Wang B, Xu X X, Wen H X, Hao H Y, Yang Z Q, Shi X H, Fu Z D, Wang X F, Zhang F, Wang B, Wang S P
Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China.
The Third People's Hospital of Taiyuan, Taiyuan 030001, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Jul 10;38(7):911-915. doi: 10.3760/cma.j.issn.0254-6450.2017.07.013.
To investigate the influencing factors for non/low-response to hepatitis B vaccine in infants of HBsAg-positive mothers. A total of 286 HBsAg-positive pregnant women and their infants were recruited from the Third People's Hospital of Taiyuan during July 2011 to January 2013. The infants were immunized with hepatitis B vaccine according to the 0-1-6 month vaccination schedule and followed up for 12 months. The serum HBV DNA level of mothers, neonates and infants were detected by electro chemilum inescence immunoassay kits and fluorescene quantiative polymerase chain rection. Among 286 infants, the rate of non/low-response to hepatitis B vaccine was 18.53 (53/286). Non-conditional logistic regression analysis indicated that the mother's HBV DNA level ≥1×10(7) copies/ml (=2.592, 95: 1.121-5.996) and natural birth (=1.932, 95: 1.021-3.654) were the risk factors for non/low-response to hepatitis B vaccine, the risks were 2.592 times and 1.932 times higher compared with the infants whose mothers were HBV DNA negative and the infants whose mothers had cesarean delivery. There was no multiplicative or additive interaction between high HBV DNA load and natural birth (=1.055, 95: 0.209-5.321), (=1.617, 95: -4.038-7.272; =0.364, 95: -0.527-1.225; =1.195, 95: 0.270-13.135). After stratified analysis of mother's HBV DNA level, delivery mode of mothers was not associated with non/low-response of their infants. The mother's load of HBV DNA≥1×10(7) copies/ml might be the factor for non/low-response to hepatitis B vaccine in infants of HBsAg positive mothers.
为探讨乙肝表面抗原(HBsAg)阳性母亲所生婴儿对乙肝疫苗无/低应答的影响因素。2011年7月至2013年1月期间,从太原市第三人民医院招募了286名HBsAg阳性孕妇及其婴儿。婴儿按照0-1-6月接种程序接种乙肝疫苗,并随访12个月。采用电化学发光免疫分析试剂盒和荧光定量聚合酶链反应检测母亲、新生儿及婴儿的血清乙肝病毒(HBV)DNA水平。286名婴儿中,乙肝疫苗无/低应答率为18.53%(53/286)。非条件logistic回归分析表明,母亲HBV DNA水平≥1×10⁷拷贝/ml(比值比=2.592,95%可信区间:1.121-5.996)和自然分娩(比值比=1.932,95%可信区间:1.021-3.654)是乙肝疫苗无/低应答的危险因素,与母亲HBV DNA阴性的婴儿及母亲剖宫产的婴儿相比,风险分别高2.592倍和1.932倍。高HBV DNA载量与自然分娩之间不存在相乘或相加交互作用(比值比=1.055,95%可信区间:0.209-5.321),(比值比=1.617,95%可信区间:-4.038-7.272;归因比=0.364,95%可信区间:-0.527-1.225;交互作用指数=1.195,95%可信区间:0.270-13.135)。对母亲HBV DNA水平进行分层分析后,母亲的分娩方式与婴儿的无/低应答无关。母亲HBV DNA载量≥1×10⁷拷贝/ml可能是HBsAg阳性母亲所生婴儿对乙肝疫苗无/低应答的因素。