广东省佛山市新生儿乙型肝炎血源疫苗免疫后1—7？…

１９９４年抽查佛山市１９８７－１９９３年出生时经乙型肝炎（乙肝）疫苗免疫的儿童共９６１例，用国产放射免疫（ＲＩＡ）药盒检测，结果，免疫儿童的抗－ＨＢｓ一率由后１年的８４．０％降至免疫后７年的６９．２％；免疫后１－７年儿童的ＨＢｓＡｇ阳性率由免疫前的１６．９％下降至１．３５％；保护率达９２．０％；抗ＨＢｃ阳性率由免疫前的４０．９％下降至３．６％。表明新生儿经乙肝疫苗免疫后７年仍具有良好的免疫保护效果     

儿童接种两针乙型肝炎疫苗1—10年免疫效果的队列…

农村１－７岁易感儿童，按０、３程式接种两针１０μｇ乙型肝炎（乙肝）疫苗，进行了１０年免疫效果的队列研究。结果表明，乙型肝炎病毒表面抗体（抗－ＨＢｓ）阳经随免疫年限延长逐渐下降，免疫后１０年阳性率仍有５９．８％；免疫组儿童观察期间ＨＢｓＡｇ年阳转率由免疫前的１．３％下降到０．０５％，保护率为９６．２％；在免疫屏障的保护作用下，对照组ＨＢｓＡｇ年阳转率为０．４１％，也比免疫前降低了６８．５％；疫苗组与     

正定县乙型肝炎疫苗纳入计划免疫1—8年免疫效果观察

乙肝型炎（乙肝）疫苗纳入农村计划免疫后，进行了１－８年免疫效果的横断面调查。结果表明，１９８６－１９９３年出生（１－８岁）的儿童上疫苗全程接种率为８７．１８％；免疫后１－８岁全体儿童（水免疫儿童）乙型肝炎病毒表面抗体（抗－ＨＢｓ）阳经，由后第１年的９７．０３％降至第８年的７６．９２％；明显地随免疫年限延长逐渐下降；乙型肝炎病毒表面抗原ＨＢｓＡｇ阳性率由免疫前的１１．７６％降至２．４５％，保护率为７     

一种新生和乙型肝炎疫苗免疫方案的长期效果考核

对上海市南市区１９８６年出生并接种乙型肝炎（乙肝）疫苗的儿童进行了９年的血清学随访。这些儿童乙肝疫苗的免疫量为母亲乙肝炎病毒表面抗原（ＨＢｓＡｇ）阳性者给予三剂２０μｇ，阴性者给予三剂１０μｇ，其中母亲ＨＢｓＡｇ阳性者约占６．１６％。免疫后１－９年内各次随访的血清ＨＢｓＡｇ阳性率在１％以下波动，没有随年龄增长而升高；在免疫后第９年共检测４６８例血清，无１例ＨＢｓＡｇ阳性，大大低于免疫前本底对照５－     

河北农村新生儿乙型肝炎疫苗免疫效果的队列研究

结合农村计划免疫给新生儿接种３剂１０μｇ惭型肝炎（乙肝）疫苗，对免疫后首次检测乙型肝炎病毒表面抗原（ＨＢｓＡｇ）阴性７６２佝免疫儿童进行了９年系统队列研究。结果表明，抗－ＨＢｓ阳性率限延长而逐渐下降；由免疫后第１年的８２．４－９４．４％，降至第９年的６０％，期间ＨＢｓＡｇ累计阳转４例，人年阳转率为０．０９％（４／４２５２），与免疫前本底相比，保护率为９３．１％，并且４例ＨＢｓＡｇ阳转儿中２例呈一过     

乙型肝炎疫苗免疫区儿童乙型肝炎病毒的血清学调查

对１９８５年６月到１９９３年５月期间乙肝疫苗免疫工钠的儿童，进行了一次性ＨＢＶ血清流行病学调查。结果表明，免疫区内接受免疫的儿童，免疫的后第８年抗－ＨＢｓ阳转率高达７９．２％，抗－ＨＢ的Ｓ／Ｎ值≥１０．０者高达６６．４７％，几何平均滴度（ＧＭＴ）在５４．９ｍＩＵ／ｍｌ。ＨＢｓＡｇ携带率平均仅为１．１２％，较免疫前同龄儿ｓＡｇ阳性率（１７．４％）相比，下降了９３．５５％。     

不同剂量乙型肝炎疫苗阻断母婴传播的长期效果观察

在１９８６年与１９８８年分别对湘潭市１４７名乙型肝炎病毒表面抗原（ＨＢｓＡｇ）和ｃ抗原（ＨＢｃＡｇ）双一母亲所生的新生儿，采用不同剂量的乙型肝炎（乙肝）疫苗阻断母婴传播，并进行长期观察。免疫后１年新生儿抗－ＨＢｓ阳性率８８组为８０．００％（７６／９５），８６组为６７．３１％（３５／５２），两组相比较无显著性差异；免疫后９年，两组的抗－ＨＢｓ一率仍无差异。免疫后１年新生儿的ＨＢｓＡｇ阳性率８６组为０     

新生儿乙型肝炎疫苗免疫后首次检测为乙型肝炎病…

报告了新生儿乙型肝炎（乙肝）疫苗免疫后１－９年的ＨＢｓＡｇ阳性者年阴转率的定人随访结果。母亲ＨＢｓＡｇ阳性儿，乙肝疫苗免疫后首次检出的８４例ＨＢｓＡｇ阳性者，动态观察了１－９年，ＨＢｓＡｇ年抗ＨＢｓ，２／１０无抗－ＨＢｓ应答。结论：母婴阻断失败者的ＨＢｓＡｇ阳性儿，其ＨＢｓＡｇ年阴转率很低，和人群观察结果（１．１１％）相似；阴转者８０％能够产生抗－ＨＢｓＡｇ阳性儿，其ＨＢｓＡｇ年阴转率很低，和人群     

乙型肝炎疫苗免疫持久性及预防效果的队列定人研究

报告了新生儿乙型肝炎疫苗免疫后１－９年乙型肝炎病毒表面抗原（ＨＢｓＡｇ）阳转率的定人随访结果。母亲ＨＢｓＡｇ阳性和阴性免疫后的ＨＢｓＡｇ阴性者，基ＨＢｓＡｇ的年阳转率分别为０．３６％和０．０３６％，前者是后者的１０倍。母亲ＨＢｓＡｇ阳性儿中１４例ＨＢｓＡｇ阳转，其中１０／１４（７１％）发生在免疫后２－３岁；１２／１４（８６％）变成慢性ＨＢｓＡｇ携带者。母亲ＨＢｓＡｇ阴性儿共发现３例ＨＢｓＡｇ阳转，     

新生儿乙型肝炎疫苗免疫后远期效果的研究

对湘潭市市区０－１０岁儿童乙型肝炎（乙肝）疫苗免疫后的效果进行了系统监测。６次共调查儿时１２２名，各次调查的乙型肝炎病毒表面抗原（ＨＢｓＡｇ）携带率在０．００１－１．８３％之间，平均ＨＢｓＡｇ携带率１．１２％，明显低于免疫前现一人群的１６．１７％，保护率为９２．４６％。初次免疫后抗－ＨＢｓ的阳经及几何平均滴度（ＧＭＴ）高峰值均出现在６－１２个月，此后随时间的推移而逐渐下降，但７－１０岁儿童中仍有５     

中山市健康人群乙肝血清学监测情况分析

目的 了解乙肝疫苗接种效果情况，进而探讨如何更好地实行免费接种乙肝疫苗，确保接种质量。方法 随机抽取152名新生儿和1岁以上健康人群2495名，应用酶联免疫法对其血清进行HBsAg和anti．HBsAg检测。结果 152名新生儿，抗-HBs阳性141人，阳性率为92．7％。HBsAg阳性0人。2495名1岁以上健康人群，抗-HBs阳性1199人，阳性率为48．1％，HBsAg阳性259人，阳性率为10．4％。1～18岁844人，HBsAg阳性10人，阳性率为1．2％。18岁以上1651人，HBsAg阳性249人，阳性率为15．1％。结论 对新生儿及时进行乙肝疫苗全程免疫，能提高新生儿对乙肝的免疫力，预防乙肝。接种乙肝疫苗、提高接种质量能提高易感人群对乙肝的免疫力。降低人群乙肝感染率。1岁以上健康人群抗-HBs阳性率偏低，存在感染乙型肝炎病毒的危险。     

山东省人群乙型肝炎病毒＂a＂抗原决定簇突变分析

目的 了解目前山东省社区人群乙型肝炎病毒（HBV）＂a＂抗原决定簇突变率和突变形式,探讨乙肝疫苗（HepB）接种对＂a＂抗原决定簇突变的影响.方法 在全省1～59岁社区人群中通过多阶段随机抽样确定调查对象,通过询问（15岁以上）或查阅接种记录（14岁以下）了解调查对象HepB免疫史;采集血标本,酶联免疫吸附方法 检测血清乙肝表面抗原（HBsAg）,阳性者提取血清DNA,采用巢式PCR方法 扩增HBV S基因,测序后与标准序列进行比较.结果 共对7601人进行调查和血标本采集,得到HBsAg阳性标本239份（3.14%）,可用于HBV DNA提取206份,扩增HBV S基因并成功测序102份.15份血清标本检测到13种HBV＂a＂抗原决定簇突变,突变率为14.70%（15/102）.新生儿普种HepB前、后出生调查对象间,以及有、无HepB免疫史调查对象间＂a＂抗原决定簇突变率差异均无统计学意义.结论 目前山东社区人群中＂a＂抗原决定簇突变率较低且突变位点比较分散;未发现HepB接种对人群＂a＂抗原决定簇突变产生影响.     

Baseline seroepidemiology of hepatitis B virus infection in children in Taipei, 1984: a study just before mass hepatitis B vaccination program in Taiwan

Hepatitis B virus (HBV) markers were studied by radioimmunoassays in serum samples of 1,200 (647 male, 553 female) apparently healthy children under 15 years of age in Taipei between June and October 1984. The prevalence rate of hepatitis B surface antigen (HBsAg) was 5.1% in infancy, increased to 10.7% between 1 and 2 years of age, and then remained constant at about 10% thereafter. The prevalence rate of surface antibody (anti-HBs), core antibody (anti-HBc), and seropositivity (at least one marker of hepatitis B detectable) were 39.0, 30.5, and 52.5%, respectively, in infancy, then decreased to 10.7, 14.3, and 17.9%, respectively, between 1 and 2 years of age. Thereafter, the antibody prevalence increased in parallel with age. By the age of 13-14 years, nearly half of the children were infected by HBV. The results suggested that in our children, most HBsAg carriers resulted from infections before 3 years of age, and HBV infections after 3 years of age infrequently resulted in a carrier state. One hundred (83.3%) of the 120 HBsAg-positive children had hepatitis B e antigen (HBeAg), indicating high prevalence in young asymptomatic HBsAg carriers. The prevalence rate of HBeAg tended to decrease with age and a reversed trend was observed with anti-HBe. Our study, just before our government extends mass hepatitis B vaccination program from newborns to children, provides background seroepidemiologic data of HBV infections in the healthy children in Taiwan.     

Does Hepatitis B Virus Prenatal Transmission Result in Postnatal Immunoprophylaxis Failure?

The objective of this work was to evaluate whether postnatal hepatitis B immunization failure in children is caused by prenatal infections. A prospective study was conducted from October 2006 to September 2008. Fetal samples from HBsAg-positive mothers were retrieved by either amniocentesis or cordocentesis (percutaneous umbilical blood sampling [PUBS]). Hepatitis B virus (HBV) serologic markers (HBVM) and quantitative HBV DNA assays were performed to assess prenatal infection. All neonates were given combined HBV immunoprophylaxis after delivery. The newborns were followed up with HBV serologic testing at 1 year old. For the 252 pregnant women recruited, 16 fetuses were found to be HBV DNA positive, with all HBV DNA levels under 10(4) copies/ml. HBsAg and HBV DNA detected in the uterus were uncommon and were expressed at low levels. In contract to the case with prenatal statuses, neonatal serologies were more similar to their mothers'. The response rate of vaccination was 95%. Six children for whom immunoprophylaxis failed were born to HBeAg-positive mothers with high HBV DNA levels (>10(8) copies/ml), but only one of them was found to be positive for intrauterine HBV DNA (8.5 × 10(2) copies/ml). The presence of intrauterine hepatitis B antigen and DNA does not indicate postnatal HBV infection and vaccination failure.     

新生儿乙型肝炎疫苗免疫后13年效果观察

目的 研究乙型肝炎的远期免疫效果。方法 采用单纯随机方法连续13年对1986年出生并接种乙型肝炎疫苗的儿童进行隔年随访,采血检测HBsAg、抗-HBs、抗-HBc。结果 13年间HBsAg阳性率在0.46%-0.97%之间,未随免疫时间的延长而上升,乙型肝炎疫苗的远期保护效果为81.67%,与近期免疫效果相当。结论 免疫后13年仍无需加强免疫。     

西藏墨脱县1262名中小学生乙肝标志物检测结果分析

目的了解墨脱县1262名中小学生乙型肝炎病毒（HBV）感染状况,为乙肝防治工作的开展提供依据。方法用酶联免疫方法检测HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc五项乙肝标志物,Excel统计软件对检测结果进行统计分析。结果1262名中小学生乙肝标志物五项全阴者有886人,占70.2%;仅有303名中小学生有保护性的乙肝表面抗体,占24.0%;39名学生HBsAg阳性,阳性率3.1%。HBsAg阳性39名学生中,HBsAg、HBeAg和抗-HBc三项阳性的学生有27名,占69.2%。结论1262名中小学生中乙肝标志物五项全阴者比例较高,有保护性抗体的比例较低,存在接触感染乙肝病毒的较大风险,因此,加强西藏墨脱县中小学生乙肝疫苗接种工作刻不容缓。     

Analysis of a pregnancy-screening and neonatal-immunization program for hepatitis B in Hamilton, Ontario, Canada, 1977-1988

During the 12 years from January, 1977, to December, 1988, the Hamilton Centre of the Canadian Red Cross Society (CRCS) Blood Transfusion Service screened 98,712 pregnant patients for hepatitis B surface antigen (HBsAg) and identified 120 positives (0.12%). The number of positives ranged from six to 16 per year. We were able to trace and enroll 65 mothers (54%) and 96 of their children in the follow-up study. The majority of the women were between 20 and 30 years of age (95.4%) and married (86%), and about one-half were employed outside the home. Sixty-five percent were white and 34% Asian, and 20 countries were listed as their places of origin. Hepatitis B immune globulin (HBIG) was available for neonatal immunization since 1977 and combined with vaccine since 1982. Of the 96 candidates for HBIG, 60 (63%) received HBIG within 24 hr, one after 3 months, four unknown, and 31 did not receive it. Of the 56 candidates for vaccination from 1982 to 1989, 26 (46%) received three doses, seven had two doses, eight had one dose, one was unknown, and 14 had none. HBsAg tests were performed on 69 children (71.8%) and anti-HBs on 61 (63.5%). Four of the children are HBsAg positive, 31 have anti-HBs, and 31 have no detectable antibodies. All four HBsAg positives had not received vaccine, and only one had received HBIG. Of the children positive for hepatitis B surface antibodies, five had received no immunization and therefore had been subclinically infected.(ABSTRACT TRUNCATED AT 250 WORDS)     

Prevention and control of hepatitis B in China

About 170 million Chinese are infected chronically with HBV and 10% suffer from chronic hepatitis. Around half a million Chinese die from hepatitis B caused hepatocellular carcinoma and endstage cirrhosis each year. From 1983 to the present, a controlled clinical trial involving 80,000 children on a universal hepatitis B vaccination programme to prevent chronic hepatitis, hepatocellular carcinoma, and endstage cirrhosis was implemented in Qidong, China. A pilot study demonstrated that the HBsAg rate reached the adult level before the fifth year of age, and neonatal vaccination with either plasma-derived or recombinant hepatitis B vaccines provided a similar 75% protective efficacy against HBV infection. The high rate of follow-up and blood tests coverage of the cohorts provided data to show 75% protection at the tenth to eleventh years of age against serum HBsAg and also against prolonged hepatic dysfunction. The strategy of controlling hepatitis B nationwide was based on the universal immunisation of newborns, beginning in cities and then the rural areas. The large-scale vaccine source was provided by domestic plants through technology transfer, first providing plasma-derived vaccine replaced completely by recombinant DNA vaccine in 1997. An official survey in 1999 using a cluster sampling of 25,878 children from 31 provinces reported an average coverage rate of three dose of hepatitis B vaccination of 70.7%, being higher in urban areas. The Ministry of Public Health of China has planned to integrate hepatitis B vaccination into the nationwide EPI program with Government-provided vaccines starting January 1, 2002.     

乙肝疫苗免疫失败儿童病毒S基因"a"决定簇变异研究

目的 探讨江苏常州地区乙型肝炎疫苗免疫失败儿童病毒S基因“a”决定簇的变异情况。方法 对15例乙肝疫苗接种后血清表面抗原(HBsAg)阳性的儿童,采用聚合酶链反应方法(PCR)扩增其血清中HBV DNA S基因区。并对PCR产物直接标记测序。结果 15例HBsAg阳性儿童有14例血清HBV DNA阳性,其中有4例出现了S基因“a”决定簇的变异,变异率为28．6％,第126位的异亮氨酸（Ile)被苏氨酸(Thr)替代1例,第134位苯丙氨酸(Phe)被异亮氨酸替代1例。第145位甘氨酸(Gly)被丙氨酸(Pha)替代2例。结论乙型肝炎疫苗免疫失败儿童中存在s基因“a”抗原决定簇变异,江苏常州地区存在HBVS基因“a”决定簇变异的新类型。     

乙型肝炎疫苗高覆盖率对接种人群发病的影响

目的 评价乙型肝炎(乙肝)疫苗高免疫覆盖率的免疫效果.方法 收集接种人群历年的接种报告、乙肝血清学流行率调查结果,分析乙肝疫苗接种后历年乙肝发病的疫情报告,采用酶联免疫吸附试验测定乙肝表面抗原、乙肝表面抗体和乙肝核心抗体,并与接种前期的检测结果进行比较.结果 1992—2011年(乙肝疫苗接种20年)烟台市15岁以下儿童乙肝发病下降了86.84%.5~14岁发病高峰被削平.全人群乙肝表面抗原携带率从1990年13.59%,降至2006年4.61%,从乙肝高度流行区降到了中度流行区.同期0~15岁乙肝表面抗原携带率由12.67%降至0.82%,降幅达到93.53%.结论 乙肝疫苗高覆盖率接种有显著的免疫保护效果,应继续坚持.