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婴儿期接种加强疫苗可降低母亲HBsAg阳性儿童隐匿性HBV感染的发生率。

Booster Vaccination in Infancy Reduces the Incidence of Occult HBV Infection in Maternal HBsAg-positive Children.

作者信息

Li Yi, Li Lili, Song Yarong, Liu Minmin, Zhai Xiangjun, Duan Zhongping, Ding Feng, Zhu Liguo, Jiang Jie, Zou Huaibin, Wang Jie, Li Jie

机构信息

Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China.

Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

J Clin Transl Hepatol. 2023 Jun 28;11(3):661-669. doi: 10.14218/JCTH.2022.00213. Epub 2023 Jan 4.

Abstract

BACKGROUND AND AIMS

Occult HBV infection (OBI) in children has proven to be associated with their immune response to hepatitis B vaccine (HepB). This study aimed to investigate the effect of a booster HepB on OBI, which is rarely investigated.

METHODS

This study enrolled 236 maternal HBsAg-positive children who were followed up annually until 8 years of age and were hepatitis B surface antigen (HBsAg) negative. Of those 100 received a booster HepB between 1 and 3 years of age (booster group), and 136 were never boosted (non-booster group). Serial follow-up data of children and baseline data of their mothers were collected and between-group differences were analyzed.

RESULTS

The incidence of OBI varied dynamically during follow-up, with 37.14% (78/210), 19.09% (42/220), 20.85% (44/211), 31.61% (61/193), 8.65% (18/208) and 12.71% (30/236) at 7 months, 1, 2, 3, 4, and 8 years of age. At 8 years of age, the negative conversion rate of HBV DNA in the booster group was significantly higher than that in non-booster group [57.89% (11/19) vs. 30.51% (18/59), =0.032]. For children without OBI at 7 months old, the incidence of OBI in booster group was significantly lower than that in non-booster group [25.64% (10/39) vs. 67.74% (63/93), <0.001].

CONCLUSIONS

The incidence of OBI in maternal HBsAg-positive children was high, serum HBV DNA in children with OBI was intermittently positive at low levels, and a booster HepB in infancy reduced the incidence of OBI in children with HBsAg-positive mothers.

摘要

背景与目的

已证实儿童隐匿性乙型肝炎病毒感染(OBI)与其对乙型肝炎疫苗(HepB)的免疫反应有关。本研究旨在调查加强剂量的HepB对OBI的影响,目前对此研究较少。

方法

本研究纳入了236名母亲HBsAg阳性的儿童,对其进行年度随访直至8岁,这些儿童乙型肝炎表面抗原(HBsAg)均为阴性。其中100名儿童在1至3岁时接受了加强剂量的HepB(加强组),136名儿童从未接受加强剂量(非加强组)。收集了儿童的系列随访数据及其母亲的基线数据,并分析了组间差异。

结果

随访期间OBI的发病率动态变化,7个月、1岁、2岁、3岁、4岁和8岁时分别为37.14%(78/210)、19.09%(42/220)、20.85%(44/211)、31.61%(61/193)、8.65%(18/208)和12.71%(30/236)。8岁时,加强组HBV DNA的阴转率显著高于非加强组[57.89%(11/19)对30.51%(18/59),P=0.032]。对于7个月时无OBI的儿童,加强组OBI的发病率显著低于非加强组[25.64%(10/39)对67.74%(63/93),P<0.001]。

结论

母亲HBsAg阳性儿童中OBI的发病率较高,OBI儿童的血清HBV DNA呈间歇性低水平阳性,婴儿期接种加强剂量的HepB可降低母亲HBsAg阳性儿童中OBI的发病率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87e3/10037503/3ffcf901755f/JCTH-11-661-g001.jpg

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