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[不同剂量和类型的乙肝疫苗在成人中快速接种的有效性]

[Effectiveness of rapid hepatitis B vaccination with different vaccine dosages and types in adults].

作者信息

Nie L, Pang X H, Zhang Z, Ma J X, Liu X Y, Qiu Q, Liang Y, Li Q, Zhang W

机构信息

Department of Research and Education Administration.

Department of Infectious Diseases and Endemic Diseases Prevention, Chaoyang District Center for Disease Control and Prevention, Beijing 100021, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Sep 10;38(9):1151-1155. doi: 10.3760/cma.j.issn.0254-6450.2017.09.001.

Abstract

To evaluate the effectiveness of rapid hepatitis B vaccination with different vaccine dosages and types in adults. Adults who were aged ≥20 years, negative in the detections of 5 HBV serum markers or only anti-HBc positive were selected from Chaoyang district of Beijing. They were divided into 4 community-based specific groups and given three doses of 10 μg HepB-SCY vaccine, 20 μg HepB-SCY vaccine, 20 μg HepB-CHO vaccine and 10 μg HepB-HPY vaccine respectively at month 0, 1, and 2. Their blood samples were collected within 1-2 months after completing the three dose vaccination to test anti-HBs level by using chemiluminesent microparticle immunoassay. A face to face questionnaire survey was conducted, and (2) test, Mantel- Haensel (2) test, Kruskal-Wallis rank test and multiple logistic regression analysis were performed. A total of 1 772 participants completed vaccination and observation. Their average age was 48.5 years, and 62.75 of them were females. The anti-HBs positive rates in the groups of 10 μg HepB-SCY, 20 μg HepB-SCY, 20 μg HepB-CHO and 10 μg HepB-HPY vaccines were 79.49, 84.34, 82.50 and 74.15 respectively (=0.005), and the geometric mean titers (GMT) were39.53 mIU/ml, 62.37 mIU/ml, 48.18 mIU/ml and 33.64 mIU/ml respectively (=0.025). The overall anti-HBs positive rate and GMT were 79.01 and 41.18 mIU/ml. The anti-HBs GMT of 4 groups declined with age. The differences in anti-HBs GMT among 4 groups minimized with age. The result of logistic modeling indicated that vaccine type and dosage, age and smoking were associated with anti-HBs statistically after controlling the variables of"only anti-HBc positive or not"and"history of hepatitis B vaccination". Hepatitis B vaccination at dosage of 20 μg based on 0-1-2 month rapid schedule could achieved anti-HBs positive rates>80 in middle aged and old people, which can be used as supplement of 0-1-6 month routine schedule.

摘要

评估不同剂量和类型的乙肝疫苗在成人中进行快速接种的效果。从北京市朝阳区选取年龄≥20岁、5项乙肝血清学标志物检测均为阴性或仅抗-HBc阳性的成年人。将他们分为4个社区特定组,分别在第0、1、2个月接种3剂10μg重组酵母乙肝疫苗、20μg重组酵母乙肝疫苗、20μg重组乙肝疫苗(CHO细胞)和10μg重组乙肝疫苗(汉逊酵母)。在完成3剂接种后的1-2个月内采集他们的血样,采用化学发光微粒子免疫分析法检测抗-HBs水平。进行面对面问卷调查,并进行卡方检验、Mantel-Haensel检验、Kruskal-Wallis秩和检验及多因素logistic回归分析。共有1772名参与者完成接种和观察。他们的平均年龄为48.5岁,其中女性占62.75%。10μg重组酵母乙肝疫苗组、20μg重组酵母乙肝疫苗组、20μg重组乙肝疫苗(CHO细胞)组和10μg重组乙肝疫苗(汉逊酵母)组的抗-HBs阳性率分别为79.49%、84.34%、82.50%和74.15%(P=0.005),几何平均滴度(GMT)分别为39.53mIU/ml、62.37mIU/ml、48.18mIU/ml和33.64mIU/ml(P=0.025)。总体抗-HBs阳性率和GMT分别为79.01%和41.18mIU/ml。4组的抗-HBs GMT均随年龄增长而下降。4组间抗-HBs GMT的差异随年龄增长而减小。logistic模型分析结果显示,在控制“仅抗-HBc是否阳性”和“乙肝疫苗接种史”变量后,疫苗类型和剂量、年龄及吸烟与抗-HBs存在统计学关联。基于0-1-2月快速程序接种20μg剂量的乙肝疫苗可使中老年人抗-HBs阳性率>80%,可作为0-1-6月常规程序的补充。

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