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接受化疗的伊朗患者接种乙型肝炎病毒疫苗后的免疫反应

The Immune Response of Vaccination Against Hepatitis B virus in Iranian Patients Undergoing Chemotherapy.

作者信息

Meidani Mohsen, Khorvash Farzin, Hemati Simin, Ashrafi Farzaneh, Ataei Behrouz, Daneshmand Dana

机构信息

Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Adv Biomed Res. 2017 Jul 25;6:88. doi: 10.4103/abr.abr_330_13. eCollection 2017.

Abstract

INTRODUCTION

Hepatitis B virus (HBV) infection and its complications are major public health problems. As it is hard to treat and control the chronic state, control of disease depends on the prevention especially by vaccination. There is an impaired immune response to vaccinations including HBV in patients with some malignancies. The aim of this study is to assess the response rate of patients undergoing chemotherapy to HBV vaccination.

MATERIALS AND METHODS

All patients from two hematology/oncology clinics in Isfahan, Iran with the history of at least 1 month chemotherapy who had the inclusion criteria were enrolled in a case control study. Also a sex- and age-matched control group from healthy population was selected. They were vaccinated in a schedule of 0, 1, and 6 months and were examined for antibody titers 1 month after the last dose. The titers more than 10 mIU/ml were determined as positive response to vaccination.

RESULTS

In this study, 50 patients and 50 healthy subjects were enrolled. The two groups were age and sex matched ( > 0.05). Frequency of negative responses to HBV vaccination in case and control groups were 9 (18%) and 1 (2%), respectively (OR = 10.75, CI = 1.30-88.47, = 0.027). Of 50 patients, 54%, 12%, 22%, and 12% had breast cancer, lymphoma, gastrointestinal, and genitourinary cancers, respectively, and frequency of negative responses were 3 (11%), 1 (16%), 4 (36.4%), and 1 (16%), respectively ( = 0.167).

CONCLUSION

According to our results, malignancy and chemotherapy will have an important effect on the immune system and cause negative response to HBV vaccination. Our results revealed the importance of passive immunity and screening for HBV infection in patients undergoing chemotherapy. Also more studies for better vaccination schedules in this group of patients are recommended.

摘要

引言

乙型肝炎病毒(HBV)感染及其并发症是主要的公共卫生问题。由于慢性状态难以治疗和控制,疾病的控制依赖于预防,尤其是通过接种疫苗。一些恶性肿瘤患者对包括HBV疫苗在内的疫苗接种的免疫反应受损。本研究的目的是评估接受化疗的患者对HBV疫苗接种的反应率。

材料与方法

来自伊朗伊斯法罕两家血液学/肿瘤学诊所的所有有至少1个月化疗史且符合纳入标准的患者均纳入一项病例对照研究。此外,还从健康人群中选取了性别和年龄匹配的对照组。他们按照0、1和6个月的时间表接种疫苗,并在最后一剂接种后1个月检测抗体滴度。滴度超过10 mIU/ml被确定为对疫苗接种的阳性反应。

结果

本研究纳入了50例患者和50名健康受试者。两组在年龄和性别上匹配(>0.05)。病例组和对照组对HBV疫苗接种阴性反应的频率分别为9例(18%)和1例(2%)(OR = 10.75,CI = 1.30 - 88.47,P = 0.027)。在50例患者中,分别有54%、12%、22%和12%患有乳腺癌、淋巴瘤、胃肠道癌和泌尿生殖系统癌,阴性反应的频率分别为3例(11%)、1例(16%)、4例(36.4%)和1例(16%)(P = 0.167)。

结论

根据我们的结果,恶性肿瘤和化疗会对免疫系统产生重要影响,并导致对HBV疫苗接种的阴性反应。我们的结果揭示了被动免疫以及对接受化疗患者进行HBV感染筛查的重要性。此外,建议针对这组患者开展更多关于更好的疫苗接种时间表的研究。

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Timing of hepatitis B vaccination: its effect on vaccine response in health care workers.
Vaccine. 2007 Oct 23;25(43):7568-72. doi: 10.1016/j.vaccine.2007.08.025. Epub 2007 Sep 4.
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Epidemiology and natural history of hepatitis B.乙型肝炎的流行病学与自然史
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