Sharma Rajiv, Ahlm Clas, Ostergaard Lars, Dowell Anthony, Tran Clément, Thomas Stéphane, Eymin Cécile
a Sea Road Surgery; Bexhill-on-Sea , East Sussex , UK.
Hum Vaccin Immunother. 2015;11(7):1709-16. doi: 10.1080/21645515.2015.1019187.
Hepatitis B vaccines do not generate protective immune responses in older adults as effectively as they do in children and young adults. Improved formulations of existing vaccines may have the potential to improve this. This study investigated the persistence of serum antibodies against hepatitis B surface antigens (anti-HBs) 3.1-3.5 years following primary vaccination with 3 doses of HBvaxPRO® or Engerix B™ in healthy adults aged ≥ 50 years who were further challenged with 1 dose of recombinant hepatitis B antigen. This was an open-label extension study. Individuals (N = 204) with a mean (standard deviation) age at enrollment of 63.7 (7.0) years receiving HBvaxPRO® or Engerix B™ in a randomized, double-blind primary study were challenged with 1 dose of HBvaxPRO® (10 μg). Anti-HBs were measured pre- and 30 days post-challenge. 45.5% (34.8, 56.4 [95% CI]) of individuals who received HBvaxPRO® in the per protocol set (PPS) had anti-HBs titers ≥ 10 mIU/mL pre-challenge and 85.2% (76.1, 91.9) 1-month post-challenge. In those who received Engerix B™ in the primary vaccination series, the results were 58.8% (48.6, 68.5) and 88.3% (80.5, 93.8), respectively. The challenge dose of HBvaxPRO® was generally well tolerated. Subjects aged ≥ 50 years receiving a challenge dose of HBvaxPRO® demonstrated immune memory against hepatitis B 3 years after a 3-dose primary. The safety profile of this challenge dose of HBvaxPRO® was consistent with the well-established safety profile of the vaccine HBvaxPRO®.
乙肝疫苗在老年人中产生保护性免疫反应的效果不如在儿童和年轻人中显著。现有疫苗的改进配方可能有潜力改善这一情况。本研究调查了年龄≥50岁的健康成年人在接种3剂HBvaxPRO®或Engerix B™进行初次疫苗接种后3.1 - 3.5年,血清中抗乙肝表面抗原(抗-HBs)抗体的持久性,这些成年人随后又接受了1剂重组乙肝抗原的激发。这是一项开放标签扩展研究。在一项随机、双盲的初次研究中接受HBvaxPRO®或Engerix B™的204名个体(入组时平均年龄为63.7[7.0]岁)接受了1剂HBvaxPRO®(10μg)的激发。在激发前和激发后30天测量抗-HBs。在符合方案集(PPS)中接受HBvaxPRO®的个体中,45.5%(34.8,56.4[95%CI])在激发前抗-HBs滴度≥10 mIU/mL,激发后1个月为85.2%(76.1,91.9)。在初次疫苗接种系列中接受Engerix B™的个体中,相应结果分别为58.8%(48.6,68.5)和88.3%(80.5,93.8)。HBvaxPRO®的激发剂量总体耐受性良好。年龄≥50岁接受HBvaxPRO®激发剂量的受试者在3剂初次接种3年后表现出对乙肝的免疫记忆。HBvaxPRO®这一激发剂量的安全性与已确立的HBvaxPRO®疫苗安全性一致。