HIV感染后接种乙肝疫苗应答反应情况的研究

Study on the Response to Hepatitis B Vaccine after HIV Infection

目的研究HIV感染者接种乙肝疫苗后的免疫应答反应情况。方法方便选取2017年2月-2019年4月该院感染科门诊40名健康体检者为健康对照组,均经检查HBsAg、抗-HBs均阴性,选取同期关爱门诊收治的40例HIV感染者为HIV感染组,两组分别在0、1、6个月给予三角肌肌内注射重组乙肝疫苗(酵母)10μg/次,疗程结束后1个月内,检测两组患者抗-HBs水平,高于10 mlU/mL即为阳性,HIV感染组患者检测外周血CD4+T淋巴细胞计数。结果两组阳转率(87.50%vs 77.50%)比较,差异无统计学意义(χ~2=1.385,P>0.05),HIV感染组中CD4+T淋巴细胞计数>200个/μL者26例,CD4+T淋巴细胞计数<200个/μL者14例,按标准方案接种乙肝疫苗后,两组阳性率分别为88.50%(23/26)和57.10%(8/14),差异有统计学意义(χ~2=4.991,P<0.05)。结论健康人群和HIV感染者接种乙肝疫苗后的免疫应答情况基本一致,但CD4+T淋巴细胞计数越低,接种乙肝疫苗后免疫反应越差。

Objective To study the immune response of HIV-infected patients after receiving hepatitis B vaccine. Methods From February 2017 to April 2019, 40 healthy medical examiners in the outpatient department of the hospital were convenientselected as the healthy control group, and all of them were negative for HBsAg and anti-HBs. The 40 HIV-infected patients admitted to the outpatient clinic during the same period were selected as the HIV-infected group, the two groups were given intramuscular injection of recombinant hepatitis B vaccine(yeast) 10 ug/time at 0, 1, and 6 months. The anti-HBs levels in the two groups were detected within 1 month after the end of the course of treatment, higher than 10 mlU/mL was positive. Patients in the HIV-infected group were tested for peripheral blood CD4+T lymphocyte counts.Results There was no significant difference in positive conversion rate(87.50% vs 77.50%) between the two groups(χ~2=1.385, P>0.05). There were 26 cases of CD4+T lymphocyte counts in the HIV infection grou P >200/μL. There were 14 cases with CD4+T lymphocyte counts less than 200/μL. After the hepatitis B vaccine was administered according to the standard protocol, the positive rates of the two groups were 88.50%(23/26) and 57.10%(8/14). The difference was statistically significant. significance(χ~2=4.991, P <0.05). Conclusion The immune response of HBV vaccine in healthy people and HIV-infected patients is basically the same, but the lower the CD4+T lymphocyte count, the worse the immune response after HBV vaccine.