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庄贵华, 王学良, 徐慧文, 翟样军, 吴谦. 乙型肝炎疫苗无/弱应答者复种远期效果[J]. 中国公共卫生, 2003, 19(7): 778-779.
引用本文: 庄贵华, 王学良, 徐慧文, 翟样军, 吴谦. 乙型肝炎疫苗无/弱应答者复种远期效果[J]. 中国公共卫生, 2003, 19(7): 778-779.
ZHUANG Gui-hua, WANG Xue-liang, XU Hui-wen, . Long-term efficacy of hepatitis B revaccination in non and hypo-responders[J]. Chinese Journal of Public Health, 2003, 19(7): 778-779.
Citation: ZHUANG Gui-hua, WANG Xue-liang, XU Hui-wen, . Long-term efficacy of hepatitis B revaccination in non and hypo-responders[J]. Chinese Journal of Public Health, 2003, 19(7): 778-779.

乙型肝炎疫苗无/弱应答者复种远期效果

Long-term efficacy of hepatitis B revaccination in non and hypo-responders

  • 摘要:
      目的   探讨乙肝疫苗无/弱应答者复种远期效果。
      方法   严格筛选无/弱应答者40名, 分肌肉和皮内接种, 用3针加倍剂量(每次10μg或2μg), 以80名同期筛检人群正常应答者作对照, 完成30个月随访观察。
      结果   无/弱应答者复种后39人产生抗体应答; 第30个月, 肌肉与皮内组仍有64.7% 和34.8% 维持抗体阳性。但无/弱应答者抗-HBs阳性率和抗体阳性者GMT均明显低于正常应答对照(P < 0.01)。无/弱应答者HBV累积感染率(单项抗-HBc阳性)为25.0% (肌肉组1.76%, 皮内组30.4%), 显著高于正常应答对照2.6% (P < 0.01)。
      结论   肌肉接种好于皮内接种。无/弱应答者复种确实能起到改善应答, 并在一个相对较长时间维持抗体水平的作用, 但效果不容乐观。最终结论还需结合免疫记忆的研究做进一步追踪观察。

     

    Abstract:
      Objective   To evaluate long-term efficacy of hepatitis B revaccination in non-and hypo-responders.
      Methods   40 non-and hypo-responders diagnosed with severe screening were given three 2-fold-dose boosters(10Lg or 2 μg per dose) randomly by intramuscular or intradermal route, and 80 normal responders diagnosed from the same screening were selected as the controls.A 30-month follow-up was finished after the first booster.
      Results   39 non-and hypo-responders produced protective level anti-HBs, and 64.7% of intramuscular vaccinees and 34.8% of intradermal vaccinees still kept anti-HBs positive at the 30th month.However, the anti-HBs positive rate and the GMT of the antibody positive subjects in non-and hypo-responders were significantly lower than those in normal responders(P < 0.01), and the cumulative HBV infection rate(isolated anti-HBc positiveconversion as infection marker)in non-and hypo-responders was 25.0% (17.6% for intramuscular and 30.4% for intradermal), dramatically higher than 2.6% in normal responders(P < 0.01).
      Conclusion   Intramuscular route was more effective than intradermal route.It is undoubted that revaccination in non-and hypo-responders can improve response to the vaccine and keep protective anti-HBs within a relatively long time, but the efficacy was limited.The final conclusion needed further research with observation on immune memory.

     

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