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12至13岁青少年在婴儿期曾接种4剂六价白百破-乙肝-脊灰- Hib疫苗后对乙肝具有持久的免疫记忆。

Lasting immune memory against hepatitis B in 12-13-year-old adolescents previously vaccinated with 4 doses of hexavalent DTPa-HBV-IPV/Hib vaccine in infancy.

作者信息

Behre Ulrich, Van Der Meeren Olivier, Crasta Priya, Hanssens Linda, Mesaros Narcisa

机构信息

a Pediatric Practice , Kehl , Baden-Württemberg , Germany.

b GSK Vaccines , Wavre , Belgium.

出版信息

Hum Vaccin Immunother. 2016 Nov;12(11):2916-2920. doi: 10.1080/21645515.2016.1202388. Epub 2016 Sep 21.

Abstract

BACKGROUND

Vaccinating infants against hepatitis B virus (HBV) is the most effective way of preventing the disease. However, since HBV exposure can increase during adolescence, it is essential that antibody persistence is maintained. We evaluated the antibody persistence and immune memory against hepatitis B, in 12-13 y olds who had received complete primary + booster vaccination with diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated poliovirus/Haemophilus influenza type b (DTPa-HBV-IPV/Hib) vaccine in infancy.

METHODS

Open phase-IV study conducted at 12 centers in Germany [NCT02052661]. Adolescents aged 12-13 y, vaccinated with 4 doses of DTPa-HBV-IPV/Hib (Infanrix hexa™, GSK Vaccines) in infancy, received a single challenge dose of monovalent pediatric hepatitis B vaccine (Engerix™-B Kinder; GSK Vaccines). Blood samples were taken before and 1-month post-challenge to measure anti-hepatitis B (anti-HBs) antibodies using a chemiluminescence immunoassay (seroprotection cut-off: ≥10 mIU/ml). Post-challenge adverse events (AEs) were monitored.

RESULTS

300 subjects were vaccinated; of 293 subjects in the ATP immunogenicity cohort, 60.5% had pre-challenge anti-HBs antibodies ≥10 mIU/ml, which rose to 97.6% post-challenge (≥100 mIU/ml in 94.1%). An anamnestic response was seen in 96.5% subjects. A 150-fold increase in antibody geometric mean concentrations was observed (22.4 to 3502.6 mIU/ml). Pain (44%) and fatigue (24.3%) were the most frequent solicited local and general AEs, respectively; 14.7% subjects reported unsolicited symptoms during the 31-day post-vaccination period. Two vaccine-unrelated serious AEs occurred.

CONCLUSION

Vaccination with DTPa-HBV-IPV/Hib in infancy induces sustained seroprotection and immune memory against HBV, as shown by the strong anamnestic response to the hepatitis B vaccine challenge in 12-13 year-old adolescents.

摘要

背景

给婴儿接种乙型肝炎病毒(HBV)疫苗是预防该疾病的最有效方法。然而,由于青春期期间HBV暴露可能增加,维持抗体持久性至关重要。我们评估了在婴儿期接受白喉-破伤风-无细胞百日咳-乙型肝炎-灭活脊髓灰质炎病毒/ b型流感嗜血杆菌(DTPa-HBV-IPV/Hib)疫苗完整基础免疫+加强免疫的12至13岁儿童对乙型肝炎的抗体持久性和免疫记忆。

方法

在德国的12个中心进行的开放IV期研究[NCT02052661]。12至13岁的青少年在婴儿期接种了4剂DTPa-HBV-IPV/Hib(Infanrix hexa™,葛兰素史克疫苗公司),接受一剂单价儿童乙型肝炎疫苗(Engerix™-B Kinder;葛兰素史克疫苗公司)的激发剂量。在激发前和激发后1个月采集血样,使用化学发光免疫分析法测量抗乙型肝炎(抗-HBs)抗体(血清保护阈值:≥10 mIU/ml)。监测激发后不良事件(AE)。

结果

300名受试者接种了疫苗;在ATP免疫原性队列的293名受试者中,60.5%的受试者激发前抗-HBs抗体≥10 mIU/ml,激发后升至97.6%(≥100 mIU/ml的占94.1%)。96.5%的受试者出现回忆反应。观察到抗体几何平均浓度增加了150倍(从22.4至3502.6 mIU/ml)。疼痛(44%)和疲劳(24.3%)分别是最常见的激发后局部和全身AE;14.7%的受试者在接种疫苗后31天内报告了非激发后症状。发生了两例与疫苗无关的严重AE。

结论

婴儿期接种DTPa-HBV-IPV/Hib可诱导对HBV的持续血清保护和免疫记忆,12至13岁青少年对乙型肝炎疫苗激发的强烈回忆反应表明了这一点。

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