Gilca Vladimir, De Serres Gaston, Boulianne Nicole, De Wals Philippe, Murphy Donald, Trudeau Gisele, Deceuninck Genevieve, Massé Richard, Duval Bernard
Institut national de santé publique du Québec, Laval University, Québec, Canada.
Hum Vaccin. 2010 Feb;6(2):212-8. doi: 10.4161/hv.6.2.10299. Epub 2010 Feb 11.
Little is known about the impact of low-dose hepatitis B vaccine on the persistence of anti-HBs and immune memory in school-age children. Recombivax-HB 2.5 μg (RB) has been widely used in school-age children. RB induces high seroprotectionrates, but relatively low anti-HBs titers. The main objectives of this phase of the study were to assess anti-HBs persistence and the presence of immune memory 10 years post-vaccination of 8-10 year-old children with 3 doses of RB and the persistence of anti-HBs post-booster dose administration 5 (Group A; n=250) or 10 years (Group B; n=263) post-vaccination. No significant difference was observed between GMTs and the proportion of subjects with anti-HBs titers ≥ 10 mIU/mL 5 or 10 years post-vaccination. In both groups, a 56-fold decrease of anti-HBs GMTs was observed. One month post-booster, all but two subjects in Group A had an anti-HBs titer ≥ 10 mIU/mL. A 4.9- and 11.4-fold decrease in anti-HBs GMTs were observed during the first year post-booster in Group A and B, respectively. One year post-booster, the two groups were equivalent: ≥ 98.8% of subjects had an anti-HBs ≥ 10 mIU/mL. In group A, five years post-booster, 96.8% had a titer ≥ 10 mIU/mL; the GMT was 17-fold higher than the GMT 5 years post-vaccination (p<0.0001). In both groups, there was a strong positive correlation (p<0.0001) between anti-HBs titers observed post-primary vaccination and at following study time points (r=0.70-0.90). Three doses of RB administered at the age of 8-10 years induce a 10 years long-lasting immunity in virtually all vaccinees. The booster does not appear necessary on a 10 years perspective.
关于低剂量乙型肝炎疫苗对学龄儿童抗-HBs持久性和免疫记忆的影响,人们了解甚少。重组酵母乙型肝炎疫苗2.5μg(RB)已在学龄儿童中广泛使用。RB诱导出高血清保护率,但抗-HBs滴度相对较低。本阶段研究的主要目的是评估8至10岁儿童接种3剂RB疫苗后10年的抗-HBs持久性和免疫记忆情况,以及接种疫苗后5年(A组;n = 250)或10年(B组;n = 263)加强剂量给药后的抗-HBs持久性。接种疫苗后5年或10年,两组的几何平均滴度(GMT)以及抗-HBs滴度≥10 mIU/mL的受试者比例均未观察到显著差异。两组中,抗-HBs GMT均下降了56倍。加强接种后1个月,A组除两名受试者外,所有受试者的抗-HBs滴度均≥10 mIU/mL。A组和B组在加强接种后的第一年,抗-HBs GMT分别下降了4.9倍和11.4倍。加强接种后1年,两组情况相当:≥98.8%的受试者抗-HBs≥10 mIU/mL。在A组,加强接种后5年,96.8%的受试者滴度≥10 mIU/mL;GMT比接种疫苗后5年时高17倍(p<0.0001)。两组中,初次接种疫苗后及后续研究时间点观察到的抗-HBs滴度之间均存在强正相关(p<0.0001)(r = 0.70 - 0.90)。8至10岁时接种3剂RB疫苗可在几乎所有接种者中诱导出长达10年的持久免疫力。从10年的角度来看,似乎没有必要进行加强接种。