Marangi A L, Giordano R, Montanaro A, De Padova F, Schiavone M G, Dongiovanni G, Basile C
Division of Nephrology, Hospital of Martina Franca, Italy.
Am J Kidney Dis. 1994 Apr;23(4):537-42. doi: 10.1016/s0272-6386(12)80375-1.
Active immunization is crucial for eradicating hepatitis B virus infection from dialysis units. A prospective study was performed in 63 consecutive chronic uremic patients, which included the following: (1) the intramuscular (IM) administration of 40 micrograms of a DNA-recombinant vaccine (Engerix-B, Smith Kline & French Laboratories, Milan, Italy) to all chronic uremic patients at 0, 1, 2, and 6 months; (2) the antibody titer determination at the seventh month (chronic uremic patients with a titer > 100 mIU/mL received an IM booster dose of 40 micrograms at 18 months [group A], and those with a titer < 100 mIU/mL received a further IM dose of 40 micrograms at 12 months [group B]); and (3) the intradermal inoculation of 5 micrograms of vaccine every 2 weeks until the protective titer (> or = 10 mIU/mL) was achieved, and then monthly for 6 months, in chronic uremic patients who did not have a protective titer even after 19 months (group C). Thus, 41, 17, and five chronic uremic patients were allocated to groups A, B, and C, respectively. All developed a protective titer: 79.4%, 84.0%, and 87.5% after the fourth, fifth, and sixth IM dose at 7, 13, and 19 months, respectively. Five chronic uremic patients (group C) achieved seroprotection after 3.8 +/- 0.5 (SEM) intradermal inoculations.(ABSTRACT TRUNCATED AT 250 WORDS)
主动免疫对于在透析单位消除乙肝病毒感染至关重要。对63例连续的慢性尿毒症患者进行了一项前瞻性研究，包括以下内容：（1）在0、1、2和6个月时对所有慢性尿毒症患者肌肉注射40微克重组DNA疫苗（Engerix - B，意大利米兰史克必成实验室）；（2）在第7个月测定抗体滴度（抗体滴度>100 mIU/mL的慢性尿毒症患者在18个月时接受40微克的肌肉加强剂量[ A组]，抗体滴度<100 mIU/mL的患者在12个月时接受另一剂40微克的肌肉注射[ B组]）；（3）对于即使在19个月后仍未产生保护性滴度的慢性尿毒症患者，每2周皮内接种5微克疫苗，直至达到保护性滴度（≥10 mIU/mL），然后每月接种1次，持续6个月（C组）。因此，分别有41例、17例和5例慢性尿毒症患者被分配到A组、B组和C组。所有患者均产生了保护性滴度：分别在第7、13和19个月，在第4、5和6次肌肉注射后，产生保护性滴度的患者比例分别为79.4%、84.0%和87.5%。5例慢性尿毒症患者（C组）在3.8±0.5（SEM）次皮内接种后获得了血清保护。（摘要截短于250字）
