Craven D E, Awdeh Z L, Kunches L M, Yunis E J, Dienstag J L, Werner B G, Polk B F, Syndman D R, Platt R, Crumpacker C S
Ann Intern Med. 1986 Sep;105(3):356-60. doi: 10.7326/0003-4819-105-3-356.
Twenty-eight health care workers who had a poor antibody response when initially vaccinated with hepatitis B vaccine were revaccinated with three additional 20-microgram doses. Eight of the twenty nonresponders, who had levels of antibody to hepatitis B surface antigen (anti-HBs) of less than 8 estimated radioimmunoassay (RIA) units, and all 8 of the hyporesponders, who had anti-HBs levels of 8 or 16 RIA units, attained anti-HBs levels of 36 RIA units or more after revaccination. Tests for HLA-A, B, C, and DR; for complement proteins C2, C4A, C4B, and BF; and for the erythrocyte enzyme glyoxalase I were done in 17 nonresponders and 3 hyporesponders. Nine (45%) had HLA-DR7 and 8 (40%) had HLA-DR3, compared with an expected rate of 23% in the general population. At least one of two extended haplotypes (B44, DR7, FC31 or B8, DR3, SCO1) were detected in 6 of the 9 who did not respond to revaccination, compared with 2 of 11 who responded to a second course of vaccine. Poor responders to vaccine may benefit from revaccination, and genetic factors may modulate the immune response to vaccination.
28名初次接种乙肝疫苗时抗体反应较差的医护人员又接种了3剂20微克的疫苗。20名无反应者中，8名乙肝表面抗原抗体（抗-HBs）水平低于8个放射免疫测定（RIA）单位，所有8名低反应者抗-HBs水平为8或16个RIA单位，再次接种后抗-HBs水平达到36个RIA单位或更高。对17名无反应者和3名低反应者进行了HLA-A、B、C和DR检测；补体蛋白C2、C4A、C4B和BF检测；以及红细胞酶乙二醛酶I检测。9人（45%）有HLA-DR7，8人（40%）有HLA-DR3，而一般人群的预期发生率为23%。在9名再次接种无反应者中，6人检测到至少一种两个扩展单倍型（B44、DR7、FC31或B8、DR3、SCO1），而11名对第二疗程疫苗有反应者中2人检测到。疫苗反应不佳者可能从再次接种中获益，遗传因素可能调节对疫苗的免疫反应。
