摘要
目的 探讨高病毒载量e抗原（HBeAg）阳性慢乙肝孕妇母婴阻断成功后,在1岁和3岁之间儿童HBsAb滴度变化以及分析其长期保护性和感染率.方法 入组乙肝表面抗原（HBsAg）、HBeAg双阳性、孕28周HBV DNA≥106IU/ml慢性HBV感染孕妇的1周岁龄儿童,并随访至3岁,分别在1岁和3岁时检测这些儿童的进口乙肝五项及生化检测并分析1岁至3岁未补打加强疫苗儿童HBsAb滴度变化、阳性率、阴性率和感染率;同时回顾性收集这些1岁儿童在我院有7个月HBsAb滴度检测者,分析7个月至1岁期间未补打加强疫苗儿童HBsAb滴度变化、阳性率和阴性率.结果 该研究入组264例1岁儿童,其中有7个月至1岁期间未补打加强疫苗儿童有178例,1岁至3岁期间的儿童中有114例未补打加强疫苗.结果显示在l岁和3岁时未发现感染儿童.7个月至1岁儿童HBsAb滴度呈现下降趋势,HBsAb滴度中位数从1 000 IU/L降至509.43 IU/L（P＜0.05）,抗体仍然具有保护性;而1岁至3岁期间,HBsAb滴度中位数从466.72 IU/L降至67.3 IU/L （P＜0.05）,3岁时有60.52％儿童处于低免疫应答或无应答状态,但仍具有保护性,但显著低于补打加强疫苗者,因此,这些1岁至3岁期间未补打加强疫苗的儿童仍处于高危状态.结论 7个月抗体有保护性,则1岁和3岁时不易感染;而3岁时抗体降至低或无应答状态,儿童仍处于高危状态,有必要对其采取保护措施,补打加强疫苗.
Objective To investigate the change of hepatitis B surface antibody （HBsAb） titer and its long-term protection and infection rates between 1 and 3-year-old children whose mothers were chronic hepatitis B pregnant woman with HBeAg positive and high viral load after successful blocking of mother-to-child transmission.Methods One-year-old children whose mothers were hepatitis B surface antigen （HBsAg） and hepatitis B e antigen （HBeAg） positive,with HBV DNA ≥ 106IU/ml were enrolled,then were followed up till 3 years old,and tested the five serological markers of hepatitis B and biochemical parameters at the age of one and three years respectively,and analyzed HBsAb titer,positive rate,negative rate and infection rate of 1 to 3-year-old children without enhanced vaccination;meanwhile,data of HBsAb titers at the age of 7 months were collected HBsAb titer,positive rate,and negative rate were analyzed.Results Totally 264 1-year-old children were enrolled into the study,including 178 children without enhanced vaccination between seven months and 1 year of age,and 114 children without enhanced vaccination between 1 year and 3 years of age.Our result showed that there were no infected children at the age between 1 and 3 years.HBsAb titer decreased from 7 months to 1 year old and dropped from 1 000 IU/L to 509.43 IU/L （P 〈 0.05）,and the antibody was still protective.From 1 year to 3 years old,HBsAb titer dropped from 466.72 IU/L to 67.3 IU/L （P 〈 0.05）;at the age of 3 years,60.52 % children were either weakly positive or negative,but still protective,but significantly less than those who had the reinforced vaccination.As a result,the children without the enhanced vaccination between 1 and 3 years of age were still at high risk.Conclusions If the antibody was protective at 7 months,children were not easily infected between-1 year and 3 years of age.At the age of 3,the antibody dropped to low or no responsive levels,and the children were still at high risk.It is necessary to take protective measures a
出处
《中华实验和临床病毒学杂志》
CAS
CSCD
2017年第5期401-404,共4页
Chinese Journal of Experimental and Clinical Virology
基金
北京市卫生系统高层次卫生人才项目（2015-3-106）
北京市科委首都『临床特色应用课题（Z141107002514131）
关键词
肝炎病毒
乙型
乙肝表面抗体
疫苗肝炎
乙肝
母婴传播
Hepatitis B virus
Hepatitis B surface antibody
Hepatitis B vaccine
Mother-to-child transmission
