Afzal Muhammad Faheem, Sultan Muhammad Ashraf, Saleemi Ahmad Imran
Department of Paediatrics, King Edward Medical University, Lahore, Pakistan.
J Ayub Med Coll Abbottabad. 2016 Oct-Dec;28(4):715-717.
Diseases caused by Hepatitis B virus (HBV) have a worldwide distribution. Pakistan adopted the recommendations of World Health Organization (WHO) for routine universal infant vaccination against hepatitis B in 2002, currently being administered at 6, 10, and 14 weeks of age in a combination vaccine. This study was conducted to determine the immune response & anamnestic immune response in children, 9 months-10 years of age, after a 3dose primary Hepatitis B vaccination.
This cross sectional study was conducted in the Department of Paediatrics, King Edward Medical University/Mayo Hospital, Lahore, Pakistan, from January to June, 2014. A total of 200 children of either sex between the ages of 9 months to 10 years, documented to have received 3 doses of hepatitis B vaccines according to Expanded Program of Immunization (6,10,14 weeks) schedule in infancy, were recruited by consecutive sampling. The level of serum antiHBsAb by ELIZA was measured. Children with antiHBs titers ≥10 mIU/mL were considered to be immune. Those with anti HBsAb levels <10 mIU/mL were offered a booster dose of infant recombinant hepatitis B vaccine. The second serum sample was obtained 21-28 days following the administration of the booster dose and the anamnestic immune response was measured. Data was analysed using SPSS 17 to determine the relation between time interval since last vaccination and antibody titer. Chi square test was applied.
Of the 200 children, protective antibody response was found in 58%. Median serological response was 18.60 (range 2.82 - 65.15). Antibody levels were found to have a statistically significant ( pvalue 0.019) negative correlation with the time since last administration of vaccine. A booster dose of Hepatitis B vacci ne was administered to all nonresponders, with each registering a statistically significant (pvalue 0.00) anamnestic response.
The vaccination schedule with short dosage interval was unable to provide protection to 42% of the study population. Introduction of birth dose of Hepatitis B vaccine to the existing schedule is recommended.
乙型肝炎病毒（HBV）引起的疾病在全球范围内均有分布。巴基斯坦于2002年采纳了世界卫生组织（WHO）的建议，对婴儿进行常规普遍的乙型肝炎疫苗接种，目前在6周、10周和14周龄时通过联合疫苗进行接种。本研究旨在确定9个月至10岁儿童在3剂次乙型肝炎疫苗基础免疫后的免疫反应及回忆性免疫反应。
本横断面研究于2014年1月至6月在巴基斯坦拉合尔爱德华国王医科大学/梅奥医院儿科进行。通过连续抽样招募了总共200名年龄在9个月至10岁之间的儿童，这些儿童均有记录表明在婴儿期按照扩大免疫规划（6周、10周、14周）的时间表接种了3剂次乙型肝炎疫苗。通过酶联免疫吸附测定（ELIZA）法检测血清抗-HBsAb水平。抗-HBs滴度≥10 mIU/mL的儿童被视为有免疫力。抗-HBsAb水平<10 mIU/mL的儿童接种一剂婴儿重组乙型肝炎疫苗加强针。在接种加强针后21 - 28天采集第二份血清样本，并检测回忆性免疫反应。使用SPSS 17分析数据，以确定自上次接种疫苗以来的时间间隔与抗体滴度之间的关系。应用卡方检验。
在200名儿童中，58%出现了保护性抗体反应。血清学反应中位数为18.60（范围2.82 - 65.15）。发现抗体水平与上次接种疫苗后的时间存在统计学显著的负相关（p值0.019）。对所有无反应者接种了一剂乙型肝炎疫苗加强针，每个人都出现了统计学显著的（p值0.00）回忆性反应。
短剂量间隔的疫苗接种方案无法为42%的研究人群提供保护。建议在现有接种方案中引入乙型肝炎疫苗出生剂量接种。
