狂犬病暴露后使用“2-1-1”程序接种人用狂犬病疫苗(Vero细胞)3年免疫持久性及2剂加强免疫效果观察

Persistence of rabies antibody 3 years after postexposure prophylaxis with 2-1-1 regimen of Vero-cell rabies vaccine for human use and antibody response to two booster doses

目的评价使用'2-1-1'程序接种狂犬病疫苗的免疫持久性及2剂加强免疫效果。方法选择曾暴露后使用'2-1-1'程序后1年、2年和3年的对象314人,进行2剂加强免疫,在加强免疫前、后14天分别采集血清,采用酶联免疫吸附实验(enzyme linked immunosorbent assay, ELISA)法检测人狂犬病毒IgG抗体,分析使用'2-1-1'程序后1年、2年、3年及经2剂加强免疫后的抗体几何平均浓度(geometric mean concentration, GMC)和抗体阳性率。结果 303人按'2-1-1'程序接种疫苗后1年、2年和3年的抗体GMC分别为1.33 IU/mL、1.04 IU/mL和0.72 IU/mL,抗体阳性率分别为77.78%、66.67%和55.56%。282人经2剂加强免疫后,1年组、2年组和3年组的抗体GMC分别为16.83 IU/mL、19.37 IU/mL和21.05 IU/mL,加强免疫后抗体GMC均高于加强免疫前(t=16.54,P<0.001;t=13.85,P<0.001;t=16.02,P<0.001);抗体阳性率分别为100.00%、99.00%和100.00%。结论狂犬病暴露后使用'2-1-1'程序具有良好的免疫持久性,3年内2剂次加强免疫后具有较好的免疫应答。

Objective To evaluate the antibody persistence following rabies postexposure prophylaxis(PEP)with 2-1-1 regimen and antibody response to two booster doses.Methods A total of 314 healthy volunteers at year 1,year 2,year 3 who had received a complete rabies PEP using 2-1-1 regimen were recruited.Two booster doses of rabies vaccine were inoculated,and blood samples were obtained before and 14 days after two booster doses.Human rabies virus IgG antibody was evaluated by ELISA,and the antibody levels and antibody positive rates were analyzed.Results The antibody GMC of 303 people at year 1,year 2,year 3 after a complete immunization was 1.33 IU/mL,1.04 IU/mL and 0.72 IU/mL,with an antibody positive rate of 77.78%,66.67%and 55.56%,respectively.Among 282 people who received 2 doses for booster immunization,the antibody GMC at day 14 of 1 year,2 year and 3 year immunization group was 16.83 IU/mL,19.37 IU/mL and 21.05 IU/mL respectively,which was higher than that before booster immunization(t=16.54,P<0.001;t=13.85,P<0.001;t=16.02,P<0.001).The antibody positive rate was 100.00%,99.00%and 100.00%,respectively.Conclusions The immune persistence of rabies antibody after PEP with antirabies vaccine using the 2-1-1 regimen is good so as to the immune response after 2 doses of booster immunization in 3 years is effective.