Wolters Bernd, Junge Ulrich, Dziuba Stefan, Roggendorf Michael
Institute of Virology, University of Essen, 45122 Essen, Germany.
Vaccine. 2003 Sep 8;21(25-26):3623-8. doi: 10.1016/s0264-410x(03)00399-2.
More and more elderly people travel to areas where hepatitis A and B are endemic. Their immune system is less effective than in young persons. Therefore, it has to be insured that these travelers have protective immunity after vaccination. In a retrospective study we measured anti hepatitis virus (anti-HAV) and anti-HBs in elderly persons (N = 104, mean age 54 years) after combined hepatitis A/B vaccination under every-day conditions. After complete vaccination only 36 (34.6%) had antibodies against both viruses. Only 23 (29%) of 80 vaccinees older than 40 years were protected against hepatitis B and 52 (65%) against hepatitis A. The response to the vaccination decreased with increasing age. Vaccination against hepatitis B-but not against hepatitis A-was also influenced by the presence of chronic disease. After one booster 87% of the anti-HAV negative vaccinees developed protective anti-HAV antibodies. Anti-HBs can be expected in about 50% of the HBV negative vaccinees with every single booster. These results indicate that combined hepatitis A/B vaccination is not very effective in elderly persons. After complete vaccination their anti-HAV and anti-HBs antibodies have to be controlled to insure protection. In case of vaccination-failure boosters are very effective.
越来越多的老年人前往甲型和乙型肝炎的流行地区。他们的免疫系统比年轻人的免疫系统效率更低。因此，必须确保这些旅行者在接种疫苗后具有保护性免疫力。在一项回顾性研究中，我们在日常条件下对104名老年人（平均年龄54岁）进行甲型/乙型肝炎联合疫苗接种后，检测了他们的抗肝炎病毒（抗-HAV）和抗-HBs。完全接种疫苗后，只有36人（34.6%）对两种病毒都有抗体。在80名40岁以上的接种者中，只有23人（29%）对乙型肝炎有免疫力，52人（65%）对甲型肝炎有免疫力。接种疫苗的反应随着年龄的增长而降低。接种乙型肝炎疫苗（而非甲型肝炎疫苗）还受慢性病的影响。在一次加强接种后，87%的抗-HAV阴性接种者产生了保护性抗-HAV抗体。每次加强接种后，预计约50%的HBV阴性接种者会产生抗-HBs。这些结果表明，甲型/乙型肝炎联合疫苗接种对老年人的效果不太理想。完全接种疫苗后，必须检测他们的抗-HAV和抗-HBs抗体以确保获得保护。万一接种失败，加强接种非常有效。
