HBsAg阳性母亲其婴幼儿联合阻断后无/低应答状态及加强免疫效果

Non-or Low-response Status in Infants of HBsAg Positive Mothers after Hepatitis B Vaccination and How to Strengthen Immune Effects

目的评价HBsAg阳性母亲其婴幼儿联合阻断后无应答或低应答状态,了解乙肝疫苗加强免疫的干预效果。方法249例HBsAg阳性母亲其婴幼儿出生后予以联合免疫阻断,跟踪并测定出生后7～11个月、12～23个月、24～35个月、≥36个月的HBsAb水平,对其中50例无应答或低应答儿进行乙肝疫苗加强免疫接种,1个月后复查HBsAb水平。结果HBsAg阳性母亲其婴幼儿出生7个月后无应答和低应答的发生率为23.29%(58/249);高应答儿出生12～23个月时无应答和低应答的发生率为37.50%(45/120);持续高应答儿出生24～35个月时无应答和低应答率的发生率为48.14%(13/27)。给予乙肝疫苗加强免疫接种后,幼儿的HBsAb水平增高(P<0.05),加强免疫成功率为94%。性别及加强免疫接种时的年龄不影响加强免疫的效果(P>0.05)。结论HBsAg阳性母亲其婴幼儿全程乙肝疫苗接种后存在无应答及低应答状态,给予乙肝疫苗加强免疫干预后多见高应答状态。

Objective To evaluate the immune response status and changes in infants of HBsAg positive mothers to learn the intervention effects of booster hepatitis B vaccine. Methods Two hundred forty - nine infants of HBsAg positive mothers were given combined immunoblocking after birth. HBsAb levels was detected 7 - 11, 12 - 23, 24 - 35, ~〉 36 months after birth. Fifty non - or low - response cases were given booster hepatitis B vaccine. HBsAb level was re - detected after 1 month. Results The incidence of non - or low - response was 23.29% in infants of HBsAg positive mothers 7 months after birth, 37.43 % in high- response infants 12 -23 months after birth, and 48. 14% in sustained high- response infants 24 -35 months after birth. HBsAb levels increased after booster Hepatitis B vaccine （ P 〈 0. 01 ） , with a success rate of 94%. Gender and age did not affect the effects of booster immunization. Conclusion After intervention of booster hepatitis B vaccine, high response may be noted in infants of HBsAg positive mothers in non - or low - response status after whole range of hepatitis B vaccine.