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吸毒者中高剂量乙肝疫苗的免疫原性和安全性:一项随机、开放标签、空白对照试验。

Immunogenicity and safety of high-dose hepatitis B vaccine among drug users: A randomized, open-labeled, blank-controlled trial.

作者信息

Feng Yongliang, Shi Jing, Gao Linying, Yao Tian, Feng Dan, Luo Dan, Li Zhansheng, Zhang Yawei, Wang Fuzhen, Cui Fuqiang, Li Li, Liang Xiaofeng, Wang Suping

机构信息

a School of Public Health, Shanxi Medical University , Taiyuan, Shanxi , China.

b Yongji Center for Disease Control and Prevention , Yongji, Shanxi , China.

出版信息

Hum Vaccin Immunother. 2017 Jun 3;13(6):1-7. doi: 10.1080/21645515.2017.1283082. Epub 2017 Mar 16.

Abstract

Due to the low uptake, adherence, and completion of vaccination among drug users, and their compromised immune responses to hepatitis B vaccination, the current practice of hepatitis B vaccination may not provide optimal protection. The aim of this study was to evaluate the immunogenicity and safety of 60 µg and 20 µg hepatitis B vaccines among drug users. A randomized, open-labeled, blank-controlled trial was conducted among drug users at 2 drug rehabilitation centers in China. The eligible participants were drug users who were serologically negative for the hepatitis B surface antigen (HBsAg) and the hepatitis B surface antibody (anti-HBs). Participants were randomized in a ratio of 1:1:1 to receive 20 µg (IM20 group) or 60 µg (IM60 group) of hepatitis B vaccine or blank control at months 0, 1, and 6, and followed at months 6, 7, and 12. Seroconversion rates of 94.7% and 92.6% were observed in IM20 and IM60 groups at month 7, and correspondingly decreased to 89.5% and 91.7% respectively at month 12. The IM60 group showed significantly higher geometric mean concentrations (GMCs) of anti-HBs (2022.5 and 676.7 mIU mL-1) than the IM20 group did (909.6 and 470.5 mIU mL-1) at months 7 and 12 (P < 0.05). No safety concerns associated with vaccination were noted. Three-dose intramuscular immunization with hepatitis B vaccines showed good immunogenicity among the drug users.

摘要

由于吸毒者对疫苗接种的接受度、依从性和完成率较低,且他们对乙肝疫苗的免疫反应受损,目前的乙肝疫苗接种做法可能无法提供最佳保护。本研究的目的是评估60μg和20μg乙肝疫苗在吸毒者中的免疫原性和安全性。在中国的2个戒毒中心对吸毒者进行了一项随机、开放标签、空白对照试验。符合条件的参与者为乙肝表面抗原(HBsAg)和乙肝表面抗体(抗-HBs)血清学阴性的吸毒者。参与者按1:1:1的比例随机分组,在第0、1和6个月接受20μg(IM20组)或60μg(IM60组)乙肝疫苗或空白对照,并在第6、7和12个月进行随访。IM20组和IM60组在第7个月的血清转化率分别为94.7%和92.6%,在第12个月相应降至89.5%和91.7%。在第7个月和第12个月,IM60组的抗-HBs几何平均浓度(GMCs)(分别为2022.5和676.7 mIU/mL)显著高于IM20组(分别为909.6和470.5 mIU/mL)(P<0.05)。未发现与疫苗接种相关的安全问题。乙肝疫苗三剂肌肉注射在吸毒者中显示出良好的免疫原性。

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