上海市黄浦区新生儿两种乙肝疫苗免疫后16年免疫效果

Evaluation on 16-years immune efficacy of two kinds of hepatitis B vaccines among newborns in Huangpu District of Shanghai

目的为了评价血源性乙肝疫苗和重组酵母乙肝疫苗的长期免疫效果。方法对上海市黄浦区1986年出生的并全程接种血源性乙肝疫苗和1997年出生并全程接种重组酵母乙肝疫苗的对象隔年随访,采血测得乙肝表面抗原(HBsAg)、乙肝表面抗体(抗-HBs)、乙肝核心抗体(抗-HBc),与本底值(1984—1985年乙肝病毒横断面调查)相比计算保护率。结果 16年间,血源性乙肝疫苗组的HBsAg、抗-HBs和抗-HBc的阳性率分别为0.47%、28.20%和1.18%,重组乙肝疫苗组为0.94%、12.85%和0.63%;血源疫苗组抗-HBs阳性率从89.72%下降到28.20%,重组疫苗组从93.72%下降到12.85%。两种疫苗的主要差别在于重组乙肝疫苗抗-HBs阳性率在5~16年间均低于血源性疫苗,且下降程度(80.87%)大于血源性疫苗(61.52%)。结论两种疫苗虽然抗体逐年下降,重组酵母乙肝疫苗更加明显,但是两种疫苗的乙肝保护效果没有差异,提示血源疫苗和重组疫苗免疫后16年免疫效果良好,但血源疫苗组优于重组疫苗组,均无需加强免疫。

[Objective]To evaluate the long-term immune efficacy of plasma-derived hepatitis B vaccine（PDV） and domestic yeast-derived recombinant hepatitis B vaccine（YDV）[.Methods]The subjects born in 1986 immunized with PDV and subjects born in 1997 immunized with YDV in Huangpu District of Shanghai were followed up every other year. The blood samples were collected to test HBsAg,Anti-HBs and Anti-HBc,which were compared to the background results from a cross-sectional survey of hepatitis B virus in 1984-1985 to calculate protecting rate,and an added survey on acute hepatitis B was carried out. [Results]In the past 16 years,the positive rates of HBsAg,Anti-HBs and Anti-HBc were respectively 0.47%,28.20% and 1.18% in PDV group,and they were respectively 0.94%,12.85% and 0.63% in YDV group. There were no significant increases in the positive rate of HBsAg and Anti-HBc in both groups,while the positive rates of Anti-HBs in two groups decreased significantly（the positive rate decreased from 89.72% to 28.20% in PDV group and decreased from 93.72% to 12.85% in YDV group）. The main difference between these two vaccines was the positive rate of Anti-HBs in YDV group was lower than that in PDV group between5 th and 16 th years after vaccination,and the former（decreased by 80.87%） dropped more dramatically than the latter（decreased by 61.52%）.[Conclusion] The antibody levels of two vaccines decrease year by year,and YDV drops more dramatically than PDV,but there is no difference in protection effect against hepatitis B between them. It is indicated that the16-years immune efficacy of PDV and YDV is satisfactory,and there is no need for a booster dose