国产重组酵母乙型肝炎疫苗阻断乙型肝炎病毒母婴传播6年免疫效果观察

IMMUNE PERSISTENCE OF PERINATAL TRASMISSION INTERRUPTION IN 1 TO 6 YEAR OF HBSAG AND HBEAG CARRIER MOTHER WITH A RECOMBINANT YEAST DERIVED HEPATITIS B VACCINE

目的 :观察国产重组酵母乙型肝炎疫苗 (YDV)阻断乙型肝炎病毒母婴传播的免疫持久性及探讨母亲为 HBs Ag和HBe Ag双阳性 (乙肝双阳性 )婴儿的免疫方法。方法 :对母亲乙肝双阳性的 97例婴儿 ,按 0、1、6个月程序 ,接种国产 YDV,5 μg/次。于免疫后 9个月和 1～ 6岁每年各采血 1次 ,用 RIA法检测 HBs Ag和抗 - HBs。结果 :共有 1 2例 HBs Ag阳性儿 ,HB-s Ag阳性率、再感染率和母婴传播阻断率分别为 1 2 .37% (1 2 / 97)、3.4 1 % (3/ 88)和 85 .4 4 %。免疫后 1～ 6年的抗 - HBs(>1 0IU/ L)阳性率分别为 83.95 % (6 8/ 81 )、82 .86 % (5 8/ 70 )、71 .1 9% (4 2 / 5 9)、6 4 .2 9% (2 7/ 4 2 )、5 0 .0 0 % (1 8/ 36 )和 4 0 .0 0 % (1 4 /35 )。结论 :国产 YDV对乙型肝炎病毒母婴传播 6年内仍有较好的阻断效果 ,但保护性抗体已下降到 4 0 %。母亲乙肝双阳性的婴儿 3岁半需加强免疫 ,1岁时对抗 - HBs<30 IU/ L 的无、弱应答儿复种效果会更好。

Objective:To assess the efficacy and immunogenicity of recombinant yeast derived hepatitis B vaccine in infants born from HBsAg and HBeAg carrier mother.Methods:A total 97 neonates born from HBsAg, HBeAg positive mothers were vaccinated with 5 5,5 μg doses of recombinant yeast derived hepatitis B vaccine at 0,l,6 months schedule. They were all followed for 9, 12,24,36, 48,60,72 months after the primary vaccination,and detected for HBsAg and anti HBs with RIA method.Result:12 infants (l2.37%) become HBsAg positivel, and perinatal transmission interruption of the HBsAg positive rates, reinfection rates and perinatal trasmission rates were l2 37%, 3 4l% and 85 44%, respectively.The positive rates of anti HBs(>10 IU/L) were 83.95%,82.86%, 7l.19%, 64.29%, 50.0% and 40.0% after the primary vaccination for 1 to 6 years respectively.Conclusion:The recombinant yeast derived hepatitis B vaccine has good immunogenicity and high protective efficacy in interruption of perinatal transmission,and a booster dose seems necessary in the age of 3~4 years after vaccination.