Kmush Brittany L, Yu Huan, Huang Shoujie, Zhang Xuefang, Wu Ting, Nelson Kenrad E, Labrique Alain B
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China.
Open Forum Infect Dis. 2019 Mar 28;6(4):ofz144. doi: 10.1093/ofid/ofz144. eCollection 2019 Apr.
Hepatitis E virus (HEV) is of global significance. HEV is a common cause of acute hepatitis in China. One of the major unanswered questions about HEV is the persistence of antibodies after infection and vaccination.
We examined antibody persistence 6.5 years after HEV exposures through natural infection and vaccination. Ninety-seven vaccine recipients and 70 individuals asymptomatically infected with HEV enrolled in the phase III HEV239 vaccine trial in Dongtai, China, were revisited.
Antibody loss was 23.4% (95% confidence interval [CI], 17.1%-30.5%), with a nonsignificantly higher percentage of loss among those naturally infected (30.0%; 95% CI, 19.6%-42.1%) than those vaccinated (18.6%; 95% CI, 11.4%-27.7%; = .085). Age and gender were not associated with antibody persistence. Only 2 people (1.2%) self-reported medically diagnosed jaundice or hepatitis-like illness in the last 10 years, both of whom had persistent antibodies. Contact with a jaundice patient and injectable contraceptive use were marginally associated with loss of detectable anti-HEV antibodies ( = .047 and .082, respectively), whereas transfusion was marginally associated with antibody persistence ( = .075).
Antibody loss was more common among those naturally infected compared with those vaccinated. However, none of the characteristics examined were strongly associated with antibody loss, suggesting that factors not yet identified may play a more important role in antibody loss. Long-term postvaccination antibody persistence is currently unknown and will be an important consideration in the development of policies for the use of the highly efficacious HEV vaccine. NCT01014845.
戊型肝炎病毒（HEV）具有全球重要性。HEV是中国急性肝炎的常见病因。关于HEV的主要未解决问题之一是感染和接种疫苗后抗体的持续存在情况。
我们通过自然感染和接种疫苗对HEV暴露6.5年后的抗体持续存在情况进行了检测。重新访查了参与中国东台III期HEV239疫苗试验的97名疫苗接种者和70名无症状感染HEV的个体。
抗体丢失率为23.4%（95%置信区间[CI]，17.1%-30.5%），自然感染组的抗体丢失率（30.0%；95%CI，19.6%-42.1%）略高于接种疫苗组（18.6%；95%CI，11.4%-27.7%；P = 0.085）。年龄和性别与抗体持续存在无关。在过去10年中，只有2人（1.2%）自述经医学诊断患有黄疸或肝炎样疾病，两人均有持续抗体。与黄疸患者接触和使用注射用避孕药与可检测到的抗HEV抗体丢失略有相关（分别为P = 0.047和0.082），而输血与抗体持续存在略有相关（P = 0.075）。
与接种疫苗者相比，自然感染者中抗体丢失更为常见。然而，所检测的特征均与抗体丢失无强关联，这表明尚未确定的因素可能在抗体丢失中起更重要作用。目前尚不清楚接种疫苗后抗体的长期持续存在情况，这将是制定使用高效HEV疫苗政策时的一个重要考虑因素。NCT01014845。
