Isken Leslie D, Zaaijer Hans L, van Steenbergen Jim E
Rijksinstituut voor Volksgezondheid en Milieu, Centrum Infectieziektebestrijding, Landelijke Coördinatie Infectieziektebestrijding, Bilthoven, The Netherlands.
Ned Tijdschr Geneeskd. 2009;153:A415.
To evaluate the long-term protection following hepatitis B vaccination and assess whether revaccination is necessary after 15 years for those who have an increased occupational risk of hepatitis B infection.
Systematic literature review
Medline was searched for English language publications from the period 2002-2008 concerning vaccination against the hepatitis B virus. We included follow-up studies in which the interval between vaccination and titre measurement was at least 4 years.
The 22 articles included describe 30 studies. Post-vaccination titre measurement was performed in 10 studies. Four of these described a change from negative to positive testing for anti-hepatitis B core antigen (anti-HBc) (seroconversion) in 0.64% of the 1,880 subjects tested. In the 20 studies in which no post-vaccination titre measurement was carried out, seroconversion was observed for anti-HBc and for hepatitis B surface antigens (HBsAg) in 1.0% and 1.78% of the vaccinees, respectively. These studies were predominantly carried out in high-endemic regions, mostly in newborns of HBsAg positive mothers. Seroconversions were not accompanied by clinical signs or symptoms. In 6 studies there was a follow-up of more than 15 years; the maximum was 23 years. Seroconversions did not appear specifically after a long period of time but were observed independent of time after vaccination.
Seroconversions occur in < 1% of successfully vaccinated subjects and do not increase after a period of 15 years following vaccination. In all the 23 years of experience with hepatitis B vaccination, it seems to have provided protection. This also applies to those at increased risk. Revaccination after successful vaccination would therefore not seem to be necessary, even after a period of 15 years.
评估乙肝疫苗接种后的长期保护效果，并评估对于乙肝感染职业风险增加的人群，15年后是否有必要再次接种疫苗。
系统文献综述
检索Medline中2002年至2008年期间关于乙肝病毒疫苗接种的英文出版物。我们纳入了接种疫苗与抗体滴度测量间隔至少4年的随访研究。
纳入的22篇文章描述了30项研究。10项研究进行了接种后抗体滴度测量。其中4项研究描述了在1880名检测对象中，0.64%的人抗乙肝核心抗原（抗-HBc）检测从阴性转为阳性（血清学转换）。在20项未进行接种后抗体滴度测量的研究中，分别有1.0%和1.78%的接种者出现了抗-HBc和乙肝表面抗原（HBsAg）的血清学转换。这些研究主要在高流行地区进行，大多针对HBsAg阳性母亲的新生儿。血清学转换未伴有临床体征或症状。6项研究的随访时间超过15年；最长为23年。血清学转换并非在长时间后特别出现，而是在接种疫苗后的任何时间都有观察到。
成功接种疫苗的对象中血清学转换发生率低于1%，接种后15年也未增加。在乙肝疫苗接种的23年经验中，似乎一直提供了保护。这也适用于风险增加的人群。因此，即使在15年后，成功接种疫苗后再次接种似乎也没有必要。
