Salama Iman I, Sami Samia M, Said Zeinab Nabil Ahmed, El-Sayed Manal H, El Etreby Lobna A, Rabah Thanaa M, Elmosalami Dalia M, Abdel Hamid Amany T, Salama Somaia I, Abdel Mohsen Aida M, Emam Hanaa M, Elserougy Safaa M, Hassanain Amal I, Abd Alhalim Naglaa F, Shaaban Fatma A, Hemeda Samia A, Ibrahim Nihad A, Metwally Ammal M
Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt.
World J Hepatol. 2015 Oct 8;7(22):2418-26. doi: 10.4254/wjh.v7.i22.2418.
To assess the effectiveness of hepatitis B virus (HBV) vaccination program among fully vaccinated children.
A national community based cross-sectional study was carried out in 6 governorates representing Egypt. A total of 3600 children aged from 9 mo to 16 years who were fully vaccinated with HBV vaccine during infancy were recruited. Face to face interviews were carried out and sera were evaluated for hepatitis B surface antigen (HBsAg), anti-HBV core antibodies (total) and quantitative detection of hepatitis B surface antibody using enzyme linked immunoassays techniques. Samples positive to HBsAg/anti-HBV core antibodies were subjected to quantitative HBV-DNA detection by real time polymerase chain reaction with 3.8 IU/L detection limit.
Sero-protection was detected among 2059 children (57.2%) with geometric mean titers 75.4 ± 3.6 IU/L compared to 3.1 ± 2.1 IU/L among non-seroprotected children. Multivariate logistic analysis revealed that older age and female gender were the significant predicting variables for having non sero-protective level, with adjusted odds ratio 3.3, 9.1 and 14.2 among children aged 5 to < 10, 10 to < 15 and ≥ 15 years respectively compared to those < 5 years and 1.1 among girls compared to boys with P < 0.01. HBsAg was positive in 0.11% and breakthrough infection was 0.36% and 0.39% depending on positivity of anti-HBc and DNA detection respectively. The prevalence of HBV infection was significantly higher among children aged ≥ 7 years (0.59%) compared to 0.07% among younger children with odds ratio equal to 8.4 (95%CI: 1.1-64.2) and P < 0.01.The prevalence was higher among girls (0.48%) than boys (0.29%) with P > 0.05.
The Egyptian compulsory HBV vaccination program provides adequate protection. Occult HBV infection exists among apparently healthy vaccinated children. Adherence to infection control measures is mandatory.
评估在已完成全程疫苗接种的儿童中乙肝病毒（HBV）疫苗接种计划的效果。
在代表埃及的6个省份开展了一项基于社区的全国性横断面研究。共招募了3600名在婴儿期已完成乙肝疫苗全程接种的9个月至16岁儿童。进行面对面访谈，并采用酶联免疫分析技术对血清进行乙肝表面抗原（HBsAg）、抗乙肝核心抗体（总抗体）检测以及乙肝表面抗体定量检测。对HBsAg/抗乙肝核心抗体呈阳性的样本，采用实时聚合酶链反应进行定量HBV-DNA检测，检测限为3.8 IU/L。
在2059名儿童（57.2%）中检测到血清保护，其几何平均滴度为75.4±3.6 IU/L，而未获得血清保护的儿童中该滴度为3.1±2.1 IU/L。多因素逻辑回归分析显示，年龄较大和女性性别是血清保护水平未达标的显著预测变量，5至<10岁、10至<15岁和≥15岁儿童与<5岁儿童相比，校正比值比分别为3.3、9.1和14.2，女孩与男孩相比校正比值比为1.1，P<0.01。HBsAg阳性率为0.11%，突破性感染率分别为0.36%和0.39%，取决于抗-HBc和DNA检测的阳性情况。≥7岁儿童的HBV感染患病率（0.59%）显著高于年龄较小儿童（0.07%），比值比为8.4（95%CI：1.1-64.2），P<0.01。女孩的患病率（0.48%）高于男孩（0.29%），P>0.05。
埃及的强制性乙肝疫苗接种计划提供了充分的保护。在表面健康的已接种疫苗儿童中存在隐匿性HBV感染。必须坚持感染控制措施。
