Ti Y N, Han B, Liu T F, Yuan Y J, Zhang L Y
First Hospital of Shanxi Medical University, Taiyuan 030001, China.
The Forth People's Hospital in Taiyuan City, Taiyuan 030001, China.
Zhonghua Gan Zang Bing Za Zhi. 2022 Dec 20;30(12):1370-1374. doi: 10.3760/cma.j.cn501113-20220825-00437.
To explore the safety of inactivated novel coronavirus vaccine inoculation and the fluctuating neutralizing antibody in patients with chronic hepatitis B (CHB). Retrospective and prospective epidemiological research methods were employed. 153 CHB patients who visited the Department of Infectious Diseases at the First Hospital of Shanxi Medical University from September 2021 to February 2022 were selected as the research subjects. Information on vaccination-related adverse reactions was collected. Colloidal gold immunochromatography was used to identify neutralizing antibodies in the body after 3-6 months of vaccination. Statistical analysis was performed using the -test or Fisher's exact test. The positive rates of neutralizing antibodies after inactivated novel coronavirus vaccine inoculation in 153 patients with CHB were 45.50%, 44.70%, 40.00% and 16.20%, respectively, at 3, 4, 5, and 6 months. The neutralizing antibody concentrations were 10.00 (2.95, 30.01) U/ml, 6.08 (3.41, 24.50) U/ml, 5.90 (3.93, 14.68) U/ml, and 1.25 (0.92, 3.75) U/ml, respectively. The difference was not statistically significant (>0.05) when the neutralizing antibody positivity rates in hepatitis B virus (HBV) DNA-negative and positive patients and HBeAg-negative and positive patients at different time points were compared. The overall incidence of adverse reactions following vaccination was 18.30%. Pain at the site of inoculation and fatigue were the main presentations, and no serious adverse reactions occurred. CHB patients, when inoculated with an inactivated novel coronavirus vaccine, can produce neutralizing antibodies, which can stay at certain levels for 3, 4, and 5 months. However, the neutralizing antibody level gradually decreases over time, and the decrease is remarkable at 6 months. So, it is recommended to boost vaccinations at an appropriate time. Additionally, the results of the study suggest that HBV replication status has little effect on the production of neutralizing antibodies in CHB patients with relatively stable liver function, which means the inactivated novel coronavirus vaccine has a good safety profile.
探讨慢性乙型肝炎(CHB)患者接种新型冠状病毒灭活疫苗的安全性及中和抗体的波动情况。采用回顾性和前瞻性流行病学研究方法。选取2021年9月至2022年2月在山西医科大学第一医院感染科就诊的153例CHB患者作为研究对象。收集疫苗接种相关不良反应信息。采用胶体金免疫层析法检测接种疫苗3 - 6个月后体内的中和抗体。使用t检验或Fisher确切检验进行统计分析。153例CHB患者接种新型冠状病毒灭活疫苗后3、4、5、6个月时中和抗体阳性率分别为45.50%、44.70%、40.00%和16.20%。中和抗体浓度分别为10.00(2.95,30.01)U/ml、6.08(3.41,24.50)U/ml、5.90(3.93,14.68)U/ml和1.25(0.92,3.75)U/ml。比较不同时间点乙型肝炎病毒(HBV)DNA阴性和阳性患者以及HBeAg阴性和阳性患者的中和抗体阳性率,差异无统计学意义(>0.05)。接种疫苗后不良反应的总发生率为18.30%。主要表现为接种部位疼痛和乏力,未发生严重不良反应。CHB患者接种新型冠状病毒灭活疫苗后可产生中和抗体,且在3、4、5个月时可维持在一定水平。然而,中和抗体水平随时间逐渐下降,6个月时下降明显。因此,建议适时进行加强接种。此外,研究结果表明,在肝功能相对稳定的CHB患者中,HBV复制状态对中和抗体的产生影响较小,这意味着新型冠状病毒灭活疫苗具有良好的安全性。