Department of Family Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey.
Eur J Pediatr. 2012 Dec;171(12):1761-6. doi: 10.1007/s00431-012-1815-4. Epub 2012 Aug 16.
Neonatal vaccination against hepatitis B virus (HBV) infection was launched in 1998 in Turkey. The aim was to evaluate the persistence of seroprotection after HBV vaccination in order to determine the necessity of a single booster dose in 2- to 12-year-old children. This study was conducted retrospectively using hospital records of the children aged 2-12 years old who attended the pediatric outpatient clinics of Diskapi Training and Research Hospital, Ankara, Turkey between January 2010 and June 2011. Children who had received three doses of HBV vaccination in their infancy were included. A total of 530 children enrolled into the study, and 352 (66.4 %) of them had protective antibody to hepatitis surface antigens (anti-HBs) titer greater than 10 mIU/ml. The proportions of children with low, intermediate, and high anti-HB titers are different for those under 3 years of age. The majority were in the intermediate category. Those aged 4-10 years and 11 or older represented two-thirds of the children with high titers (p = 0.000). None of the children had chronic HBV infection. Unprotected children responded well after receiving the booster dose. The mean anti-HB concentration after the booster dose was more than 200 times higher than the mean antibody concentration before (p < 0.001).
Our data suggest that HBV vaccination may confer long-term immunity. Use of routine booster doses of vaccine at these ages does not appear necessary to maintain long-term protection in successfully vaccinated immunocompetent children in the region.
评估乙型肝炎病毒(HBV)疫苗接种后血清保护力的持久性,以确定 2 至 12 岁儿童是否需要单剂加强免疫。
本研究采用回顾性研究方法,分析了 2010 年 1 月至 2011 年 6 月期间在土耳其安卡拉 Diskapi 培训与研究医院儿科门诊就诊的 2 至 12 岁儿童的病历资料。入选标准为婴幼儿期接种过 3 剂 HBV 疫苗的儿童。
共纳入 530 例儿童,其中 352 例(66.4%)儿童乙型肝炎表面抗原抗体(抗-HBs)滴度大于 10 mIU/ml。不同年龄组儿童低、中、高抗-HB 滴度的比例不同,<3 岁者以中滴度为主,4~10 岁和≥11 岁者高滴度者占 2/3(p=0.000)。无慢性 HBV 感染者。加强免疫后,未保护者抗体应答良好。加强免疫后平均抗-HB 浓度较免疫前升高 200 倍以上(p<0.001)。
本研究数据提示 HBV 疫苗接种可产生长期免疫。在该地区,成功接种疫苗的免疫功能正常儿童可能无需在这些年龄段常规使用疫苗加强免疫来维持长期保护。