Leroy Vincent, Bourliere Marc, Durand Magali, Abergel Armand, Tran Albert, Baud Maryline, Botta-Fridlund Danielle, Gerolami André, Ouzan Denis, Halfon Philippe, Zarski Jean-Pierre
Department of Hepatogastroenterology, Grenoble, France.
Eur J Gastroenterol Hepatol. 2002 May;14(5):485-9. doi: 10.1097/00042737-200205000-00004.
The purpose of this work was to evaluate in a case-control study the immunogenicity of a recombinant hepatitis B virus (HBV) vaccine in patients with chronic hepatitis C. Seventy-seven patients with histologically proven chronic hepatitis C without cirrhosis were included in a prospective trial and matched for sex and age to 231 healthy adult subjects. Recombinant HBV vaccine was administered at a dose of 20 microg at months 0, 1 and 2. The definition of 'responder to vaccination' was anti-HBs titre > 10 mIU/ml after the three injections. Forty-nine (63.6%) chronic hepatitis C patients were responders to vaccination, compared with 217 (93.9%) controls (P < 0.0001). After the three injections, anti-HBs titres were 156 +/- 260 and 615 +/- 435 mIU/ml (P < 0.0001), respectively. Chronic hepatitis C patients who were non-responders to vaccination had significantly higher viral load than responders to vaccination. Moreover, a negative correlation was observed between viral load and anti-HBs concentration (r = -0.36, P = 0.003). No significant side effects were observed. There was no effect of vaccination on alanine aminotransferase (ALT) levels and hepatitis C virus (HCV) viral load during or after vaccination. In multivariate analysis, the main predictive factors of response to HBV vaccine were absence of anti-HCV antibodies (OR = 7.65, P < 0.0001), weight < 75 kg (OR = 1.99, P < 0.035), and age < 50 years (OR = 1.58, P < 0.082). Our results suggest that viral load seems to negatively influence the response to HBV vaccine.
这项研究的目的是在一项病例对照研究中评估重组乙型肝炎病毒（HBV）疫苗对慢性丙型肝炎患者的免疫原性。77例经组织学证实无肝硬化的慢性丙型肝炎患者被纳入一项前瞻性试验，并根据性别和年龄与231名健康成人受试者进行匹配。重组HBV疫苗在第0、1和2个月时以20微克的剂量接种。“疫苗接种应答者”的定义是三次注射后抗-HBs滴度>10 mIU/ml。49例（63.6%）慢性丙型肝炎患者为疫苗接种应答者，而对照组为217例（93.9%）（P<0.0001）。三次注射后，抗-HBs滴度分别为156±260和615±435 mIU/ml（P<0.0001）。疫苗接种无应答的慢性丙型肝炎患者的病毒载量显著高于疫苗接种应答者。此外，观察到病毒载量与抗-HBs浓度之间呈负相关（r=-0.36，P=0.003）。未观察到明显的副作用。疫苗接种期间或接种后，疫苗接种对丙氨酸转氨酶（ALT）水平和丙型肝炎病毒（HCV）病毒载量均无影响。在多变量分析中，对HBV疫苗应答的主要预测因素是无抗-HCV抗体（OR=7.65，P<0.0001）、体重<75 kg（OR=1.99，P<0.035）和年龄<50岁（OR=1.58，P<0.082）。我们的结果表明，病毒载量似乎会对HBV疫苗的应答产生负面影响。
