Centre Hospitalier Intercommunal de Créteil, France.
Adv Ther. 2010 Jan;27(1):28-38. doi: 10.1007/s12325-010-0005-x. Epub 2010 Feb 25.
The World Health Organization (WHO) recommends universal infant hepatitis B virus (HBV) vaccination as the most effective preventive measure against HBV-induced disease in endemic areas. More than 160 countries have followed the WHO recommendations to incorporate HBV vaccination in their national infant immunization programs. While antibodies to hepatitis B surface antigen (anti-HBs) concentrations progressively decrease following vaccination in infancy, protection persists, probably due to lasting immune memory. Hence, it is thought that future exposure to wild-type virus or HBV vaccine will induce a protective secondary immune response.
Children aged 7-8 years old who had been vaccinated in infancy with a hexavalent DTacP-IPV-HB-Hib vaccine (Hexavac(R); Sanofi Pasteur MSD, Lyon, France) and children aged 7-9 years vaccinated in infancy with a DT-HB vaccine (Primavax(R); Sanofi Pasteur MSD), whose anti-HBs concentrations had fallen below the seroprotective threshold of 10 mIU/mL at age 4.5-6 years, received a challenge dose of monovalent HBV vaccine (HBVAXPRO(R); Sanofi Pasteur MSD) to assess persistence of protection.
One month postchallenge, 54 of 61 (88.5%) Hexavac-primed seronegative children and 34 of 40 (85.0%) Primavax-primed seronegative children had anti-HBs concentrations > or =10 mIU/mL. The percentage of protected children would have been even higher if the children who still had protective antibody levels (who were not included in this challenge study) had been assessed (42.1% with Hexavac, 55.4% with Primavax).
Vaccination with a HBV-containing multivalent vaccine during infancy induces a lasting immune memory that can be boosted, even in children with a decline in anti-HBs concentrations. The present results confirm that the full primary vaccination schedule in infancy seems to confer long-term protection via immune memory and that an additional HBV dose is not generally required.
世界卫生组织（WHO）建议在流行地区普遍为婴儿接种乙型肝炎病毒（HBV）疫苗，这是预防 HBV 感染性疾病的最有效措施。已有 160 多个国家遵循世卫组织的建议，将 HBV 疫苗纳入国家婴儿免疫计划。尽管婴儿期接种乙肝疫苗后，乙型肝炎表面抗原（抗-HBs）抗体浓度逐渐下降，但仍具有保护作用，这可能是由于持续的免疫记忆。因此，人们认为未来接触野生型病毒或 HBV 疫苗会引发保护性的二次免疫反应。
7-8 岁的儿童曾在婴儿期接种过六价 DTacP-IPV-HB-Hib 疫苗（Hexavac（R）；赛诺菲巴斯德，里昂，法国）和 7-9 岁的儿童曾在婴儿期接种过二价 DT-HB 疫苗（Primavax（R）；赛诺菲巴斯德），他们在 4.5-6 岁时的抗-HBs 浓度已降至 10mIU/ml 的血清保护阈值以下，随后接受了单剂量 HBV 疫苗（HBVAXPRO（R）；赛诺菲巴斯德）的挑战剂量，以评估保护的持续性。
在接种挑战疫苗后 1 个月，54 名 Hexavac 疫苗接种后血清学阴性的儿童和 34 名 Primavax 疫苗接种后血清学阴性的儿童的抗-HBs 浓度>或=10mIU/ml。如果评估那些仍具有保护性抗体水平的儿童（这些儿童未纳入本次挑战研究），则保护儿童的百分比会更高（Hexavac 组为 42.1%，Primavax 组为 55.4%）。
在婴儿期接种含 HBV 的多价疫苗可诱导持久的免疫记忆，即使在抗-HBs 浓度下降的儿童中也可增强免疫记忆。目前的结果证实，婴儿期全程基础免疫接种方案似乎通过免疫记忆提供长期保护，通常不需要额外的 HBV 剂量。
