭活疫苗(Hepatitis A Inactivated Vaccine,HepA-I)进行比较。方法按个体随机的方法,把筛检出的甲肝易感者随机分为A、B、C三组。A组按0、6、12个月程序接种3剂国产H2株HepA-L,B、C两组按0、6个月程序分别接种HepA-L和HepA-I,分别于免疫后1、6、7、12、13、24、84个月采集血清标本,检测抗甲肝病毒抗体(Anti-hepatitis A Virus Antibody,Anti-HAV)总抗体。结果三组Anti-HAV阳性率均于接种第2剂后1个月达100%,抗体峰值几何平均浓度(Geometric Mean Concentration,GMC)以C组最高,为2938.1mIU/ml(毫国际单位/毫升),A、B组分别为1315.6mIU/ml、1586.0mIU/ml。A组于12个月时再加强免疫1剂,抗体GMC上升,达1945.3mIU/ml。首剂免疫后84个月,Anti-HAV阳性率三组均保持100%,尽管A组抗体GMC降至336.8mIU/ml,仍显著高于B、C两组。结论HepA-L近期加强免疫效果良好,抗体反应与持久性同HepA-I相当,远期效果有待于进一步观察。

Objective To study the antibody persistence of live attenuated hepatitits A vaccine,and to compare the antibody between with inactivated vaccine. Methods 211 HAV susceptible children were divided randomly into three groups,Group A was injected three doses HepA-L at 0,6 and 12 monthes; Group B was administrated two dose HepA-L at 0 and 6 months,and group C was immunized with inactivated vaccine at month 0 and 6. Serum samples were detected for Anti-HAV at 1,6,7,12,13,24,84 months after vaccination in each group. Results The seroconversion rates reached 100% after 2nd dose in all groups. The highest GMC was 2938.1 mIU/ml,founded in group C,and it was 1315.6mIU/ml and 1586mIU/ml in group A and B respectively. After the 3rd dose at month 12 in group A,the antibody increased dramatic,which reached1945.3mlU/ml. 84 months after f irst dose in each group,the antibody can be detected from all subjects. Though the GMC in group A declined to 336.8mIU/ml,it was significant higher than that in grou.p B and C. Conclusion The good booster effect with HepA-L was well observed in a short-term. The immune response induced by 2 to 3 doses HepA-L could compete with inactivated hepatitis A vaccine. However,long-term effects of both vaccines need further study.