Yang Z Q, Hao H Y, Shi X H, Fu Z D, Zhang F, Wang X F, Xu X X, Wang B, Wen H X, Feng S Y, Wang B, Wang S P
Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China.
Department of Obstetrics and Gynecology, the Third People Hospital of Taiyuan City, Taiyuan 030012, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Jun 10;39(6):805-809. doi: 10.3760/cma.j.issn.0254-6450.2018.06.021.
To explore the relationship between the status of HBsAg-positive infection of mothers and the non/low-response to hepatitis B vaccine of their infants. A total of 225 pairs of mothers and their infants were recruited in our cohort from June 2011 to July 2013. Infants were given three doses of hepatitis B vaccine at hour 24, first month and month 6(t)h respectively and were followed up for one year after birth. HBV serological markers and HBV DNA in the peripheral blood of both mothers and infants were detected by Electro-chemiluminescence immunoassay and fluorescence quantitative Polymerase Chain Reaction. Six HBV infection models were detected in HBsAg-positive mothers, and "HBsAg (+), HBeAg (+), anti-HBc (+)" (model one) and "HBsAg (+), anti-HBe (+), anti-HBc (+)" (model two) accounted for 92.5(208/225) of all the models. Rate of non/low-response to hepatitis B vaccine in infants born to mothers in model one was lower than those in model two, the differences are statistically significant ((2)=4.80, =0.029). The rate of non/low-response to hepatitis B vaccine in infants showed a downward trend with the rising of HBeAg level in their mothers ((2)=4.86, =0.028). Results from the unconditional logistic regression analysis showed that the HBeAg of the HBsAg-positive mothers was significantly correlated with the low risk of non/low-response to hepatitis B vaccine in infants (=0.598, 95: 0.378-0.947). The positive rate of serum HBV DNA in HBsAg-positive mothers was 54.2, while the rate of non/low-response to hepatitis B vaccine in infants born to HBV DNA positive mothers was similar to those infants born to HBV DNA negative mothers ((2)=0.22, =0.640). "HBsAg (+), HBeAg (+), anti-HBc (+)" and "HBsAg (+), anti-HBe(+), anti-HBc (+)" were the common models seen in HBsAg-positive mothers, and the rate of non/low-response to hepatitis B vaccine was different between the two models. HBeAg of HBsAg-positive mothers might have positive effects on the immune response to hepatitis B vaccine in infants but the mechanisms remained not clear. HBV DNA of the HBsAg-positive mothers did not seem to be correlated with the immune response to hepatitis B vaccine in infants.
探讨母亲HBsAg阳性感染状态与其婴儿对乙型肝炎疫苗无/低应答之间的关系。2011年6月至2013年7月,我们的队列中共招募了225对母婴。婴儿分别在出生后24小时、1个月和6个月时接种3剂乙型肝炎疫苗,并在出生后随访1年。采用电化学发光免疫分析法和荧光定量聚合酶链反应检测母婴外周血中的HBV血清学标志物和HBV DNA。在HBsAg阳性母亲中检测到6种HBV感染模式,其中“HBsAg(+)、HBeAg(+)、抗-HBc(+)”(模式一)和“HBsAg(+)、抗-HBe(+)、抗-HBc(+)”(模式二)占所有模式的92.5%(208/225)。模式一母亲所生婴儿对乙型肝炎疫苗无/低应答率低于模式二母亲所生婴儿,差异有统计学意义(χ²=4.80,P=0.029)。婴儿对乙型肝炎疫苗无/低应答率随母亲HBeAg水平升高呈下降趋势(χ²=4.86,P=0.028)。非条件logistic回归分析结果显示,HBsAg阳性母亲的HBeAg与婴儿对乙型肝炎疫苗无/低应答的低风险显著相关(OR=0.598,95%CI:0.378-0.947)。HBsAg阳性母亲血清HBV DNA阳性率为54.2%,HBV DNA阳性母亲所生婴儿对乙型肝炎疫苗无/低应答率与HBV DNA阴性母亲所生婴儿相似(χ²=0.22,P=0.640)。“HBsAg(+)、HBeAg(+)、抗-HBc(+)”和“HBsAg(+)、抗-HBe(+)、抗-HBc(+)”是HBsAg阳性母亲中常见的模式,两种模式下婴儿对乙型肝炎疫苗无/低应答率不同。HBsAg阳性母亲的HBeAg可能对婴儿乙型肝炎疫苗免疫应答有正向作用,但机制尚不清楚。HBsAg阳性母亲的HBV DNA似乎与婴儿乙型肝炎疫苗免疫应答无关。