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乙肝疫苗接种与儿童期多发性硬化症风险

Hepatitis B vaccination and the risk of childhood-onset multiple sclerosis.

作者信息

Mikaeloff Yann, Caridade Guillaume, Rossier Mélanie, Suissa Samy, Tardieu Marc

机构信息

Assistance publique-Hôpitaux de Paris, Service de Neurologie Pédiatrique, Hôpital Bicêtre, INSERM U802, Université Paris Sud XI, 78 Avenue du Général Leclerc, 94275 Le Kremlin Bicêtre Cedex, France.

出版信息

Arch Pediatr Adolesc Med. 2007 Dec;161(12):1176-82. doi: 10.1001/archpedi.161.12.1176.

Abstract

OBJECTIVE

To investigate whether vaccination against hepatitis B (HB) increases the risk of incident multiple sclerosis (MS) in childhood in the short and long terms.

DESIGN

Case-control study.

SETTING

Population-based study conducted in France from January 1, 1994, to December 31, 2003.

PARTICIPANTS

The case patients had incident MS with onset before age 16 years. Each case was individually matched for age, sex, and geographic location (current place of residence) to 12 control participants randomly selected from the general population of France.

EXPOSURE

Hepatitis B vaccine.

MAIN OUTCOME MEASURE

The risk of MS associated with HB vaccine exposure.

RESULTS

One hundred forty-three case patients with MS were matched to 1122 control participants. The rate of HB vaccination in the 3 years before the index date was approximately 32% for both cases and controls. Vaccination against HB within the 3-year study period was not associated with an increased rate of a first episode of MS (adjusted odds ratio, 1.03; 95% confidence interval, 0.62-1.69). The rate was also not increased for HB vaccination within 6 months of the index date or at any time since birth or as a function of the number of injections or the brand of HB vaccine.

CONCLUSION

Vaccination against HB does not seem to increase the risk of a first episode of MS in childhood.

摘要

目的

探讨乙肝(HB)疫苗接种在短期和长期内是否会增加儿童患多发性硬化症(MS)的风险。

设计

病例对照研究。

背景

1994年1月1日至2003年12月31日在法国进行的基于人群的研究。

参与者

病例患者为发病年龄在16岁之前的新发MS患者。每个病例根据年龄、性别和地理位置(现居住地)与从法国普通人群中随机选取的12名对照参与者进行个体匹配。

暴露因素

乙肝疫苗。

主要观察指标

与乙肝疫苗暴露相关的MS风险。

结果

143例MS病例患者与1122名对照参与者进行了匹配。病例组和对照组在索引日期前3年的乙肝疫苗接种率均约为32%。在3年研究期内接种乙肝疫苗与MS首发率增加无关(调整后的优势比为1.03;95%置信区间为0.62 - 1.69)。在索引日期前6个月内、自出生以来的任何时间、根据注射次数或乙肝疫苗品牌接种乙肝疫苗的发生率也未增加。

结论

接种乙肝疫苗似乎不会增加儿童患MS首发的风险。

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