Zheng Zhigang, Li Guojian, Liao Fuhui, Zhang Lujuan, Wang Xueyan, Fang Zhongliao, Chen Qinyan, Liu Huabin, Hu Liping
Department of Epidemiology and Statistic, School of Public Health, Guangxi Medical University, Nanning, China.
Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, China.
Hum Vaccin Immunother. 2021 Mar 4;17(3):845-851. doi: 10.1080/21645515.2020.1801076. Epub 2020 Sep 22.
Recommendations promoted worldwide have suggested a period of protection lasting more than 20 years against hepatitis B (HB) following primary immunization. Starting in 1987, universal HB vaccinations were carried out in Long An County, Guangxi Province, one of the earliest counties in which plasma-derived HB vaccine was delivered to newborns across China. Data collection targeted toward understanding the long term (26-33 years since primary immunization) immune effects of the plasma-derived HB vaccine was conducted in 2015; a second data collection was carried out in 2019 to assess seroconversion in the same cohort. This study qualitatively compared positive vs negative results and quantitatively assessed HB biomarkers - HB surface antigen (HBsAg), antibody to HBsAg (anti-HBs), HB e-antigen (HBeAg), antibody to HBeAg (anti-HBe), and antibody to HB core antigen (anti-HBc) - in serum 26-33 years after the full initial course of HB vaccination, then analyzed anti-HBs seroconversion using the two-phase sampling method in the same cohort and calculated the anti-HBs seroconversion rate from 2015 to 2019. The protective sero-conversion rate (anti-HBs ≥10mIU/mL) was 37.6% (192/511); the HBsAg-positive rate was 5.3% (27/511); the anti-HBs mean geometric titer (GMT) was 11.1 mIU/mL. Among the 143 participants involved in both 2015 and 2019 data collections, the seroconversion rate was 3.5% (5/143); two individuals had protective anti-HBs levels in 2015. These findings indicate that anti-HBs status can be seroconverted to a protective concentration level 4 years earlier in a high HBV epidemic region. The role of genomic mutations and the disappearance of immune memory and seroconversion should be investigated.
全球推广的建议表明，初次免疫后对乙型肝炎（HB）的保护期持续超过20年。从1987年开始，广西龙州县开展了普遍的乙肝疫苗接种，该县是中国最早向新生儿提供血浆源性乙肝疫苗的县之一。2015年针对了解血浆源性乙肝疫苗的长期（初次免疫后26 - 33年）免疫效果进行了数据收集；2019年进行了第二次数据收集，以评估同一队列中的血清转化情况。本研究定性比较了阳性与阴性结果，并定量评估了初次全程接种乙肝疫苗26 - 33年后血清中的乙肝生物标志物——乙肝表面抗原（HBsAg）、乙肝表面抗原抗体（抗-HBs）、乙肝e抗原（HBeAg）、乙肝e抗原抗体（抗-HBe）和乙肝核心抗原抗体（抗-HBc），然后在同一队列中使用两阶段抽样方法分析抗-HBs血清转化情况，并计算2015年至2019年的抗-HBs血清转化率。保护性血清转化率（抗-HBs≥10mIU/mL）为37.6%（192/511）；HBsAg阳性率为5.3%（27/511）；抗-HBs平均几何滴度（GMT）为11.1 mIU/mL。在参与2015年和2019年两次数据收集的143名参与者中，血清转化率为3.5%（5/143）；2015年有两人的抗-HBs水平具有保护性。这些发现表明，在高乙肝流行地区，抗-HBs状态可提前4年血清转化为保护性浓度水平。应研究基因变异的作用以及免疫记忆的消失和血清转化情况。
