Avazova Dildora, Kurbanov Fuat, Tanaka Yasuhito, Sugiyama Masaya, Radchenko Ivan, Ruziev Dilmurod, Musabaev Erkin, Mizokami Masashi
National Reference Laboratory, Ministry of Public Health, Tashkent, Uzbekistan.
J Med Virol. 2008 Feb;80(2):217-24. doi: 10.1002/jmv.21035.
A national program of universal vaccination for the prevention of chronic hepatitis B virus (HBV) infection was launched in Uzbekistan since 1998. To evaluate the 6 years' outcome of the program, 567 children were enrolled in the study. Among those enrolled, 333 had immunized with adw2 type based Engerix-B (Glaxo Smith Kline Beechem, Rixensart, Belgium) and 48 with adr type based Hepavax-Gene (Green Cross Vaccine Corporation, Korea). A cohort of 186 children born before the immunization program, was also included in the study. When 45 vaccinated children were compared to age/sex-matched 45 unvaccinated children, the sero-prevalence of HBsAg was 0 versus 11% (P = 0.56), and of anti-HBc was 0% versus 44% (P < 0.0001), respectively. Loss of anti-HBs was observed in 18.4% after 5 years. Among 13 HBsAg carriers found in this study, genotype HBV/D was found in 69%, HBV/A in 23% (all in unvaccinated group) and HBV/C in 8% (in vaccinated group). No significant differences were observed in this study between groups which received different vaccine formulation. Phylogenetic analysis of the HBV isolates obtained from family members of the HBsAg-positive children, revealed evidence suggesting that transmission in the vaccinated group was exclusively perinatal, whereas in the unvaccinated group horizontal transmission pattern predominated. In conclusion, HBV universal vaccination is efficient in Uzbekistan irrespective of the vaccine formulation used, because the horizontal transmission pattern predominates currently in this endemic region.
自1998年起，乌兹别克斯坦启动了一项预防慢性乙型肝炎病毒（HBV）感染的全国性普遍疫苗接种计划。为评估该计划6年的实施效果，567名儿童参与了此项研究。在这些参与者中，333人接种了基于adw2型的安在时（葛兰素史克生物制品公司，比利时里克森萨特），48人接种了基于adr型的希必信（绿十字疫苗公司，韩国）。一组186名在免疫计划实施前出生的儿童也被纳入研究。当将45名接种疫苗的儿童与年龄/性别匹配的45名未接种疫苗的儿童进行比较时，HBsAg的血清流行率分别为0%和11%（P = 0.56），抗-HBc的血清流行率分别为0%和44%（P < 0.0001）。5年后观察到18.4%的人抗-HBs消失。在本研究中发现的13名HBsAg携带者中，69%为HBV/D基因型，23%为HBV/A基因型（均在未接种疫苗组），8%为HBV/C基因型（在接种疫苗组）。本研究中接受不同疫苗制剂的组间未观察到显著差异。对从HBsAg阳性儿童家庭成员中获得的HBV分离株进行系统发育分析，结果表明接种疫苗组的传播方式仅为围产期传播，而未接种疫苗组以水平传播方式为主。总之，在乌兹别克斯坦，无论使用何种疫苗制剂，普遍接种HBV疫苗都是有效的，因为目前在这个流行地区水平传播方式占主导。
