Zhang Li, Yan Bingyu, Liu Jiaye, Lyu Jingjing, Feng Yi, Xu Aiqiang, Song Lizhi, Liang Xiaofeng, Li Li, Cui Fuqiang, Zhang Guomin, Wang Fuzhen
Expanded Program Immunization Division of Shandong Provincial Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Jinan 250014, China; Email :
Expanded Program Immunization Division of Shandong Provincial Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Jinan 250014, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2015 Dec;36(12):1372-6.
To examine the immune memory status to hepatitis B vaccine among infants with normal or high antibody response to primary vaccination, 5 years after the primary vaccination and the risk factors associated with the immune memory.
Titers of the antibody against hepatitis B surface antigen (anti-HBs) were detected, five years after the primary vaccination among children who appeared normal or high response to hepatitis B primary vaccination in infancy. Those whose anti-HBs titers were low than protective level (10 mIU/ml) were given a challenge dose of hepatitis B vaccine and titers of anti-HBs were detected 14 days after the challenge. Positive rate and geometric mean titer (GMT) of anti-HBs were calculated. Level of the anti-HBs titers after primary vaccination, at following-up and after the challenge periods were divided into different levels, respectively. Risk factors associated with the levels of anti-HBs titer after the challenge were examined by univariate analysis that and multivariable analysis.
Anti-HBs waned to the level below protective standard among 37.98% of the children with normal or high antibody response to hepatitis B primary vaccination; among those children whose anti-HBs were below the protection standard. The seroconversion rate and GMT of anti-HBs after the challenge dose were 98.95% (757/765) and 2 811.69 mIU/ml [95% Confidence Interval (CI) :2 513.55-3 145.19 mIU/ml] , respectively. Titers and levels of anti-HBs after the challenge, appeared an increase with anti-HBs after primary vaccination and the anti-HBs in the following-up (F=5.46, 10.23 respectively; P<0.000 1 for both) periods. Results from the multivariable analysis showed that gender, premature birth and birth weight were factors insignificantly associated with the anti-HBs titers after the dose of challenge, while the anti-HBs levels were independently associated with the levels of anti-HBs titer after the challenge [OR = 1.001 (95%CI: 1.000-1.002) , P<0.001; OR=1.28 (95%CI: 1.81-1.39) , P<0.001]at the following-up periods.
Strong immune memory could be found among those children with normal or high responses to hepatitis B vaccination, 5 years after the primary vaccination. The intensity of immune memory might be associated with the anti-HBs titer after primary vaccination as well as the anti-HBs titers before the challenge dose was given.
检测初次接种乙肝疫苗后抗体反应正常或高的婴儿在初次接种5年后对乙肝疫苗的免疫记忆状态，以及与免疫记忆相关的危险因素。
对婴儿期初次接种乙肝疫苗后抗体反应正常或高的儿童，在初次接种5年后检测其乙肝表面抗原抗体（抗-HBs）滴度。将抗-HBs滴度低于保护水平（10 mIU/ml）的儿童给予一剂乙肝疫苗加强免疫，并在加强免疫14天后检测抗-HBs滴度。计算抗-HBs的阳性率和几何平均滴度（GMT）。将初次接种后、随访时和加强免疫后的抗-HBs滴度水平分别分为不同等级。通过单因素分析和多因素分析检测与加强免疫后抗-HBs滴度水平相关的危险因素。
在初次接种乙肝疫苗后抗体反应正常或高的儿童中，37.98%的儿童抗-HBs降至保护标准以下；在抗-HBs低于保护标准的儿童中，加强免疫后抗-HBs的血清转化率和GMT分别为98.95%（757/765）和2811.69 mIU/ml [95%置信区间（CI）：2513.55 - 3145.19 mIU/ml]。加强免疫后抗-HBs的滴度和水平随初次接种后抗-HBs以及随访时抗-HBs的升高而升高（F分别为5.46、10.23；两者P均<0.0001）。多因素分析结果显示，性别、早产和出生体重与加强免疫后抗-HBs滴度无关，而随访时抗-HBs水平与加强免疫后抗-HBs滴度水平独立相关[比值比（OR） = 1.001（95%CI：1.000 - 1.002），P<0.001；OR = 1.28（95%CI：1.81 - 1.39），P<0.001]。
初次接种乙肝疫苗5年后，在初次接种后抗体反应正常或高的儿童中可发现较强的免疫记忆。免疫记忆的强度可能与初次接种后抗-HBs滴度以及给予加强免疫剂量前的抗-HBs滴度有关。
