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肝炎免疫接种的进展(A、B、E):公共卫生政策和新型疫苗输送。

Advances in hepatitis immunization (A, B, E): public health policy and novel vaccine delivery.

机构信息

Viral Hepatitis Prevention Board, Centre for the Evaluation of Vaccination, Vaccine & Infectious Diseases Institute, University of Antwerp, Antwerpen, Belgium.

出版信息

Curr Opin Infect Dis. 2012 Oct;25(5):578-83. doi: 10.1097/QCO.0b013e328357e65c.

Abstract

PURPOSE OF REVIEW

This review offers an update on hepatitis A, B and E vaccines based on relevant literature published in 2011-2012. Hepatitis A and B vaccines have been commercially available for years; however, the development of the hepatitis E vaccine is still facing some challenges.

RECENT FINDINGS

Current scientific evidence shows that both hepatitis A and B vaccines confer long-term protection. These data supported the updated recommendations from the WHO on hepatitis A and B vaccines and the respective booster policy. In addition, a single-dose hepatitis A vaccination programme may be an option for some intermediate endemic countries, as far as the epidemiological situation is further monitored. Recent data illustrate the co-administration of hepatitis A with infant vaccines, as well as the interchangeability with other hepatitis A vaccines. Two genetically engineered hepatitis E vaccines are currently in development, showing more than 95% protective efficacy.

SUMMARY

Follow-up of vaccinated individuals confirms the long-term protection offered by the hepatitis A as well as hepatitis B vaccines. Data confirm the safety and immunogenicity profile of both vaccines, also when used in patient groups. The first data on the hepatitis E vaccine look promising, but questions on cross-protection, long-term efficacy and safety and immunogenicity in pregnant women and children less than 2 years remain unanswered.

摘要

目的综述

本文基于 2011-2012 年发表的相关文献,就甲型、乙型和戊型肝炎疫苗更新作一综述。甲肝和乙肝疫苗已上市多年,而戊型肝炎疫苗的研发仍面临诸多挑战。

最近发现

现有科学证据表明,甲肝和乙肝疫苗均可提供长期保护。这些数据支持世卫组织对甲肝和乙肝疫苗的最新建议以及相应的加强针政策。此外,在进一步监测流行病学情况的前提下,对于某些中度流行国家,单剂甲肝疫苗接种方案可能是一种选择。最近的数据表明,甲肝疫苗可与婴幼儿疫苗联合使用,并且与其他甲肝疫苗可互换。目前正在开发两种基因工程戊型肝炎疫苗,其保护效力均超过 95%。

总结

对疫苗接种者的随访证实了甲肝和乙肝疫苗可提供长期保护。数据证实了这两种疫苗的安全性和免疫原性,即使在患者群体中使用也是如此。戊型肝炎疫苗的首批数据令人鼓舞,但关于交叉保护、长期疗效和安全性以及孕妇和 2 岁以下儿童的免疫原性等问题仍未得到解答。

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