Kostinov M P, Chikina E Y, Kulakova N A, Borisova V N, Magarshak O O
Vopr Virusol. 2015;60(6):9-14.
The problem of the anti-hepatitis B vaccination of patients with chronic obstructive lung disease (COPD) was discussed due to the lack of studies concerning the developing of the postvaccinal immunity, especially when vaccination is combined with the immunomodulating treatment. The data on the vaccination safety and its influence on the clinical course of COPD are also insufficient. Therefore, in this work we investigated the efficiency of the antihepatitis B vaccination in adults with chronic obstructive pulmonary disease under the treatment with the immunomodulating Affonoleikin drug. A total of 93 patients were tested including 59 patients with severe and moderate COPD (aged from 35 to 65 years). 34 of these 59 patients were vaccinated against hepatitis B (Kombioteh) according to 0-1-6 month scheme, and 25 of them were vaccinated against hepatitis B during the treatment with Affinoleikin. The control group, consisted of 34 healthy patients. Our study demonstrated good tolerance and high immune efficiency of the anti-hepatitis B vaccine. However, after the first vaccination the level of HBs-AT was below protective level in patients with COPD compared to healthy patients. Also, 64 to 70 % of patients with COPD were seronegative excluding the patients receiving the Affinoleikin treatment, whose antibody titer was protective after the first vaccine dose, but did not reach the level typical of healthy patients. After the second vaccination we detected low and medium protective antibody levels in 58.9% of patients from the 1st group, whereas 41% were seronegative. Introduction of the third vaccine-dose led to fast and significant increase in the antibody level mainly in high concentrations with 100% seroconversion in all patients. Combined antihepatitis B vaccination and Affinoleikin treatment in patients with COPD leads to faster biosynthesis of HBs- AT in protective concentrations and decrease of seronegative response, but it has no effect on frequency and type of general and local postvaccinal response.
由于缺乏关于疫苗接种后免疫发展的研究，尤其是当疫苗接种与免疫调节治疗相结合时，因此讨论了慢性阻塞性肺疾病（COPD）患者的乙肝疫苗接种问题。关于疫苗接种安全性及其对COPD临床病程影响的数据也不足。因此，在这项工作中，我们研究了在使用免疫调节药物阿夫诺利金治疗的情况下，慢性阻塞性肺疾病成年患者接种乙肝疫苗的效果。总共测试了93名患者，其中包括59名重度和中度COPD患者（年龄在35至65岁之间）。这59名患者中有34名按照0-1-6月方案接种了乙肝疫苗（Kombioteh），其中25名在使用阿夫诺利金治疗期间接种了乙肝疫苗。对照组由34名健康患者组成。我们的研究表明乙肝疫苗具有良好的耐受性和高免疫效率。然而，与健康患者相比，COPD患者首次接种疫苗后乙肝表面抗体（HBs-AT）水平低于保护水平。此外，排除接受阿夫诺利金治疗的患者（其首次接种疫苗后抗体滴度具有保护作用，但未达到健康患者的典型水平），64%至70%的COPD患者血清学呈阴性。第二次接种疫苗后，我们在第一组58.9%的患者中检测到低和中等水平的保护性抗体，而41%的患者血清学呈阴性。接种第三剂疫苗导致抗体水平快速显著升高，主要为高浓度，所有患者血清转化率达100%。COPD患者联合接种乙肝疫苗和阿夫诺利金治疗可导致保护性浓度的HBs-AT更快生物合成，并降低血清学阴性反应，但对全身和局部疫苗接种后反应的频率和类型没有影响。
