De Silvestri A, Avanzini M A, Terulla V, Zucca S, Polatti F, Belloni C
Divisione Neonatologia-Patologia Neonatale, IRCCS Policlinico S. Matteo Pavia, Italy.
Acta Paediatr. 2002;91(8):882-4. doi: 10.1080/080352502760148577.
Hepatitis A is a common viral infection causing substantial morbidity and mortality. The anti-hepatitis A virus (HAV) vaccination in infants would guarantee control of the infection. However, the immunogenicity of the HAV vaccine in infants could be impaired by the presence of passively acquired maternal HAV antibodies. This study evaluated the prevalence of HAV antibodies in 103 women at delivery and in their babies in the first year of life. Eighteen mothers (17.5%) had anti-HAV serum level >10 mIU ml(-1). In their infants the anti-HAV level was still positive in 11 out of 18 (61.1%) at 12 mo. Two out of 85 infants born to anti-HAV-negative mothers and anti-HAV negative at birth were found to be positive at 5 mo of age.
It is proposed that all women be screened at delivery for anti-HAV antibodies. Children born to anti-HAV-negative mothers could be vaccinated early during the first year of life, whereas vaccination could be postponed in children born to anti-HAV-positive mothers, if necessary.
甲型肝炎是一种常见的病毒感染,可导致相当高的发病率和死亡率。婴儿接种甲型肝炎病毒(HAV)疫苗可确保控制该感染。然而,母体被动获得的HAV抗体的存在可能会损害HAV疫苗在婴儿中的免疫原性。本研究评估了103名产妇及其婴儿在出生后第一年的HAV抗体流行情况。18名母亲(17.5%)的抗-HAV血清水平>10 mIU/ml。在她们的婴儿中,18名中有11名(61.1%)在12个月时抗-HAV水平仍为阳性。85名出生时母亲抗-HAV阴性且自身抗-HAV阴性的婴儿中,有2名在5个月大时被发现呈阳性。
建议在分娩时对所有女性进行抗-HAV抗体筛查。抗-HAV阴性母亲所生的儿童可在出生后第一年尽早接种疫苗,而抗-HAV阳性母亲所生的儿童如有必要可推迟接种。