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[当抗-HBs滴度降至10 IU/L以下时,是否有必要重新接种乙型肝炎病毒疫苗?]

[Is it necessary to revaccinate against hepatitis B virus when the titer of anti-HBs drops below 10 IU/L?].

作者信息

Polák Pavel, Husa Petr, Smejkal Petr, Kamelander Jan, Chlupová Gabriela, Penka Miroslav

机构信息

Department of University Hospital Brno, Czech Republic, e-mail:

出版信息

Klin Mikrobiol Infekc Lek. 2016 Sep;22(3):125-130.

Abstract

Viral hepatitis B still represents a major epidemiological issue worldwide. After recombinant vaccine administration, a titer of anti-HBs antibodies ≥ 10 IU/L has long been considered to be seroprotective. Persons without this antibody level after complete vaccination are referred to as non-responders. A progressive decline in anti-HBs levels over years is also commonly seen in responders. Recently, there has been increasing evidence that the titer of anti-HBs ≥ 10 IU/L does not provide 100 % protection against infection and clinically manifest illness. Additionally, an important role of cellular immune memory has been demonstrated - without any correlation with anti-HBs titer. Based on current knowledge, there is no need for regular anti-HBs titer testing or booster vaccination in immunocompetent individuals with anti-HBs ≤ 10 IU/L. At present, regular serological testing and, if need be, revaccination to maintain anti-HBs ≥ 10 IU/L are recommended in immunocompromised persons and after liver transplantation.

摘要

乙型病毒性肝炎仍是全球主要的流行病学问题。接种重组疫苗后,长期以来一直认为抗-HBs抗体滴度≥10 IU/L具有血清保护作用。完全接种疫苗后未达到此抗体水平的人被称为无应答者。在有应答者中,多年来抗-HBs水平的逐渐下降也很常见。最近,越来越多的证据表明,抗-HBs滴度≥10 IU/L并不能提供100%的感染防护和临床显性疾病防护。此外,细胞免疫记忆的重要作用已得到证实——与抗-HBs滴度无关。根据目前的知识,对于抗-HBs≤10 IU/L的免疫功能正常个体,无需定期进行抗-HBs滴度检测或加强接种。目前,建议对免疫功能低下者和肝移植后患者进行定期血清学检测,如有必要进行再接种以维持抗-HBs≥10 IU/L。

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