State Key Lab of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Beijing, 100021, People's Republic of China.
Jiangsu, Qidong Liver Cancer Institute & Qidong People's Hospital, Qidong, 226200, People's Republic of China.
Hepatol Int. 2021 Apr;15(2):328-337. doi: 10.1007/s12072-021-10156-z. Epub 2021 Mar 22.
Among elder children/young adults who received hepatitis B virus (HBV) vaccination during infancy, the serological status of HBsAg-negative and anti-HBc-positive [HBsAg(-)/anti-HBc(+)] was frequently reported, indicating potential occult HBV infection (OBI). It is required to define the long-term protection of neonatal vaccination against OBI in their mature adulthood.
Building upon the 1983-1990 established Qidong Hepatitis B Intervention Study, we sampled 10% of the 28-35-year-old participants, who remained in the cohort by 2012. Each participant was tested for serological markers of HBsAg, anti-HBs, HBeAg, anti-HBe and anti-HBc. HBV-DNA and relaxed circular DNA (rcDNA) were determined in some HBsAg(-)/anti-HBc(+) individuals.
Totally, 3615 individuals from the neonatal vaccination group and 3100 individuals from the control group donated blood samples, respectively. In the vaccination group, the prevalence of HBsAg was 1.58% (57/3615), HBsAg(-)/anti-HBc(+) was 4.70% (170/3615), significantly lower than in the control group, which was 7.45% (231/3100) and 19.48% (640/3100) respectively (all p < 0.001). With aging, HBsAg(-)/anti-HBc(+) prevalence increased in the sampled participants from the control group (p < 0.001), but uncertain from the vaccination group. Of HBsAg(-)/anti-HBc(+), HBV-DNA was detected in 13.08% (17/130) from the vaccination group, and in 4.18% (12/287) from the control group. HBV rcDNA was detected in most sera that were tested positive for HBV-DNA.
OBI occurred in some vaccinated adults. However, neonatal HBV vaccination kept the effective protection against OBI in mature adults.
在婴儿时期接受乙型肝炎病毒（HBV）疫苗接种的大龄儿童/青年中，经常报告乙型肝炎表面抗原阴性和抗乙型肝炎核心抗体阳性（HBsAg(-)/抗-HBc(+)）的血清学状态，表明存在潜在的隐匿性乙型肝炎病毒感染（OBI）。需要确定新生儿接种疫苗对其成年后 OBI 的长期保护作用。
基于 1983-1990 年建立的启东乙型肝炎干预研究，我们抽取了 2012 年仍留在队列中的 28-35 岁参与者的 10%作为样本。每位参与者都进行了乙型肝炎表面抗原、抗乙型肝炎表面抗体、乙型肝炎 e 抗原、抗乙型肝炎 e 抗体和抗乙型肝炎核心抗体的血清学标志物检测。在一些 HBsAg(-)/抗-HBc(+)个体中检测了乙型肝炎病毒 DNA 和松弛环状 DNA（rcDNA）。
共有 3615 名来自新生儿疫苗接种组和 3100 名来自对照组的个体捐献了血液样本。在疫苗接种组中，HBsAg 的患病率为 1.58%（57/3615），HBsAg(-)/抗-HBc(+)为 4.70%（170/3615），明显低于对照组的 7.45%（231/3100）和 19.48%（640/3100）（均 P<0.001）。随着年龄的增长，对照组抽样参与者的 HBsAg(-)/抗-HBc(+)患病率增加（P<0.001），但疫苗接种组不确定。在 HBsAg(-)/抗-HBc(+)中，HBV-DNA 检测到疫苗接种组 13.08%（17/130），对照组 4.18%（12/287）。HBV rcDNA 检测到大多数 HBV-DNA 检测呈阳性的血清中。
一些接种疫苗的成年人发生了 OBI。然而，新生儿乙型肝炎疫苗接种对成年后 OBI 仍保持有效保护。
