摘要
目的探讨乙肝疫苗接种后无(低)应答者加大剂量再免疫的效果,以提高乙肝疫苗预防接种的保护率。方法对近3年已完成标准乙肝疫苗免疫接种程序至少一年、复查乙肝病毒标志物均为阴性的健康人群,随机地接受3种再免疫方案,按常规程序(0、1、6个月)予肌肉注射。A组40例:进口重组乙肝疫苗(安在时),每次剂量40μg;B组40例:安在时,每次剂量20μg;C组40例:国产重组乙肝疫苗,每次剂量20μg。在首针乙肝疫苗接种前及接种后第1、2、7个月(T1、T2、T7)采血检测抗-HBs。结果 T1时,进口40μg组、进口20μg组和国产20μg组复种后应答率分别为45.0%(18/40)、37.5%(15/40)和30.0%(12/40),3组应答率差异无统计学意义(χ2=1.920,P=0.383);T2和T7时,3组复种后应答率分别为67.5%(27/40)、47.5%(19/40)、40.0%(16/40)和77.5%(31/40)、55.0%(22/40)、50.0%(20/40),进口40μg组应答率高于其余两组(χ2为4.014～6.545之间,P均<0.05)。T2和T7时,进口40μg组应答率差异无统计学意义(χ2=1.003,P=0.317)。各组患者复种后均未出现严重副反应。结论对乙肝疫苗无(低)应答者增加疫苗剂量加强免疫是有效的措施,抗-HBs应答率随疫苗剂量增加而提高。进口40μg组加强2针即可,加强3针未能较加强2针明显提高抗-HBs应答率。
Objective To evaluate the effectiveness of booster dose of yeast recombinant hepatitis B vaccine in the low-responding adult subjects. Methods Individuals with a history of immunization with recombinant hepatitis B vaccine according to the standard scheme in the past three years and negative for hepatitis B markers （HBsAg, anti-HBs, HBeAg, anti-HBe and anti-HBe） were randomly divided into various groups for 3 booster immunization, namely 0, 1st and 6th month.40 adults in group A were given with Engerix 40 txg each time by intramuscular route. 40 adults in group B were given with Engerix 20 μg and 40 adults of group C were given with hepatitis B vaccine （made in China） 20 μg. The level of serum anti-HBs was determined before the 1st injection and at the 1st （T1）, 2nd （T2） and 7th （T3） month after the first injection. Results In T1, the positive anti-HBs sero-conversion rate of group A, B and C was 45.0% （18/40）, 37.5% （15/40） and 30.0% （12/40）, respectively. The difference was not statistical significant （χ^2=1.920,P=0.383）. The positive anti-HBs sero-conversion rate for these three groups in T2 was 67.5% （27/40）, 47.5% （19/40） and 40.0% （16/40）; and was 77.5% （31/40）, 55.0% （22/40） and 50.0% （20/40） in T7. The positive anti-HBs sew-conversion rate in group A was higher than those in group B and group C （χ^2=4.014-6.545, P〈0.05）. In group A, there were no statistical significance （χ^2=1.003, P=0.317） of the anti-HBs positive conversion rate between T2 and T7.There was no severe side-effect in all these groups after revaccination. Conclusions Booster dose of yeast recombinant hepatitis B vaccine is effective for the low responders. The anti-HBs sero-eonversion rate is associate with the increase in the vaccine dose.Two booster doses of 40 μg Engefix are enough for the low-responders and the third dose could not further increase the rate of anti-HBs seroconversion.
出处
《热带医学杂志》
CAS
2010年第4期457-459,共3页
Journal of Tropical Medicine
基金
广东省科技计划资助项目(No.2008B030301048)
2009年度南沙区公共服务研究项目(No.2010GG001)
关键词
乙肝疫苗
抗-HBS
免疫
无(低)应答
hepatitis B vaccine
anti-HBs
immunization
non-and hypo-responders
