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不同类型的乙肝疫苗加强针在初次免疫接种后 2-32 年内的免疫应答及其影响因素。

Immune response to different types of hepatitis B vaccine booster doses 2-32 years after the primary immunization schedule and its influencing factors.

机构信息

Hebei Province Center for Disease Control and Prevention, 97 Huai'an East Road, Yuhua District, Shijiazhuang 050021, Hebei, People's Republic of China.

Hebei Province Center for Disease Control and Prevention, 97 Huai'an East Road, Yuhua District, Shijiazhuang 050021, Hebei, People's Republic of China.

出版信息

Int J Infect Dis. 2020 Apr;93:62-67. doi: 10.1016/j.ijid.2020.01.047. Epub 2020 Jan 28.

Abstract

OBJECTIVE

To assess the immune effect of different types of hepatitis B vaccine (HepB) booster doses 2-32 years after primary immunization, explore the influencing factors, and offer guidance regarding the necessity and timing of boosters.

METHODS

In total, 1163 participants who were born from 1986 to 2015, received the HepB full-course primary vaccination, were hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (anti-HBc) negative, and had hepatitis B surface antibody (anti-HBs) <10 mIU/mL were enrolled. Individuals were randomly divided into two groups and received a booster dose of HepB. Venous blood samples were collected 30 days later and tested for anti-HBs.

RESULTS

In total, 595 and 568 individuals received a single dose of HepB (CHO) and HepB (SC), respectively. Venous blood samples were obtained from 1079 vaccinees (CHO: 554, SC: 525). The seroconversion rates were 93.68% (519/554) and 86.67% (455/525) (p < 0.05), with geometric mean concentrations (GMCs) of 426.58 mIU/ml and 223.8 mIU/ml, respectively. This result indicated that BMI, smoking status, vaccine types of booster and prebooster anti-HBs concentration significantly influenced anti-HBs levels. Only BMI, prebooster anti-HBs concentrations and booster types were different between the anti-HBs positive and negative groups.

CONCLUSIONS

Participants boostered with HepB (CHO) had a relatively higher seroconversion rate than those boostered with HepB (SC). The high seroconversion rates in the two groups suggested that the subjects remained protected despite low circulating antibodies, so there is currently no urgent need for booster immunization. Factors including BMI ≥ 25 and prebooster anti-HBs concentration <2.5 mIU/mL, which contributed to lower responses to a booster dose, might indicate a greater risk of breakthrough infection.

摘要

目的

评估乙型肝炎疫苗(HepB)加强免疫后 2-32 年对不同类型的免疫效果,探讨影响因素,为加强免疫的必要性和时机提供指导。

方法

共纳入 1163 名于 1986 年至 2015 年出生、全程接种过 HepB 疫苗、乙型肝炎表面抗原(HBsAg)和乙型肝炎核心抗体(抗-HBc)阴性、乙型肝炎表面抗体(抗-HBs)<10mIU/ml 的个体,随机分为两组,分别接种 HepB 加强免疫。30 天后采集静脉血样本,检测抗-HBs。

结果

共 595 人和 568 人分别接种了 1 剂 HepB(CHO)和 HepB(SC)。1079 名疫苗接种者(CHO:554 人,SC:525 人)采集了静脉血样本。血清转换率分别为 93.68%(519/554)和 86.67%(455/525)(p<0.05),几何平均浓度(GMC)分别为 426.58mIU/ml 和 223.8mIU/ml。这表明 BMI、吸烟状况、加强免疫疫苗类型和加强免疫前抗-HBs 浓度显著影响抗-HBs 水平。仅 BMI、加强免疫前抗-HBs 浓度和加强免疫疫苗类型在抗-HBs 阳性和阴性组之间存在差异。

结论

接种 HepB(CHO)加强免疫的参与者血清转换率相对较高,接种 HepB(SC)的参与者血清转换率较低。两组的高血清转换率表明,尽管循环抗体水平较低,但受试者仍受到保护,因此目前没有迫切需要进行加强免疫。BMI≥25 和加强免疫前抗-HBs 浓度<2.5mIU/ml 等因素导致对加强免疫剂量的反应较低,可能提示突破感染的风险更大。

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