摘要
目的评价广西隆安县乙肝血源疫苗长期免疫效果,为乙肝疫苗加强免疫策略提供依据。方法在广西隆安县开展横断面调查,采用多阶段抽样方法选取766名1987—1989年出生,并于出生72 h内全程接种乙肝血源疫苗者作为研究对象。采集血清标本用微粒子酶免疫法(microparticle enzyme immunoassay,MEIA)检测乙肝表面抗原(hepatitis B surface antigen,HBs Ag),抗乙肝病毒表面抗原抗体(antibody to HBs Ag,Anti-HBs),抗乙肝病毒核心抗原抗体(antibody to HBV core antigen,Anti-HBc)。结果 766名研究对象中,HBs Ag携带率为4.96%,首针不及时接种组(10.42%)显著高于及时接种组HBs Ag阳性率(4.60%)(P〈0.05)。首针及时接种的718例研究对象中,HBs Ag和Anti-HBc阳性率分别为4.60%(95%CI:3.29-6.38)和22.42%(95%CI:19.52-25.62)。Anti-HBs阳性率为21.59%(95%CI:18.73-24.74)。Anti-HBs阳性者抗体几何平均浓度(geometric mean concentration,GMC)为98.39 m IU/m L(95%CI:60.87-135.91),单独Anti-HBs阳性者平均GMC为47.34 m IU/m L(95%CI:40.58-54.10),随着免疫年限延长呈下降趋势。GMC〈10 m IU/m L组随着免疫年限延长构成比呈上升趋势,而100-999.99 m IU/m L组构成比呈下降趋势。首针及时接种乙肝血源疫苗保护率为74.30%。结论乙肝血源疫苗免疫后26-28年抗体水平已降至较低水平,疫苗保护HBV感染和发病的效果已显著下降。建议继续提高新生儿乙肝疫苗首针接种及时率,对Anti-HBs阴性(GMC〈10 m IU/m L)且未感染HBV者应进行乙肝疫苗加强免疫。
Objective To evaluate the long-term effectiveness of the plasma-derived hepatitis B vaccine in Long'anCounty,Guangxi,China,so as to provide the evidence for formulating the strategy of enhancing hepatitis B vaccine. Methods A cross-sectional investigation was conducted in Long'an County,Guangxi. The multistage sampling method was used to selectsubjects. Totally 766 subjects who received 3 doses of plasma-derived HBV vaccine within 72 h after birth and who were bornfrom 1987 to 1989 were enrolled. The serum samples were collected to test for HBV markers which included hepatitis B surfaceantigen(HBs Ag),anti- hepatitis B surface antibody(Anti- HBs)and hepatitis B core antibody(Anti- HBc)by using themicroparticle enzyme immunoassay. Results Among the 766 participants,the average HBs Ag prevalence was 4.96%. Thepositive rates of HBs Ag on subjects who delayed the first dose(10.42%)were higher than that of subjects who received the firstdose intime(4.60%)(P〈0.05). Among the 718 subjects of the birth-dose intime group,the average positive rates of HBs Agand Anti-HBc were 4.60%(95%CI: 3.29-6.38)and 22.42%(95%CI: 19.52-25.62),respectively,and the positive rate of Anti-HBs were 21.59%(95%CI: 18.73-24.74). The geometric mean concentration(GMC)of Anti-HBs-positive subjects was 98.39 m IU/m L(95%CI: 60.87-135.91).The average GMC of Anti-HBs for the subjects who were solely Anti-HBs-positive was47.34 m IU/m L(95% CI: 40.58- 54.10). The proportion of the GMC〈10 m IU/m L group increased with the rising year ofvaccination,while the proportions of the 100-999.99 m IU/m L group declined with the rising year of vaccination. The efficacy ofplasma-derived hepatitis B vaccine was 74.30%. Conclusion The long-term effectiveness of the plasma-derived hepatitis B vaccine declines 26-28 years after vaccination. It seems that a booster dose is necessary for subjects who were anti-HBs〈10m IU/m L and not infected by HBV. Enhancing the rate of the birth-dose intime is one of the most important measures to preventand control HBV infection.
出处
《中国热带医学》
CAS
2016年第7期645-648,共4页
China Tropical Medicine
基金
"十二五"国家科技重大专项(No.2012ZX10002-001-005-001)
国家自然科学基金项目(No.81360443
No.81560546)
广西自然科学基金项目(No.2013GXNSFBA019194)