[婴儿期接种过疫苗的青少年仍对乙型肝炎有免疫力吗？]

[Are teenagers immunized in infancy still protected against hepatitis B?].

作者信息

Pokorska-Lis Maria, Marczyńska Magdalena

机构信息

Klinika Chorób Zakaźnych Wieku Dzieclecego, Warszawskiego Uniwersytetu Medycznego, Wojewódzki Szpital Zakaźny w Warszawie, Kierownik Kliniki.

出版信息

Przegl Lek. 2010;67(1):13-7.

PMID:20509565

Abstract

BACKGROUND

Immunization is the best method of protection against hepatitis B. Routine vaccination for newborns and infants was introduced in Poland in 1994-96. Although duration of protection afforded by vaccination remains unknown, no routine boosters are recommended. According to references, up to 50% of 15-year old children had lost the post vaccination immune memory protecting against HBV infection. The aim of the study was to determine the immunity against hepatitis B in 10-12-year old children and to establish indications for routine booster doses.

MATERIAL AND METHODS

In 130 children aged 10-12 years, immunized against hepatitis B with recombinant vaccine in infancy (10 microg, according to schedule: 0-1-2-12 months, first dose given at birth) humoral immunity (anti-HBs antibodies) as well as cellular memory (anamnestic response to booster given in children without protective titers of anti-HBs) were determined. Titers of anti-HBs > or = 10 IU/l were considered protective. Anamnestic response was defined as increase in anti-HBs concentration from < 10 IU/l to > or = 10 IU/l 4 weeks after receiving a booster dose. MARKERS OF HBV INFECTION: hepatitis B surface antigen (HBsAg - marker of chronic hepatitis) and antibodies to core antigen (anti-HBc--marker of past HBV infection) were additionally determined.

RESULTS

Protective level of anti-HBs was found in 102/130 (78%) children, including 43/130 (33%) with high (100-999 IU/l) and 16/130 (12%) with very high (> or = 1000 IU/l) titers. 28/ 130 (22%) did not have protective level of anti-HBs, in 9/130 (7%) antibodies were undetectable. Immune memory was determined in 9 children--anamnestic response was revealed in eight of them (89%). In 6/130 (4.5%) of participants HBV infection was confirmed according to positive anti-HBc, including 2 (1.5% of the study group) with positive HBsAg.

CONCLUSIONS

Most children in the studied group had seroprotection and immune memory against hepatitis B 10-12 years after vaccination. No routine booster seems to be necessary.

摘要

背景

免疫接种是预防乙型肝炎的最佳方法。波兰于1994 - 1996年开始对新生儿和婴儿进行常规疫苗接种。尽管疫苗提供的保护持续时间尚不清楚，但不建议进行常规加强免疫。根据参考文献，高达50%的15岁儿童已失去预防HBV感染的疫苗接种后免疫记忆。本研究的目的是确定10 - 12岁儿童对乙型肝炎的免疫力，并确定常规加强剂量的指征。

材料与方法

对130名10 - 12岁儿童进行研究，这些儿童在婴儿期接种了重组乙型肝炎疫苗（10微克，按照0 - 1 - 2 - 12个月的程序接种，第一剂在出生时接种），测定其体液免疫（抗-HBs抗体）以及细胞记忆（对无抗-HBs保护性滴度的儿童接种加强剂后的回忆反应）。抗-HBs滴度>或=10 IU/l被认为具有保护性。回忆反应定义为接种加强剂4周后抗-HBs浓度从<10 IU/l增加到>或=10 IU/l。HBV感染标志物：还测定了乙型肝炎表面抗原（HBsAg - 慢性肝炎标志物）和核心抗原抗体（抗-HBc - 既往HBV感染标志物）。

结果

102/130（78%）名儿童的抗-HBs水平具有保护性，其中43/130（33%）的滴度较高（100 - 999 IU/l），16/130（12%）的滴度非常高（>或=1000 IU/l）。28/130（22%）的儿童抗-HBs水平不具有保护性，9/130（7%）未检测到抗体。对9名儿童进行了免疫记忆测定，其中8名（89%）出现了回忆反应。6/130（4.5%）的参与者根据抗-HBc阳性确诊为HBV感染，其中2名（研究组的1.5%）HBsAg阳性。