Department of Infectious Diseases, The Second Hospital of Nanjing, School of Medicine, Southeast University , Nanjing, China.
Department of Internal Medicine, Zhongda Hospital, School of Medicine, Southeast University , Nanjing, China.
Hum Vaccin Immunother. 2020 Jul 2;16(7):1533-1544. doi: 10.1080/21645515.2020.1732166. Epub 2020 Mar 18.
Vaccination against hepatitis B is the most effective strategy to control HBV infection. The first licensed hepatitis B vaccine was developed by the purification of hepatitis B surface antigen (HBsAg) from plasma of asymptomatic HBsAg carriers. Then, the recombinant DNA technology enabled the development of recombinant hepatitis B vaccine. A series of three doses vaccine can elicit long-term protection more than 30 y. Concurrent use of hepatitis B immunoglobulin and hepatitis B vaccine has substantially reduced the mother-to-child transmission of HBV, nearly zero infection in children of carrier mother with negative hepatitis B e antigen (HBeAg) and 5-10% infection in children of HBeAg-positive mothers. By the end of 2018, 189 countries adopted universal hepatitis B vaccination program, which has dramatically reduced the global prevalence of HBsAg in children <5 y of age, from 4.7% in the prevaccine era to 1.3% in 2015. However, the implementation of universal hepatitis B vaccination in some regions is suboptimal and timely birth dose vaccine is not routinely administered in more than half of newborn infants. Optimal worldwide universal hepatitis B vaccination requires more efforts to overcome the social and economic challenges.
接种乙型肝炎疫苗是控制乙型肝炎病毒感染的最有效策略。第一种获得许可的乙型肝炎疫苗是通过从无症状乙型肝炎表面抗原 (HBsAg) 携带者的血浆中纯化 HBsAg 开发的。然后，重组 DNA 技术使重组乙型肝炎疫苗得以发展。一系列三剂疫苗可以产生长达 30 年以上的长期保护。同时使用乙型肝炎免疫球蛋白和乙型肝炎疫苗可显著降低乙型肝炎病毒母婴传播的风险，使携带乙型肝炎 e 抗原 (HBeAg) 阴性的母亲所生儿童的感染率接近零，而 HBeAg 阳性母亲所生儿童的感染率为 5-10%。截至 2018 年底，189 个国家实施了乙型肝炎疫苗普遍接种计划，这大大降低了 5 岁以下儿童乙型肝炎表面抗原的全球流行率，从疫苗接种前的 4.7%降至 2015 年的 1.3%。然而，在一些地区，乙型肝炎疫苗的普及接种实施情况并不理想，超过一半的新生儿未常规接种及时的出生剂量疫苗。要实现全球乙型肝炎疫苗的最佳普及接种，还需要更多努力来克服社会和经济方面的挑战。
