阿根廷一岁儿童单剂量通用甲型肝炎免疫接种：接种疫苗后长达9年保护性抗体的高流行率

Single-dose Universal Hepatitis A Immunization in One-year-old Children in Argentina: High Prevalence of Protective Antibodies up to 9 Years After Vaccination.

作者信息

Urueña Analía, González Jorge E, Rearte Analía, Pérez Carrega María E, Calli Rogelio, Pagani María F, Uboldi Andrea, Vicentín Rosalía, Caglio Patricia, Cañero-Velasco María C, Gentile Angela, Ramonet Margarita, Vizzotti Carla

机构信息

From the *Dirección Nacional de Control de Enfermedades Inmunoprevenibles, Ministerio de Salud de la Nación, C.A.B.A., Argentina; †Laboratorio Nacional de Referencia de Hepatitis Virales, INEI-ANLIS "Dr. Carlos Malbrán", C.A.B.A., Argentina; ‡Dirección de Epidemiología del Ministerio de Salud Pública de la Provincia de Tucumán, Tucumán, Argentina; §Servicio de Gastroenterología. Hospital del Niño Jesús de Tucumán, Tucumán, Argentina; ¶Programa Ampliado de Inmunizaciones, Ministerio de Salud de la Provincia de Santa Fe, Santa Fe, Argentina; ‖Servicio de Gastroenterología, Hospital de Niños Dr. Orlando Alassia, Santa Fe, Argentina; **Hospital Nacional Prof. Dr. Alejandro Posadas, Provincia de Buenos Aires, Argentina; ††Hospital de Niños de San Justo, Provincia de Buenos Aires, Argentina; ‡‡Hospital de Niños Ricardo Gutiérrez, C.A.B.A. Argentina; and §§Comisión Nacional de Hepatología, Sociedad Argentina de pediatría, C.A.B.A., Argentina.

出版信息

Pediatr Infect Dis J. 2016 Dec;35(12):1339-1342. doi: 10.1097/INF.0000000000001322.

DOI:10.1097/INF.0000000000001322

PMID:27636725

Abstract

BACKGROUND

Single-dose hepatitis A virus (HAV) vaccination was implemented in all Argentinean children 12 months of age in 2005. Previous studies demonstrated high prevalence of protective antibody response 4 years after single-dose vaccination. This study assessed long-term seroprotection against HAV after vaccination.

METHODS

Children who received 1 dose of HAV vaccine at 1 year of age at least 6 years before enrollment were included at 5 centers in Argentina between 2013 and 2014. Demographic and socioeconomic characteristics were collected through a questionnaire. Blood samples were tested for anti-HAV antibodies. Antibody values ≥10 mIU/mL were considered seroprotective. Logistic regression analysis was performed to evaluate the association between demographic and socioeconomic variables and seroprotection.

RESULTS

A total of 1088 children were included, with a median postvaccination interval of 7.7 years (range 6.3-9.2 years). Of these children, 97.4% (95% confidence interval: 96.3%-98.3%) had protective antibodies against HAV. No association between demographic or socioeconomic variables and seroprotection was found. Geometric mean concentration of antibody levels against HAV was 170.5 mUI/mL (95% confidence interval: 163.2-178.2 mUI/mL).

CONCLUSIONS

Single-dose universal hepatitis A immunization in 1-year-old children resulted in sustained immunologic protection for up to 9 years in Argentina. These findings, along with the low current disease burden, confirm the success of the intervention.

摘要

背景

2005年，阿根廷所有12个月大的儿童都接种了单剂量甲型肝炎病毒（HAV）疫苗。先前的研究表明，单剂量疫苗接种4年后保护性抗体反应的患病率很高。本研究评估了接种疫苗后对HAV的长期血清保护作用。

方法

2013年至2014年期间，在阿根廷的5个中心纳入了至少在入组前6年1岁时接种过1剂HAV疫苗的儿童。通过问卷调查收集人口统计学和社会经济特征。检测血样中的抗HAV抗体。抗体值≥10 mIU/mL被认为具有血清保护作用。进行逻辑回归分析以评估人口统计学和社会经济变量与血清保护之间的关联。

结果

共纳入1088名儿童，接种疫苗后的中位间隔时间为7.7年（范围6.3 - 9.2年）。在这些儿童中，97.4%（95%置信区间：96.3% - 98.3%）具有抗HAV的保护性抗体。未发现人口统计学或社会经济变量与血清保护之间存在关联。抗HAV抗体水平的几何平均浓度为170.5 mUI/mL（95%置信区间：163.2 - 178.2 mUI/mL）。