Gouvêa Aída de Fátima Thomé Barbosa, Pinto Maria Isabel de Moraes, Miyamoto Maristela, Machado Daisy Maria, Pessoa Silvana Duarte, Carmo Fabiana Bononi do, Beltrão Suênia Cordeiro de Vasconcelos, Succi Regina Célia de Menezes
Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM/Unifesp), São Paulo, SP, Brasil.
Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM/Unifesp), São Paulo, SP, Brasil.
Rev Paul Pediatr. 2015 Apr-Jun;33(2):142-9. doi: 10.1016/j.rpped.2014.09.005. Epub 2015 Mar 28.
: To assess possible factors associated with the loss of antibodies to hepatitis A 7 years after the primary immunization in children of HIV-infected mothers and the response to revaccination in patients seronegative for hepatitis A.
: Quantification of HAV antibodies by electrochemiluminescence was performed in 39 adolescents followed up at the Pediatric Aids Clinic of Federal University of São Paulo (Unifesp): 29 HIV-infected (HIV group) (median age: 12.8 years) and 10 HIV-exposed but non-infected (ENI group) (median age: 13.4 years). All of them received two doses of HAV vaccine (Havrix in 2002.
: The median age at primary immunization (PI) was 5.4 years for HIV group and 6.5 years for ENI group. All children, from both groups, had antibodies to HAV >20 mIU/mL after PI. Seven years later, the ENI group showed a median concentration of antibodies = 253.5 mIU/mL, while the HIV group = 113.0 mIU/mL (Mann-Whitney test, =0.085). All ENI group and 23/29 (79.3%) from HIV group mantained HAV antibodies 7 years after PI. The levels of hepatitis A antibodies in the primary vaccination were the only factor independently associated with maintaining these antibodies for 7 years. The group that lost HAV seropositivity was revaccinated and 83.3% (5/6) responded with antibodies >20 mUI/mL.
: The antibodies levels acquired in the primary vaccination in the HIV group were the main factor associated with antibodies loss after HAV immunization.
评估感染人类免疫缺陷病毒（HIV）母亲的儿童在初次免疫7年后甲型肝炎抗体丧失的可能相关因素，以及甲型肝炎血清阴性患者再次接种疫苗的反应。
对圣保罗联邦大学（Unifesp）儿科艾滋病诊所随访的39名青少年进行电化学发光法定量检测甲型肝炎病毒（HAV）抗体：29名HIV感染儿童（HIV组）（中位年龄：12.8岁）和10名HIV暴露但未感染儿童（ENI组）（中位年龄：13.4岁）。他们均于2002年接种了两剂HAV疫苗（Havrix）。
HIV组初次免疫（PI）的中位年龄为5.4岁，ENI组为6.5岁。两组所有儿童在PI后抗HAV抗体均>20 mIU/mL。7年后，ENI组抗体中位浓度 = 253.5 mIU/mL，而HIV组 = 113.0 mIU/mL（Mann-Whitney检验，P = 0.085）。PI后7年，所有ENI组儿童及HIV组23/29（79.3%）儿童仍保持抗HAV抗体。初次接种时甲型肝炎抗体水平是与这些抗体维持7年独立相关的唯一因素。抗HAV血清阳性转阴的组再次接种疫苗，83.3%（5/6）的人抗体反应>20 mUI/mL。
HIV组初次接种疫苗时获得的抗体水平是HAV免疫后抗体丧失的主要相关因素。
