Lee S D, Chan C Y, Yu M I, Wang Y J, Lo K J, Safary A
Department of Medicine, Veterans General Hospital-Taipei, Taiwan, Republic of China.
Am J Gastroenterol. 1996 Jul;91(7):1360-2.
To investigate the feasibility of a single-dose primary hepatitis A vaccination for young travelers.
One hundred and nineteen susceptible youngsters, 9-18 yr old, received a dose of 720 ELISA units of the inactivated hepatitis A vaccine at month 0, and then a booster at month 6.
Antibodies to hepatitis A virus (anti-HAV) seroconversion ( > or = 20 mIU/ml) in these vaccinees was 91% (106/117) on day 15, and reached 99% (118/119) 1 month after the single-dose vaccination. At month 6 before the booster, 97% (110/113) of the vaccinees still had detectable anti-HAV. All vaccinees (113/113) had measurable titers of anti-HAV 1 month after booster vaccination, and were still seropositive (68/68) at month 12. The anti-HAV response was found to be slower in vaccinees positive for hepatitis B surface antigen (11/16, 68.8%), compared with noncarrier vaccinees (95/101, 94.1%; p < 0.01) 15 days after the priming dose. After initial vaccination, the geometric mean titers of anti-HAV among vaccine responders were 220, 255, 117, 3308, and 1094 mIU/ml at day 15 and months 1, 6, 7, and 12, respectively.
These results suggest that a single dose of hepatitis A vaccine could be a good alternative to immune serum globulin administration for immunoprophylaxis in young healthy travelers.
探讨对年轻旅行者进行单剂量甲型肝炎疫苗初种的可行性。
119名9至18岁的易感青少年在第0个月接种一剂720酶联免疫吸附测定单位的甲型肝炎灭活疫苗,然后在第6个月进行加强免疫。
这些接种者中甲型肝炎病毒抗体(抗-HAV)血清转化(≥20 mIU/ml)在第15天为91%(106/117),单剂量接种后1个月达到99%(118/119)。在加强免疫前的第6个月,97%(110/113)的接种者仍可检测到抗-HAV。所有接种者(113/113)在加强免疫接种后1个月抗-HAV滴度均可测,且在第12个月时仍为血清阳性(68/68)。发现乙肝表面抗原阳性的接种者(11/16,68.8%)抗-HAV反应比非携带者接种者(95/101,94.1%)在首剂接种后15天更慢(p<0.01)。初次接种后,接种反应者中抗-HAV的几何平均滴度在第15天、第1个月、第6个月、第7个月和第12个月分别为220、255、117、3308和1094 mIU/ml。
这些结果表明,对于年轻健康旅行者的免疫预防,单剂量甲型肝炎疫苗可能是免疫血清球蛋白给药的一个良好替代方案。