成人及新生儿乙肝疫苗免疫后15年内表面抗体水平的变化

目的描述和比较北京市15岁及以上人群(以下简称成人)及新生儿乙肝疫苗接种后的15年内抗体水平,为北京市乙肝疫苗接种策略提供参考。方法 2013年8月至2014年2月采用多阶段整群随机抽样方法在北京市1岁以上人群中抽取6 705人进行乙肝血清学流行病学调查,选择其中完成3针基因重组乙肝疫苗接种且没有进行加强免疫的成人和新生儿为研究对象,描述和比较成人和新生儿接种乙肝疫苗后15年抗-HBs阳性率和抗-HBs滴度变化。结果共纳入符合入组标准的新生儿和成人分别为463和129人。基于中国目前15~59岁人群自限性感染率估计为30%,成人接种后0~4、5~9和10~15年的抗-HBs阳性率仍可分别保持在58.6%、62.5%和48.4%,呈现平稳下降的趋势;对应的抗-HBs滴度中位数分别为288.8、120.6和62.6 m IU/m L。新生儿接种人群3个时间段的抗-HBs阳性率分别为83.3%、47.3%和43.5%;抗-HBs滴度中位数分别为71.8、8.9和6.7 m IU/m L;成人接种乙肝疫苗后5~15年的抗-HBs滴度及阳性率均高于新生儿。结论成人和新生儿接种乙肝疫苗15年内可获得良好的保护。

Anti-HBs level in 15 years after vaccination in adults and newborns

Objective To investigate the anti-HBs level in 15 years after vaccination in adults and newborns in Beijing and provide the suggestion for the adult hepatitis B (HB) immunization plan.Methods A serological survey was conducted in 6 705 subjects aged > 1 year old by multistage randomized cluster sampling in Beijing during August 2013 to February 2014.The subjects who had received a 3-dose recombination HB vaccine when they were newborns or adults aged ≥15 years old and did not undergo revaccination were selected.Antibody to hepatitis B surface antigen (anti-HBs) titers and positive rates in 15 years after vaccination were evaluated.Results A total of 129 and 463 subjects who were vaccinated in adults and newborns were enrolled in the study.Based on the self-limited rate(30%) of HBV infection among the general population aged 15 to 59 years, anti-HBs positive rates for the subjects vaccinated in adults were estimated to be 58.6%,62.5 % and 48.4% during 0-4, 5-9 and 10-15years after vaccination respectively.The corresponding median of anti-HBs titers were 288.8, 120.6 and 62.6 mIU/mL.The anti-HBs positive rates for the subjects vaccinated in newborns during 0-4, 5-9 and 10-15 years after vaccination were 83.3%, 47.3% and 43.5%, respectively.The corresponding anti-HBs titers were 71.8, 8.9 and 6.7 mIU/mL.Conclusions The protection afforded by primary immunization with recombination vaccine in adults and newborns lasts at least 15 years.