Troisi C L, Heiberg D A, Hollinger F B
JAMA. 1985 Dec 13;254(22):3196-9.
Institutionalized patients with Down's syndrome (DS) are uniquely predisposed to develop chronic hepatitis B infection following exposure. Therefore vaccination is particularly warranted, but there have been concerns that these individuals may react suboptimally. We examined the immune responses of 62 institutionalized patients with DS to 20 and 40 micrograms of hepatitis B vaccine inactivated (Heptavax-B) over one year. The subjects were matched by weight, age, and sex. Seroconversion rates and levels of antibodies to hepatitis B surface antigen (anti-HBs) were comparable to those found in a normal population and were higher than those found in immunocompromised patients undergoing hemodialysis. The anti-HBs levels were consistently higher in the 40-micrograms vaccine group. In patients with DS who were over 30 years old, age was a significant factor in predicting anti-HBs responses. Conversely, in younger subjects, weight was negatively correlated with anti-HBs levels. These data clearly indicate that patients with DS respond normally to hepatitis B surface antigen vaccination and need not be considered a special group when guidelines for vaccination are recommended.
患有唐氏综合征（DS）的机构收容患者在接触后特别容易感染慢性乙型肝炎。因此，接种疫苗尤为必要，但有人担心这些个体的反应可能不太理想。我们在一年时间内研究了62名机构收容的DS患者对20微克和40微克乙肝灭活疫苗（Heptavax-B）的免疫反应。受试者在体重、年龄和性别方面进行了匹配。乙肝表面抗原抗体（抗-HBs）的血清转化率和水平与正常人群相当，且高于接受血液透析的免疫功能低下患者。40微克疫苗组的抗-HBs水平一直较高。在30岁以上的DS患者中，年龄是预测抗-HBs反应的一个重要因素。相反，在较年轻的受试者中，体重与抗-HBs水平呈负相关。这些数据清楚地表明，DS患者对乙肝表面抗原疫苗反应正常，在推荐疫苗接种指南时无需将其视为特殊群体。
