40岁以上成人接种乙肝疫苗免疫原性及影响因素分析

Immunogenicity and influencing factors of hepatitis B vaccine inadults over 40 years old

目的 了解≥40岁成人乙肝疫苗接种后免疫原性及影响因素。方法 2021年1月1日—2022年1月选取北京市通州区马驹桥和甘棠社区无乙肝疫苗接种史,乙肝五项血清标志物指标均阴性的≥40岁人群,随机分为0-1-6月和0-1-2月免疫程序接种HepB。全程免疫后1个月采用化学发光微粒子免疫检测技术进行乙型肝炎表面抗体(抗-HBs)的定量检测,采用χ2检验和t检验,单因素及多因素logistic回归、单因素及多因素线性回归分析抗-HBs阳性率和浓度及影响因素。结果 0-1-6和0-1-2两种免疫程序阳转率分别为79.87%和80.50%,多因素分析显示,性别(OR=2.39,P<0.05)是抗-HBs阳转率的影响因素,免疫程序、性别、年龄、肥胖与抗-HBs浓度有关。结论 ≥40岁成人0-1-6、0-1-2免疫程序接种HepB均可产生良好的免疫应答。免疫程序、性别、年龄、肥胖可影响抗体水平的产生。

Objective To understand the immunogenicity of hepatitis B vaccine in adults over 40 years old,and to discuss its influencing factors.Methods Adults over 40 years old with no history of hepatitis B vaccination and negative serum biomarkers of HepB were recruited and randomly divided into two groups.Subjects were given 3 doses of HepB vaccine at 0,1 and 6 months(group 1)or at 0,1 and 2 months(group 2).One month after the last dosage,the anti-hepB surface antigen-antibody(anti-HBs)in serum samples was quantified using chemiluminescent microparticle immunoassay.Chi-square test and t-test,univariate and multivariate logistic regression as well as single and multiple linear regression were used to analyze and compare the positive rate and serum levels of anti-HBs and its influencing factors.Results The seropositivity rate was 79.87%in group 1 and 80.50%in group 2.Multivariate regression analysis showed that gender(OR=2.36,P<0.05)was the major influencing factor for anti-HBs seroconversion rate,while sex,age,obesity and dosing schedule were factors related to anti-HBs concentration.Conclusions Both 0-1-6 and 0-1-2 dosing schedules for HepB vaccination can trigger decent immune response in adults over 40 years old.Dosing schedule,sex,age,obesity are major factors affecting the antibody level in serum.