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随机试验评估流感嗜血杆菌 b 型和脑膜炎奈瑟菌 C 群、Y 群与破伤风类毒素结合疫苗在婴儿中的免疫原性和安全性。

Randomized trial to assess immunogenicity and safety of Haemophilus influenzae type b and Neisseria meningitidis serogroups C and Y-tetanus toxoid conjugate vaccine in infants.

机构信息

Boston University Medical Center, Boston, MA 02118, USA.

出版信息

Pediatr Infect Dis J. 2010 Jan;29(1):48-52. doi: 10.1097/INF.0b013e3181c3ce88.

Abstract

BACKGROUND

Study assessed the immunogenicity and safety of an investigational Haemophilus influenzae type b-Neisseria meningitidis serogroups C and Y-tetanus toxoid conjugate vaccine (HibMenCY-TT) in infants.

METHODS

In a single-blinded, controlled study, 609 infants were randomized 1:1 to receive primary vaccination (2, 4, and 6 months) with either HibMenCY-TT or monovalent Haemophilus influenzae type b tetanus toxoid conjugate vaccine (Hib-TT), co-administered with combined diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated poliovirus vaccine and 7-valent pneumococcal conjugate vaccine. A second control group of 3- to 5-year-old children received a single dose of licensed meningococcal ACWY polysaccharide vaccine (MPSV4). Immunogenicity was measured before and 1 month after dose 3/MPSV4 using human (hSBA) and rabbit complement bactericidal assays (rSBA) and enzyme-linked immunosorbent assay assays for IgG antibodies to MenC and MenY polysaccharides. Anti-polyribosylribitol phosphate antibody concentrations were measured 1 month after the third dose. Safety was also assessed.

RESULTS

One month after primary vaccination statistically significantly more HibMenCY-TT than Hib-TT vaccines had anti-PRP antibody concentrations > or =1.0 microg/mL (93.5% vs. 85.8%). The percentage of HibMenCY-TT recipients with hSBA titers > or =1:8 (MenC: 95.9%, MenY: 89.4%) was statistically significantly higher than for MPSV4 recipients (MenC: 30.2%, MenY: 47.5%). The percentage of subjects reporting any severe (grade 3) symptom within 4 days of each vaccination was: 11.5% (HibMenCY-TT) and 24.8% (Hib-TT) (group difference, 13.27%, 95% CI: [7.22;19.29], P < 0.001).

CONCLUSION

The investigational HibMenCY-TT vaccine was well tolerated and immunogenic in infants, induced Hib immune responses that were comparable to licensed Hib-TT vaccine, and induced high levels of bactericidal antibodies against N. meningitidis serogroups C and Y.

摘要

背景

本研究评估了一种新型 Hib 流感嗜血杆菌结合脑膜炎奈瑟菌 C 群和 Y 群-破伤风类毒素结合疫苗(HibMenCY-TT)在婴儿中的免疫原性和安全性。

方法

在一项单盲、对照研究中,609 名婴儿按 1:1 随机分组,分别接受 2、4 和 6 月龄的 HibMenCY-TT 或单价 Hib 流感嗜血杆菌结合破伤风类毒素疫苗(Hib-TT)基础免疫,同时联合使用白喉-破伤风-无细胞百日咳-乙型肝炎-灭活脊髓灰质炎疫苗和 7 价肺炎球菌结合疫苗。第三组为 3 至 5 岁儿童,给予已上市脑膜炎奈瑟菌 ACWY 多糖疫苗(MPSV4)单剂接种。在第 3 剂/MPSV4 接种前和 1 个月时,采用人血清杀菌抗体(hSBA)和兔补体杀菌抗体(rSBA)以及酶联免疫吸附试验(ELISA)检测针对 MenC 和 MenY 多糖的 IgG 抗体,1 个月后检测抗多聚核糖醇磷酸抗体浓度。同时评估安全性。

结果

基础免疫后 1 个月,HibMenCY-TT 组抗 PRP 抗体浓度≥1.0 μg/mL(93.5% vs. 85.8%)的比例显著高于 Hib-TT 组。HibMenCY-TT 组 hSBA 滴度≥1:8(MenC:95.9%,MenY:89.4%)的接种者比例显著高于 MPSV4 组(MenC:30.2%,MenY:47.5%)。每组在每次接种后 4 天内报告任何严重(3 级)症状的接种者比例分别为:11.5%(HibMenCY-TT)和 24.8%(Hib-TT)(组间差异为 13.27%,95%CI:[7.22;19.29],P<0.001)。

结论

在婴儿中,新型 HibMenCY-TT 疫苗具有良好的耐受性和免疫原性,诱导的 Hib 免疫应答与已上市 Hib-TT 疫苗相当,诱导了针对脑膜炎奈瑟菌 C 群和 Y 群的高杀菌抗体水平。

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