Santosham M
Center for American Indian and Alaskan Native Health, Johns Hopkins University, Baltimore, MD 21205.
Vaccine. 1993;11 Suppl 1:S52-7. doi: 10.1016/0264-410x(93)90161-p.
Haemophilus influenzae type b (Hib) is the leading cause of meningitis in children < 5 years of age. The majority of cases of Hib occur in infants < 2 years of age. Until recently the only vaccine available against this disease contained the pure polysaccharide (PRP) of Hib (Hib-PRP vaccine). The Hib-PRP vaccine was demonstrated to be efficacious in infants > 18 months of age but not below that age. This product was licensed for routine use in the USA for children aged 24 months or more. Recently a hyperimmune globulin termed bacterial polysaccharide immune globulin (BPIg) was prepared by immunizing adult donors with Hib-PRP, meningococcal and pneumococcal vaccines. BPIg has been demonstrated to prevent Hib infections when it is administered to infants at 4-month intervals. However, BPIg has not been licensed for routine use in the USA. A number of new Hib conjugate vaccines have also been developed in the last few years by convalently linking the Hib-PRP to different carrier proteins. Four different Hib conjugate vaccines have undergone clinical trials in the USA. Two of these vaccines, HbOC (Hib capsular oligosaccharide linked to CRM197) and Hib-OMPC (Hib capsular polysaccharide linked to Neisseria meningitidis outer membrane protein complex) have been demonstrated to protect infants aged 2 months or more from Hib disease. Both HbOC and Hib-OMPC are currently licensed for routine use in the USA. The widespread use of these vaccines should have a substantial impact in reducing morbidity and mortality from Hib disease.
b型流感嗜血杆菌（Hib）是5岁以下儿童脑膜炎的主要病因。大多数Hib病例发生在2岁以下的婴儿中。直到最近，唯一可用于预防这种疾病的疫苗含有Hib的纯多糖（PRP）（Hib-PRP疫苗）。Hib-PRP疫苗在18个月以上的婴儿中被证明是有效的，但在该年龄以下则无效。该产品在美国被批准用于24个月及以上儿童的常规接种。最近，一种名为细菌多糖免疫球蛋白（BPIg）的高效免疫球蛋白是通过用Hib-PRP、脑膜炎球菌和肺炎球菌疫苗免疫成年供体而制备的。已证明，以4个月的间隔给婴儿接种BPIg可预防Hib感染。然而，BPIg在美国尚未获得常规使用许可。在过去几年里，还通过将Hib-PRP与不同的载体蛋白共价连接，开发了多种新型Hib结合疫苗。四种不同的Hib结合疫苗在美国进行了临床试验。其中两种疫苗，HbOC（与CRM197连接的Hib荚膜寡糖）和Hib-OMPC（与脑膜炎奈瑟菌外膜蛋白复合物连接的Hib荚膜多糖）已被证明可保护2个月及以上的婴儿免受Hib疾病的侵害。HbOC和Hib-OMPC目前均已在美国获得常规使用许可。这些疫苗的广泛使用应该会对降低Hib疾病的发病率和死亡率产生重大影响。
