Tolosa Martínez N, Tenías Burillo J M, Pérez Bermúdez B, Bautista Sanchis Alvarez J
Sección de Medicina Preventiva y Salud Pública, Hospital Universitario Dr. Peset, Valencia.
Rev Esp Salud Publica. 1998 Nov-Dec;72(6):509-15.
The recombinant hepatitis B vaccine provides immunity in approximately 95% of all cases, but there is a certain percentage which responds insufficiently. The purpose of this work consists of assessing the factors which are linked to an inadequate immune response.
This is an observational, analytical study in which a retrospective follow-up is made of a group of subjects vaccinated to prevent against hepatitis B (HBV). The variables of interest of the health care personnel meeting the requirements to be included in this study in Health Care District No. 9 of the Autonomous Region of Valencia (No. 827) were gathered. Following vaccination, the titration of surface antibodies (antiHB's) was determined for checking the response, levels of over 10 m UI/ml being considered to provide protection.
An adequate serum changeover was achieved in 94.4% of those vaccinated. The low-degree or zero response to the vaccine was significantly linked independently to variables such as male gender, age, the body mass index (BMI) and the habit of smoking. Drinking alcohol and the levels of GPT, although they did not react significantly with the response to the vaccine, were possibly misleading factors.
The immunogenicity of this vaccine is satisfactory. It is important to quantify the levels of antiHB's, especially when factors predicting a poor response are involved. Therefore, it is possible to identify those which require a booster shot and those showing no response, hence avoiding situations involving a false sense of being protected against HBV.
重组乙肝疫苗在约95%的病例中可产生免疫效果，但仍有一定比例的人反应不足。本研究旨在评估与免疫反应不足相关的因素。
这是一项观察性分析研究，对一组接种乙肝疫苗的受试者进行回顾性随访。收集了瓦伦西亚自治区第9医疗保健区（第827号）符合纳入本研究要求的医护人员的相关变量。接种疫苗后，测定表面抗体（抗-HBs）滴度以检查免疫反应，抗-HBs水平超过10 mIU/ml被认为具有保护作用。
94.4%的接种者实现了足够的血清转换。疫苗低度或无反应与男性性别、年龄、体重指数（BMI）和吸烟习惯等变量独立相关。饮酒和谷丙转氨酶（GPT）水平虽然与疫苗反应无显著相关性，但可能是误导因素。
该疫苗的免疫原性令人满意。量化抗-HBs水平很重要，尤其是在涉及预测反应不佳的因素时。因此，可以识别出那些需要加强注射的人和无反应者，从而避免出现对乙肝病毒有保护作用的错误认知情况。
