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炎症性肠病患儿对乙型肝炎疫苗的免疫反应。

Immune response to hepatitis B vaccination in pediatric patients with inflammatory bowel disease.

作者信息

Baranowska-Nowak Marta, IwaŃczak Barbara, Szczepanik Mariusz, Banasiuk Marcin, DembiŃski Łukasz, Karolewska-Bochenek Katarzyna, Dziekiewicz Marcin, Radzikowski Andrzej, Banaszkiewicz Aleksandra

机构信息

Pediatric Hospital in Warsaw, Poland.

2nd Department and Clinic of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Wroclaw, Poland.

出版信息

Cent Eur J Immunol. 2020;45(2):144-150. doi: 10.5114/ceji.2020.97902. Epub 2020 Jul 27.

Abstract

AIM OF THE STUDY

To evaluate the immune response rate in children with inflammatory bowel disease (IBD) who received the full hepatitis B vaccination course in infancy. We also evaluated rates of response to booster doses.

MATERIAL AND METHODS

Participants were 1- to 18-year-old children with IBD, who received 3 doses of the hepatitis B vaccine in infancy. The study subjects were on no immunosuppressive therapy, on immunomodulators, on biological therapy, or received combo therapy. Anti-hepatitis B surface antibody (anti-HBs) level ≥ 10 mIU/ml was considered to be seroprotective. Patients with anti-HBs level < 10 mIU/ml received 1 or 3 doses of hepatitis B vaccine, and their post-vaccination anti-HBs levels were evaluated.

RESULTS

In total, we included 157 subjects, with a median age of 14.5 years. Anti-HBs levels ≥ 10 mIU/ml were found in 84/157 (53.5%) patients and were not associated with age (p = 0.3), sex (p = 0.7), or IBD type (p = 0.9). There was no significant difference in the rate of seroconversion between IBD patients treated with no immunosuppressive drugs, immunomodulators, biologicals, and combo therapy (30.4% vs. 39.3% vs. 2.7% vs. 7.1%, respectively, p = 0.3). After the first and third dose of booster vaccine, anti-HBs levels ≥ 10 mIU/ml were as follows: 92% and 100%, respectively.

CONCLUSIONS

The immune response in children with IBD, who received the full series of hepatitis B vaccinations in infancy was inadequate and did not depend on the type of therapy. The booster dose(s) of vaccine could help to protect this group of patients from hepatitis B virus.

摘要

研究目的

评估婴儿期接受全程乙型肝炎疫苗接种的炎症性肠病(IBD)患儿的免疫应答率。我们还评估了加强剂量的应答率。

材料与方法

研究对象为1至18岁的IBD患儿,这些患儿在婴儿期接受了3剂乙型肝炎疫苗接种。研究对象未接受免疫抑制治疗、接受免疫调节剂治疗、接受生物治疗或接受联合治疗。抗乙型肝炎表面抗体(抗-HBs)水平≥10 mIU/ml被认为具有血清保护作用。抗-HBs水平<10 mIU/ml的患者接受1剂或3剂乙型肝炎疫苗,并评估其接种疫苗后的抗-HBs水平。

结果

我们共纳入157名受试者,中位年龄为14.5岁。84/157(53.5%)例患者的抗-HBs水平≥10 mIU/ml,且与年龄(p = 0.3)、性别(p = 0.7)或IBD类型(p = 0.9)无关。未接受免疫抑制药物、免疫调节剂、生物制剂和联合治疗的IBD患者之间的血清转化率无显著差异(分别为30.4%、39.3%、2.7%和7.1%,p = 0.3)。在第一剂和第三剂加强疫苗接种后,抗-HBs水平≥10 mIU/ml的比例分别为92%和100%。

结论

婴儿期接受全程乙型肝炎疫苗接种的IBD患儿的免疫应答不足,且不依赖于治疗类型。疫苗加强剂量可帮助保护这组患者免受乙型肝炎病毒感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1b2/7792433/a1be3606e965/CEJI-45-41509-g001.jpg

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