Allegra V, Vasile A, Maschio M, Mengozzi G
Servizio Emodialisi, Ospedale di Palmanova, USL no. 8 Bassa Friulana, Regione Friuli-Venezia Giulia, Italy.
Nephron. 1992;61(3):339-40. doi: 10.1159/000186932.
We evaluated anti-HBs titers 2 months after vaccination with recombinant hepatitis surface antigen (rDNA-HBsAg) in 43 maintenance hemodialysis patients (MHP). Of these, 34 had not undergone hepatitis B virus vaccination previously (NV-MHP) and 9 had shown negative response to vaccination with plasma-derived HBsAg (HEVAC Pasteur; V-MHP). 120 healthy workers from the same hospital undergoing rDNA-HBsAg immunization were used as controls. All low responders (LR) (anti-HBs less than 100 mIU/ml) and nonresponders (NR; anti-HBs less than 10 mIU/ml) were given a booster dose 3 months after the last dose of vaccine. Seroconversion rates were lower in NV-MHP (52.9%) than in controls (98.4%). V-MHP showed higher seroconversion rates (88.9%) than NV-MHP. In each group, the number of responders (R; anti-HBs greater than or equal to 100 mIU/ml), LR and NR was as follows: controls 101, 17, 2; NV-MHP 6, 12, 16; V-MHP 8, 0, 1. After booster dose, 17/17 controls LR and no NV-MHP LR showed a rise in anti-HBs titers over 100 mIU/ml. Six months after the last dose of vaccine or the booster dose, anti-HBs titer fell under 10 mIU/ml in 4/12 MHP LR and under 100 mIU/ml in 6/14 MHP R. To achieve high seroconversion rates and to avoid the decline of anti-HBs to nonprotective titers in MHP, a booster injection should be made at different dates after the first vaccination.
我们评估了43例维持性血液透析患者（MHP）接种重组乙肝表面抗原（rDNA-HBsAg）疫苗2个月后的抗-HBs滴度。其中，34例此前未接种过乙肝疫苗（NV-MHP），9例对血浆源性HBsAg（巴斯德重组乙肝疫苗；V-MHP）接种显示阴性反应。将同一医院120名接受rDNA-HBsAg免疫的健康工作人员作为对照。所有低应答者（LR）（抗-HBs低于100 mIU/ml）和无应答者（NR；抗-HBs低于10 mIU/ml）在最后一剂疫苗接种后3个月给予加强剂量。NV-MHP的血清转化率（52.9%）低于对照组（98.4%）。V-MHP的血清转化率（88.9%）高于NV-MHP。每组中，应答者（R；抗-HBs大于或等于100 mIU/ml）、LR和NR的数量如下：对照组101例、17例、2例；NV-MHP 6例、12例、16例；V-MHP 8例、0例、1例。加强剂量后，17/17例对照组LR和无NV-MHP LR的抗-HBs滴度升至100 mIU/ml以上。在最后一剂疫苗或加强剂量接种6个月后，4/12例MHP LR的抗-HBs滴度降至10 mIU/ml以下，6/14例MHP R的抗-HBs滴度降至100 mIU/ml以下。为在MHP中实现高血清转化率并避免抗-HBs降至非保护性滴度，应在首次接种后的不同日期进行加强注射。
