Dienstag J L, Stevens C E, Bhan A K, Szmuness W
Ann Intern Med. 1982 May;96(5):575-9. doi: 10.7326/0003-4819-96-5-575.
We administered up to 6 monthly doses of hepatitis B vaccine to 16 chronic carriers of hepatitis B surface antigen (HBsAg) in an attempt to eliminate the antigen. The HBsAg in this vaccine differs from native antigen. No patients had elimination of HBsAg, but one of 10 no longer carried hepatitis B e antigen (HBeAg), Of 13 patients without preexisting antibody to HBsAg (anti-HBs), none acquired the antibody; two of three patients with preexisting heterotypic anti-HBs had transient, low-level increases in anti-HBs titers. Serum alanine aminotransaminase (ALT) levels fell in eight patients, remained unchanged in six, and increased transiently in two. Decreased ALT and HBeAg clearance, however, did not seem to be related to vaccination, and the transient ALT elevations appeared to represent sporadic, acute non-A, non-B hepatitis. No adverse effects other than sore arm and joint pain were seen. Immunization of chronic HBsAg carriers with hepatitis B vaccine, although ineffective in eliminating HBsAg, appeared to be safe. Such safety, if confirmed, would simplify the design of hepatitis B vaccination programs.
我们对16名慢性乙型肝炎表面抗原（HBsAg）携带者每月注射多达6剂乙肝疫苗，试图消除该抗原。此疫苗中的HBsAg与天然抗原不同。没有患者消除HBsAg，但10名患者中有1名不再携带乙肝e抗原（HBeAg）。在13名之前没有乙肝表面抗体（抗-HBs）的患者中，无人产生该抗体；3名之前有异型抗-HBs的患者中有2名抗-HBs滴度出现短暂、低水平升高。8名患者血清丙氨酸氨基转移酶（ALT）水平下降，6名患者保持不变，2名患者短暂升高。然而，ALT降低和HBeAg清除似乎与接种疫苗无关，短暂的ALT升高似乎代表散发性急性非甲非乙型肝炎。除了手臂酸痛和关节疼痛外，未观察到其他不良反应。对慢性HBsAg携带者接种乙肝疫苗，虽然在消除HBsAg方面无效，但似乎是安全的。如果这种安全性得到证实，将简化乙肝疫苗接种计划的设计。
