Dr Shahana Ferdous, Assistant Professor, Department of Paediatrics, Khulna City Medical College, Khulna, Bangladesh.
Mymensingh Med J. 2022 Apr;31(2):385-394.
Hepatitis B virus is a serious public health problem. Effective hepatitis B vaccination gives protection in about 85-90% cases. Most follow-up studies in different countries showed a similar pattern of antibody decline with increasing age. Many authors observed a declined level of HBs-antibody over a period of 3-6 years. This study was aimed at to observe immune status in children 7 years or more after primary hepatitis B vaccination. This cross sectional descriptive study was conducted at the department of Pediatric Gastroenterology and Nutrition, BSMMU, Dhaka, Bangladesh from April 2015 to March 2016. For this study children of both sexes aged between 7 to 18 years, who had history of 2 or more doses of hepatitis B vaccine 7 or more years back were included in the study. All the serum samples were tested for anti HBs by chemiluminescence's technique. Total 120 children were studied among them male was 59.2% and male female ratio was 1.4:1 with a mean age of 8.6±1.7 years. Good immune response (66.7%) was observed against hepatitis B. Significantly higher geometric mean titer of anti HBs was found in the age group of 7-8 years (p=0.02). Waning of immunity including non seroprotectivity was significantly associated with increasing age (p=0.015). Majority (96.7%) of children received EPI vaccination than commercially available vaccine. Children with weight for age percentile (WAP), height for age percentile (HAP) and BMI for age lies below 5th percentile had comparatively lower non seroprotection rate than normal children, but this was not statistically significant. History of dental or surgical procedure, blood transfusion and family history of contact with known case of hepatitis B infection did not have any significant inference on anti- HBs response. The study detected a good immune response against hepatitis B. About 66.7% of children were seroprotective 7 years or more after primary hepatitis B vaccination. Waning of immunity including non seroprotectivity was significantly associated with increasing age. Further studies with larger sample size are needed about booster dose to come to a final conclusion.
乙型肝炎病毒是一个严重的公共卫生问题。有效的乙型肝炎疫苗接种在大约 85-90%的情况下提供保护。大多数国家的后续研究表明，随着年龄的增长，抗体下降模式相似。许多作者观察到，在 3-6 年内，HBs 抗体水平下降。本研究旨在观察原发性乙型肝炎疫苗接种 7 年以上儿童的免疫状况。这是一项在孟加拉国达卡的 BSMMU 儿科胃肠病学和营养系进行的横断面描述性研究。在这项研究中，我们纳入了年龄在 7 至 18 岁之间，有 2 剂或 2 剂以上乙型肝炎疫苗接种史且已超过 7 年的儿童。所有血清样本均采用化学发光技术检测抗 HBs。共有 120 名儿童参与研究，其中男性占 59.2%，男女比例为 1.4:1，平均年龄为 8.6±1.7 岁。研究发现，乙型肝炎有良好的免疫反应（66.7%）。在 7-8 岁年龄组发现抗 HBs 的几何平均滴度明显较高（p=0.02）。免疫减弱，包括非血清保护力，与年龄增长呈显著相关（p=0.015）。大多数（96.7%）儿童接受了 EPI 疫苗接种，而非商业疫苗。体重年龄百分位数（WAP）、身高年龄百分位数（HAP）和 BMI 年龄百分位数低于第 5 百分位数的儿童，与正常儿童相比，非血清保护率较低，但差异无统计学意义。牙科或手术史、输血史和与已知乙型肝炎感染接触的家族史对抗 HBs 反应无明显影响。本研究发现，原发性乙型肝炎疫苗接种 7 年或更长时间后，儿童对乙型肝炎有良好的免疫反应。免疫减弱，包括非血清保护力，与年龄增长呈显著相关。需要进一步开展更大样本量的研究，以确定是否需要加强免疫。
