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增加乙肝疫苗剂量可减少婴儿隐匿性乙肝感染的发生：一项大型前瞻性队列研究。

Reduction of the occurrence of occult HBV infection in infants by increasing the dose of hepatitis B vaccine: a large prospective cohort study.

机构信息

Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China.

Department of Clinical Research, First Hospital of Jilin University, Changchun, People's Republic of China.

出版信息

Emerg Microbes Infect. 2020 Dec;9(1):1881-1891. doi: 10.1080/22221751.2020.1808533.

DOI:10.1080/22221751.2020.1808533
PMID:32779526
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7473118/
Abstract

Occult hepatitis B virus (HBV) infection (OBI) has been observed among infants born to hepatitis B surface antigen (HBsAg)-positive mothers despite successful immunoprophylaxis. This study enrolled 549 infants [349 infants received a 10μg/dose of hepatitis B vaccine (HepB), and 200 infants received 20μg/dose HepB] born to HBsAg-positive mothers with HBV DNA load >6logIU/mL. The anti-HBs levels in the 10μg group were significantly lower than that in the 20μg group both at 7 [652.48 (564.05-754.82) 1541.72 (1268.69-1873.51) mIU/mL, <0.001] and 12 months old [257.44 (220.29-300.88) 1073.41 (839.27-1372.78) mIU/mL, <0.001]. The OBI incidence in the 10μg group was significantly higher than that in the 20μg group at both 7 [21.55% (25/116) 7.56% (9/119), =0.002] and 12 months old [17.07% (14/82) 6.90% (6/87), =0.041]. OBI incidence in infants with anti-HBs levels <100mIU/mL was higher than that of those with anti-HBs ≥100mIU/mL [35.71% (5/14) vs. 13.12% (29/221), =0.036]. This study showed that increasing the immunisation dose from 10μg to 20μg significantly improved anti-HBs levels and decreased OBI incidence in infants with a high maternal viral load. We recommend 20μg HepB to treat this high-risk population.

摘要

隐匿性乙型肝炎病毒 (HBV) 感染 (OBI) 尽管已成功进行免疫预防，但仍可见于乙型肝炎表面抗原 (HBsAg) 阳性母亲所生的婴儿中。本研究纳入了 549 名 HBsAg 阳性母亲所生的婴儿[349 名婴儿接受了 10μg/d 的乙型肝炎疫苗 (HepB)，200 名婴儿接受了 20μg/d HepB]，这些婴儿的 HBV DNA 载量>6logIU/mL。在 7 个月[652.48(564.05-754.82) 1541.72(1268.69-1873.51)mIU/mL，<0.001]和 12 个月时，10μg 组的抗-HBs 水平明显低于 20μg 组[257.44(220.29-300.88) 1073.41(839.27-1372.78)mIU/mL，<0.001]。在 7 个月时[21.55%(25/116) 7.56%(9/119)，=0.002]和 12 个月时[17.07%(14/82) 6.90%(6/87)，=0.041]，10μg 组的 OBI 发生率明显高于 20μg 组。抗-HBs 水平<100mIU/mL 的婴儿的 OBI 发生率高于抗-HBs≥100mIU/mL 的婴儿[35.71%(5/14)比 13.12%(29/221)，=0.036]。本研究表明，在高病毒载量的母亲所生的婴儿中，将免疫剂量从 10μg 增加到 20μg，可显著提高抗-HBs 水平并降低 OBI 的发生率。我们建议对这一高危人群使用 20μg HepB 进行治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7601/7473118/e8b715232e49/TEMI_A_1808533_F0005_OB.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7601/7473118/a832af7af33d/TEMI_A_1808533_F0001_OB.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7601/7473118/de1a46e67225/TEMI_A_1808533_F0002_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7601/7473118/35a9977ea7ca/TEMI_A_1808533_F0003_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7601/7473118/8902a5fa2ab6/TEMI_A_1808533_F0004_OB.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7601/7473118/e8b715232e49/TEMI_A_1808533_F0005_OB.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7601/7473118/a832af7af33d/TEMI_A_1808533_F0001_OB.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7601/7473118/de1a46e67225/TEMI_A_1808533_F0002_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7601/7473118/35a9977ea7ca/TEMI_A_1808533_F0003_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7601/7473118/8902a5fa2ab6/TEMI_A_1808533_F0004_OB.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7601/7473118/e8b715232e49/TEMI_A_1808533_F0005_OB.jpg

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