10μg和5μg乙型肝炎疫苗与乙型肝炎免疫球蛋白联合免疫阻断乙型肝炎病毒母婴传播的效果观察
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摘要
目的观察10μg与5μg乙型肝炎(乙肝)疫苗(HepB)与乙肝免疫球蛋白(HBIG)联合免疫阻断乙肝病毒(HBV)母婴传播的效果。方法以山东省寿光市5个街道2005-2015年住院分娩的HBV表面抗原(HBsAg)阳性的母亲及所生儿童(2-12岁)为研究对象,进行问卷调查和采集血清,用ELISA方法检测HBV血清学标志物,分析5μg和10μg HepB与HBIG联合免疫后的HBV母婴传播阻断失败率及影响因素。结果共纳入HBsAg阳性母亲所生儿童696人,其中5μg组245人、10μg组451人。Hep B与HBIG联合免疫后,HBsAg阳性19人,HBV母婴传播阻断失败率为2.73%,其中5μg组、10μg组分别为4.49%、1.77%(χ~2=5.98,P=0.014)。HBVe抗原(HBeAg)阳性母亲所生儿童的阻断失败率以5μg组(20.00%)显著高于10μg组(5.22%)(χ~2=6.85,P=0.009)。结论 10μg HepB的HBV母婴传播阻断效果优于5μg HepB。
Objective To observe the effect of either 10μg or 5μg hepatitis B vaccine( HepB) co-administered with hepatitis B immunoglobulin( HBIG) for interrupting the mother-to-infant transmission of hepatitis B virus( HBV). Methods We selected HBs Ag-positive mothers and their children( 2-12 years old) from hospitals of five townships of Shouguang city,Shandong province during 2005-2015 and administered a questionnaire and obtained serum samples from the children. We used ELISA to detect serological markers of HBV. We compared failure rates of interrupting mother-to-infant transmission between 10μg and 5μg HepB vaccination combined with HBIG,and determined factors influencing failure to prevent transmission. Results We recruited a total of 696 children whose mothers were HBsAg positive-245 in the 5μg group and 451 in the 10μg group. After co-administration of HepB and HBIG,19 children were HBsAg positive,for a failure rate of 2. 73%,with a 4. 49% failure rate in the 5μg group and a 1. 77% failure rate in the 10μg group( χ~2= 5. 98,P = 0. 014). The failure rate for children whose mothers were positive to HBV e antigen( HBeAg) was higher in the 5μg group( 20. 00%) than in the 10μg group( 5. 22%)( χ~2= 6. 85,P = 0. 009). Conclusions The effect of 10μg HepB with HBIG was superior to 5μg HepB with HBIG in interrupting mother-to-infant transmission of HBV.
Objective To observe the effect of either 10μg or 5μg hepatitis B vaccine( HepB) co-administered with hepatitis B immunoglobulin( HBIG) for interrupting the mother-to-infant transmission of hepatitis B virus( HBV). Methods We selected HBs Ag-positive mothers and their children( 2-12 years old) from hospitals of five townships of Shouguang city,Shandong province during 2005-2015 and administered a questionnaire and obtained serum samples from the children. We used ELISA to detect serological markers of HBV. We compared failure rates of interrupting mother-to-infant transmission between 10μg and 5μg HepB vaccination combined with HBIG,and determined factors influencing failure to prevent transmission. Results We recruited a total of 696 children whose mothers were HBsAg positive-245 in the 5μg group and 451 in the 10μg group. After co-administration of HepB and HBIG,19 children were HBsAg positive,for a failure rate of 2. 73%,with a 4. 49% failure rate in the 5μg group and a 1. 77% failure rate in the 10μg group( χ~2= 5. 98,P = 0. 014). The failure rate for children whose mothers were positive to HBV e antigen( HBeAg) was higher in the 5μg group( 20. 00%) than in the 10μg group( 5. 22%)( χ~2= 6. 85,P = 0. 009). Conclusions The effect of 10μg HepB with HBIG was superior to 5μg HepB with HBIG in interrupting mother-to-infant transmission of HBV.
引文
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[8]刘中芹,王晓琼,郭昊,等.乙型肝炎疫苗低/无应答婴儿不同剂量和剂次再免疫效果及持久性观察[J].微生物学与免疫学进展,2015,43(6):36-39.LIU Zhongqin,WANG Xiaoqiong,GUO Hao,et al.Observation of persistence and effect of booster immunization by hepatitis B vaccine with different dose and schedule for low/no immune response infants after primary immunization[J].Progress in Microbiology and Immunology,2015,43(6):36-39.
[2]孙莲英,庞志钊,张文英,等.不同剂量重组乙型肝炎疫苗(酵母)阻断乙型肝炎病毒母婴传播的研究[J].中国计划免疫,2006,12(4):262-263.SUN Lianying,PANG Zhizhao,ZHANG Wenying,et al.Research on perinatal transmission of hepatitis B virus by using different doses yeast-derived hepatitis B vaccine[J].Chinese Journal of Vaccines and Immunization,2006,12(4):262-263.
[3]王明儒,刘中芹,王晓琼,等.HBsAg阳性者乙肝病毒血清标志物的组合模式及e抗原阳性者年龄和性别分布[J].疾病预防控制通报,2015,30(2):12-13,38.WANG Mingru,LIU Zhongqin,WANG Xiaoqiong,et al.Composite modes of serological markers of hepatitis B virus in HBs Ag positive persons and age and sex distribution among persons with HBe Ag[J].Bulletin of Disease Control&Prevention(China),2015,30(2):12-13,38.
[4]王富珍,郑徽,张国民,等.中国2014年HBsAg阳性母亲所生1-14岁儿童乙型肝炎血清流行病学特征分析[J].中华流行病学杂志,2017,38(4):457-461.WANG Fuzhen,ZHENG Hui,ZHANG Guomin,et al.Sero-epidemiological analysis on hepatitis B among children 1-14 years old born to HBs Ag positive mother in China,2014[J].Chinese Journal of Epidemiology,2017,38(4):457-461.
[5]丁峥嵘,康文玉,陆林,等.云南省乙型肝炎母婴阻断实施效果评价[J].中华流行病学杂志,2014,35(2):114-116.DING Zhengrong,KANG Wenyu,LU Lin,et al.Evaluation on the efficacy of prevention programs and relevant factors targeting mother-to-infant transmission on hepatitis B virus in Yunnan province[J].Chinese Journal of Epidemiology,2014,35(2):114-116.
[6]姜洁,戴生龙,徐建芳,等.江苏省2010-2015年乙型肝炎母婴阻断效果的随访研究[J].中华流行病学杂志,2016,37(10):1345-1349.JIANG Jie,DAI Shenglong,XU Jianfang,et al.Follow-up study on efficacy of blocking mother-to-infant transmission of HBV and its influence factors in Jiangsu province,2010-2015[J].Chinese Journal of Epidemiology,2016,37(10):1345-1349.
[7]崔富强,王富珍,郑徽,等.接种不同剂量重组乙型肝炎疫苗(酵母)阻断乙型肝炎病毒母婴传播的评价[J].中国计划免疫,2007,13(4):289-292.CUI Fuqiang,WANG Fuzhen,ZHENG Hui,et al.Evaluation on protective efficacy of recombinant yeast derived Hepatitis B vaccine in preventing mother-to-infant transmission of hepatitis B[J].Chinese Journal of Vaccines and Immunization,2007,13(4):289-292.
[8]刘中芹,王晓琼,郭昊,等.乙型肝炎疫苗低/无应答婴儿不同剂量和剂次再免疫效果及持久性观察[J].微生物学与免疫学进展,2015,43(6):36-39.LIU Zhongqin,WANG Xiaoqiong,GUO Hao,et al.Observation of persistence and effect of booster immunization by hepatitis B vaccine with different dose and schedule for low/no immune response infants after primary immunization[J].Progress in Microbiology and Immunology,2015,43(6):36-39.