新生儿接种乙型肝炎疫苗的长期免疫效果

Long-term efficacy of hepatitis B vaccine in newborns

目的了解新生儿按0-1-6月程序接种乙型肝炎疫苗1~14年后的免疫效果。方法以河北省正定县某乡2002—2016年出生、完成全程基础免疫并且无免疫加强史的人群为研究对象,对其进行问卷调查,采集3~5 mL血液样本,检测HBsAg、抗-HBs和抗-HBc。计算抗-HBs阳性率、HBsAg阳性率和抗-HBc阳性率,评价乙型肝炎疫苗的免疫效果。结果共纳入研究对象1431名,其中抗-HBs阳性率68.55%(981/1431),抗-HBs几何平均浓度(GMC)为36.65(95%CI:31.45~40.42)mIU/mL,HBsAg阳性率为0.21%(3/1431),抗-HBc阳性率为0.77%(11/1431)。抗-HBs阳性率由免疫后1~2年的90%以上下降到免疫后12~14年的50%左右,随着免疫年限延长有下降趋势(χ^2趋势=85.101,P<0.01)。结论新生儿接种乙型肝炎疫苗基础免疫14年后,仍有较好的预防免疫效果。

Objective To understand the immune effect of hepatitis B vaccine in newborns 1-14 years after primary immunization according to a 0-1-6 month vaccination.Methods Participants who were born in Zhengding county,Hebei between 2002 to 2016,and received a full course of primary vaccination with hepatitis B vaccine,and had no experience with booster vaccination were enrolled.An epidemiological investigation was performed,and 3-5 mL blood samples were collected to detect HBsAg,anti-HBs and anti-HBc.The positive rates of HBsAg,anti-HBs and anti-HBc were calculated to evaluate the immune effect of hepatitis B vaccine.Results A total of 1431 participants were included,among whom the anti-HBs positive rate was 68.55%(981/1431)with a geometric mean concentration(GMC)of 36.65(95%CI:31.45-40.42)mIU/mL.The HBsAg and anti-HBc positive rates were 0.21%(3/1431)and 0.77%(11/1431),respectively.The anti-HBs positive rate decreased from over 90%in 1-2 years after primary vaccination to about 50%in 12-14 years later.A significant downtrend with the extension of immunity years was observed in the anti-HBs positive rate(χ^2trend=85.101,P<0.01).Conclusions Hepatitis B vaccine in newborns shows a good long-term protective effect 14 years after primary vaccination.