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初免后 5-15 岁儿童乙型肝炎疫苗加强免疫的效果:5 年随访研究。

The effects of booster vaccination of hepatitis B vaccine on children 5-15 years after primary immunization: A 5-year follow-up study.

机构信息

a School of Medicine , Ningbo University , Ningbo , Zhejiang , China.

b The National Science and Technology Project , Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou , Zhejiang , China.

出版信息

Hum Vaccin Immunother. 2018 May 4;14(5):1251-1256. doi: 10.1080/21645515.2018.1426419. Epub 2018 Feb 26.

Abstract

The aim of this study was to evaluate changes in hepatitis B surface antibody titers (anti-HBs) after booster vaccinations in children aged 5-15 y and to provide suitable immunization strategies. A total of 2208 children were initially enrolled in screening, and 559 children were finally included. The participants were divided into 2 groups according to their pre-booster anti-HBs levels: Group I, <10 mIU/ml and Group II, ≥10 mIU/ml. Group I was administered 3 doses of booster hepatitis B vaccine (0-1-6 months, 10 μg), and Group II was administered 1 dose of booster hepatitis B vaccine (10 μg). The antibody titer changes were examined at 4 time points: 1 month after dose 1 and dose 3, and 1 year and 5 years after dose 3. The protective seroconversion rates at those points were 95.65%, 99.67%, 97.59% and 91.05% (p < 0.001), respectively, in Group I, and 100.00%, 99.87%, 99.66% and 98.21% (χ = 6.04, p = 0.11), respectively, in Group II. The GMT in subjects aged 5-9 y were higher than that in subjects aged 10-15 y in both Group I and Group II at 1 month after dose 1, but no difference was observed at the other three time points. This study demonstrates that booster vaccination has a good medium-term effect. A booster dose for subjects with protective antibodies is not necessary but effective, and 3 doses of hepatitis B vaccination are recommended for those who have lost immunological memory. Receiving booster immunization at the age of 10-15 years may be more appropriate for individuals living in HBV high epidemic areas.

摘要

本研究旨在评估 5-15 岁儿童加强免疫后乙型肝炎表面抗体(抗-HBs)滴度的变化,并提供合适的免疫策略。共有 2208 名儿童参加了筛查,最终有 559 名儿童入组。根据预加强抗-HBs 水平,将参与者分为 2 组:组 I,<10 mIU/ml;组 II,≥10 mIU/ml。组 I 给予 3 剂加强乙肝疫苗(0-1-6 个月,10 μg),组 II 给予 1 剂加强乙肝疫苗(10 μg)。在 4 个时间点检测抗体滴度变化:第 1 剂和第 3 剂后 1 个月,以及第 3 剂后 1 年和 5 年。在组 I 中,这些时间点的保护性血清转换率分别为 95.65%、99.67%、97.59%和 91.05%(p<0.001),在组 II 中,这些时间点的保护性血清转换率分别为 100.00%、99.87%、99.66%和 98.21%(χ=6.04,p=0.11)。在第 1 剂后 1 个月,组 I 和组 II 中年龄 5-9 岁的受试者的 GMT 均高于年龄 10-15 岁的受试者,但在其他 3 个时间点则无差异。本研究表明,加强免疫具有良好的中期效果。对于具有保护性抗体的受试者,加强免疫剂量不是必需的,但有效,建议对已失去免疫记忆的人群接种 3 剂乙肝疫苗。对于生活在乙肝高流行地区的个体,在 10-15 岁时接受加强免疫可能更为合适。

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