乙型肝炎病毒高流行区儿童接种乙型肝炎疫苗5～16年免疫效果评价

Evaluation on Immue Effect of Hepatitis B Vaccine Immunization among Children Aged 5-16 Years in High Epidemic Areas of Hepatitis B Virus

目的评价乙型肝炎(乙肝)病毒(Hepatitis B Virus,HBV)高流行区[人群乙肝病毒表面抗原(HBVSurface Antigen,HBsAg)流行率≥8%]儿童接种乙肝疫苗(Hepatitis B Vaccine,HepB)5～16年的免疫效果。方法 2009年9月,在HBV高流行区选择<1岁完成基础免疫且未加强免疫过HepB的5～16岁人群,同时按2︰1在HBV中流行区(人群HBsAg流行率2%～7%)选择<1岁完成基础免疫且未加强免疫过HepB的5～16岁人群作为对照,采集静脉血,使用化学发光法检测血清HBsAg、抗乙肝病毒表面抗原抗体(Antibody toHBsAg,Anti-HBs)、抗乙肝病毒核心抗原抗体(Antibody to HBV Core Antigen,Anti-HBc),进行阳性率、几何平均浓度(Geometric Mean Concentration,GMC)比较。结果 HBV高流行区5001人的HBsAg阳性率为1.50%,Anti-HBc阳性率为4.52%,HBV感染率为4.66%;Anti-HBs阳性率为47.33%,GMC为77.68mIU/ml(毫国际单位/毫升)[95%可信区间(Confidence Interval,CI)73.00mIU/ml～82.65mIU/ml];HBV中流行区2665人的HBsAg阳性率为0.15%,Anti-HBc阳性率为3.56%,HBV感染率为3.60%;Anti-HBs阳性率为38.09%,GMC为73.72mIU/ml(95%CI66.92mIU/ml～81.22mIU/ml)。HBV高、中流行区人群的HBsAg阳性率、Anti-HBc阳性率、HBV感染率的差异均有统计学意义(χ2=4.724～60.262,P<0.05)。结论 HBV高流行区人群接种HepB5～16年后,免疫效果良好。

Objective To evaluate the long-term immunological effects of hepatitis B vaccine（HepB）of children in high epidemic areas of hepatitis B virus（HBV）[The prevalent rate of HBV surface antigen（HBsAg）in population were over 8% is the high epidemic areas of hepatitis B virus].Methods 5001 children aged 5-16 years who had received the 3 doses of HepB immunization in infancy and no boosters were selected from HBV highly epidemic areas,while 2665 children were selected from HBV intermediate epidemic areas（The prevalent rate of HBsAg in population were between 2% and 7%）as control group.Blood plasma specimens of them were detected for HBsAg,antibody to HBsAg（anti-HBs）and antibody to HBV core antigen（anti-HBc）by chemiluminescence.Positive rates and geometric mean concentration（GMC）were compared between HBV high epidemic areas and intermediate epidemic areas.Results The rates of HBsAg positive,anti-HBc positive,HBV infection,anti-HBs positive in HBV high endemic areas were 1.50%,4.52%,4.66%,and 47.33% respectively and GMC is 77.68 mIU/ml[95%confidence interval（CI）：73.00-82.65mIU/ml];while those in HBV intermediate endemic areas were 0.15%,3.56%,3.60%,38.09% respectively and GMC is 73.72mIU/ml（95%CI：66.92-81.22mIU/ml）.There were statistical significance for the rates of HBsAg positive,anti-HBc positive and HBV infection between HBV high epidemic areas and HBV intermediate epidemic areas（χ2=4.724-60.262,P0.05）.Conclusions？The immunological effects of HepB for children aged 5-16 years are excellent in HBV high epidemic areas.