合肥市婴幼儿乙肝疫苗免疫应答观察

我站自1992年应用SPRIA法对全市接种过乙肝疫苗的婴幼儿免疫应答状况进行监测，本文汇集有关资料，以期反映合肥市婴幼儿的免疫水平。     

小鼠不同基因型与乙肝疫苗免疫应答的关系研究

目的 研究实验小鼠基因型与乙肝疫苗免疫应答的关系.以保证根据小鼠基因型选择适于进行免疫应答检测的实验小鼠,保证进行疫苗免疫应答检测时的规范化和标准化.方法 应用小鼠NIH1、2、3个种群和BALB/c、DBA/1共3种不同品系和同一品系不同种群的小鼠各40只,乙肝疫苗稀释4个不同的稀释度,每个稀释度注射动物10只.酶标法检测乙肝疫苗免疫效力,测定乙肝疫苗的半数有效剂量(ED50)值,再通过微量细胞毒法和PCR方法 检测小鼠的H-2单倍型,计算不同品系小鼠H-2q的百分比,得出乙肝疫苗与不同动物种群的相关性.结果 重组乙肝疫苗(酿酒酵母)经BALB/c鼠检测疫苗的ED50值为2.5μg/ml;经1号种群NIH鼠检测疫苗的ED50值为2.0μg/ml;经2号种群NIH鼠检测疫苗的EDM50值为1.3μg/ml;经3号种群NIH鼠检测疫苗的ED50值为2.3μg/ml;经上海某公司DBA/1鼠检测疫苗的ED50值为0.8μg/ml,对乙肝疫苗的效力反应最强.根据<中国药典>2005年版三部的规定,疫苗的ED50值为≤1.5μg/ml.所以得出的结果 是2号种群NIH鼠和DBA/1鼠检测疫苗是合格的.基因检测结果 DBA/1为H-2q近交系小鼠,2号种群NIH鼠含有H-2q型基因的百分比是96%,3号种群NIH鼠含有H-2q型基因的百分比是30%,而1号种群NIH小鼠含有H-2q型基因百分比为56%,因此DBA/1小鼠和2号种群NIH鼠对乙肝疫苗均产生高应答效应,且远远高于免疫基因型为H-2d的BALB/c小鼠.结论 在进行乙肝疫苗效力鉴定时选择含有q型基因较多的NIH小鼠作为检测动物可以取得较好的应答效果.     

乙肝疫苗免疫耐受性相关基因研究进展

乙肝疫苗接种可刺激机体免疫系统产生保护性抗体,但部分人群接种后并没有有效的抗体产生.发生乙肝疫苗低或无应答的免疫耐受因素众多,机体的遗传因素是一个重要原因.该文就接种乙肝疫苗后所产生的免疫耐受现象与机体遗传相关基因的研究进展进行综述.     

HLA-DRB1等位基因与吉林地区汉族乙肝疫苗免疫应答的关联研究

目的:探讨HLA-DRB1等位基因与吉林地区汉族乙肝疫苗免疫应答的关联性。方法:采用聚合酶链反应-序列特异性引物(PCR-SSP)分型技术,对84例乙肝疫苗无或低应答者HLA-DRB1等位基因进行检测,与78例乙肝疫苗中或强应答者人群进行对照。结果:①HLA-DRB1*14等位基因频率在无或低应答组为23.8%,中或强应答组为5.13%,两组之间比较有统计学差异(P<0.05);②HLA-DRB1*12、HLA-DRB1*15等位基因频率分别在无或低应答组为4.76%和7.14%,在中或强应答组为23.1%和24.4%,两组之间比较也存在统计学差异(P<0.05)。③等位基因HLA-DRB1*07(2.38%和5.12%),HLA-DRB1*08(9.52%和8.97%),HLA-DRB1*09(7.14%和10.3%),HLA-DRB1*11(7.14%和7.69%),HLA-DRB1*13(4.76%和6.41%)及HLA-DRB1*16(4.76%和5.13%),在无或低应答组和在中或强应答组之间基因频率分布没有统计学差异(P>0.05)。结论:吉林地区汉族乙肝疫苗接种后,①HLA-DRB1*14等位基因可能与无或低应答相关;②HLA-DRB1*12、15等位基因可能与中或强应答相关;③未检测到HLA-DRB1*07、08、09、11、13、16等位基因与免疫应答水平之间有明显的相关性。     

湖北汉族人群对乙肝疫苗免疫应答能力与HLA-DRB1等位基因相关性的研究

目的分析HLA-DRB1等位基因型别与个体乙肝疫苗免疫应答水平的相关性。方法对37名湖北汉族健康自愿者进行HBV血源型疫苗标准全程接种,共3次(0,1,6月),末次接种后8周用酶免疫法(EIA)检测血清抗-HBs抗体水平(S/N≥2.1为应答者,S/N<2.1为无应答者);同时,对全部受试者进行HLA-DRB1基因分型。结果37名个体中无应答者7名(19%),应答者30名(81%),无应答与HLA-DRB*1001等位基因具有显著相关性,RR=21.75,X2=5.55,P<0.05。结论在湖北汉族人群中,携带HLA-DRB*1001等位基因个体对乙肝疫苗的免疫应答水平明显低于其他个体     

HLA-DRB1*07,13等位基因对乙肝疫苗免疫效果影响的研究

目的:探讨机体HLA-DRB1*07,13等位基因对基因重组乙肝疫苗免疫效果的影响.方法:选取完成基因重组乙肝疫苗全程接种(10 μg/次,0、1、6月)的广西籍汉族健康大学生896名,于末次接种疫苗后的第6个月采血检测血清抗-HBs水平,对无或低应答者再次接种基因重组乙肝疫苗20 μg,4周后筛选出无或低应答者99名及初次检测中或强应答者136名作为研究对象,应用PCR-SSP技术对研究对象外周血HLA-DRB1*07,13等位基因进行检测.结果:HLA-DRB107在无或低应答组中的表达频率为16.16%,显著高于中或强应答组的表达频率(4.41%)(P＜0.05);HLA-DRB1*13在无或低应答组和中或强应答组的表达频率分别为1.01%和3.68%,两组比较无统计学差异(P＞0.05).结论:基因重组乙肝疫苗无或低应答与HLA-DRB1*07基因密切相关;而HLA-DRB1*13对乙肝疫苗的免疫应答无明显影响.     

不同剂量乙肝疫苗免疫效果对比

2003年12月～2006年10月,我们对我院没有接种过乙肝疫苗的新兵及学员258人进行乙肝疫苗接种,并对不同剂量的乙肝疫苗阳性产生率做出对比,发现剂量不同,阳性率     

湖北汉族人群对乙肝疫苗免疫应答的水平与HLA-I类分子多态性的相关研究

目的：探讨人群对乙肝疫苗免疫应答与ＨＬＡ遗传多态性的相关性。方法：对５２名湖北汉族健康自愿者进行ＨＢＶ血源疫苗标准全程接种,共３次（第０、１、６月）,末次接种后８ｗ用酶免疫法（ＥＩＡ）检测血清抗ＨＢｓ抗体水平：Ｓ／Ｎ≥２１为应答者;Ｓ／Ｎ＜２１为无应答者。同时对受试者进行ＨＬＡＩ类抗原多态性检测。结果：应答者４２人（８１０％）,无应答者１０人（１９０％）;无应答者与ＨＬＡＢ３９具有显著相关性,ＲＲ＝１７５,χ２＝５２２,Ｐ＜００５,而与ＨＬＡＢ６２呈负相关,χ２＝６４１,Ｐ＜００５。结论：在湖北汉族人群中,ＨＬＡＢ３９表型阳性个体对乙肝疫苗免疫应答水平明显低于其他个体,而ＨＬＡＢ６２表型阳性个体明显高于其他个体。     

我国乙型肝炎疫苗免疫

自 1 992年起 ,我国建议对婴儿进行国产乙型肝炎疫苗的常规免疫 ,接种程序为 0、1、6月 ,以预防乙型肝炎病毒 (HBV)的围产期传播。为了评价儿童的乙型肝炎疫苗覆盖率 ,1 999年对我国 31个省市自治区 2 5 878名 3岁以下儿童 ,进行了一次全国性调查。城市 1 2月龄以下儿童的乙型肝炎疫苗覆盖率为 88 5 % ,农村为 6 2 7% ;各省市自治区的乙型肝炎疫苗覆盖率不同 ,有 4个省为≥ 90 % ,9个省为 75 %～ 89% ,8个省为 5 0 %～ 74 % ,1 0个省为 <5 0 %。乙型肝炎疫苗覆盖率高与社会经济状况好、对乙型肝炎认识程度高、卫生保健服务完善 (如城市、非山区 )、非少数民族、在医院而不是在家里出生密切相关。我国于 2 0 0 2年将新生儿乙型肝炎疫苗正式纳入计划免疫 ,向所有新生儿免费 (除手续费外 )接种乙型肝炎疫苗 ,中央政府向贫困地区特别是西部 1 2个省提供资助 ,其他省由地方政府提供乙型肝炎疫苗资金。婴儿乙型肝炎疫苗常规免疫不仅可预防HBV急性感染 ,还可降低慢性肝病包括肝癌的发病率和死亡率。为了提高安全接种 ,我国卫生部实施了一项全国性行动计划 ,包括至 2 0 0 5年时所有免疫接种均使用一次性自毁注射器 ,以及安全免疫接种培训等     

广州市应用乙型肝炎疫苗免疫22年人群血清学效果研究

目的评价广州市长期应用乙型肝炎疫苗（hepatitis B vaccine,HepB）对乙型肝炎（乙肝）免疫防病效果。方法在广州市全市12个区、县级市按照多阶段分层整群抽样法,以家庭为单位对1～59岁人群进行横断面调查分析,包括检测HBsAg、抗-HBs,对HepB接种史及主要乙肝感染危险因素进行问卷调查,评估人群HepB接种率,分析和比较不同年龄组、不同家庭感染状况下接种与未接种HepB人群乙型肝炎病毒感染指标,评价HepB免疫防病效果。结果 1～16岁年龄组乙肝疫苗全程接种率为88.11%（2535/2877）,17～59岁人群有乙肝疫苗免疫史为20.75%（470/2113）。在推行新生儿HepB接种纳入计划免疫管理后出生的1～16岁人群,HBsAg阳性率为1.29%,而出生时尚未开展HepB接种的20～59岁人群HBsAg阳性率为13.72%。1～16岁人群中有HepB接种史人群HBsAg阳性率0.99%,无接种史人群为5.56%,疫苗保护率为82.19%。20～59岁人群接种HepB,基本都不是在新生儿时期,疫苗保护率为52.01%。新生儿接种HepB,母婴乙肝传播阻断率为94.16%,并能有效阻断家庭内水平传播。结论长期实施新生儿接种HepB能控制、消除受种人群乙肝病毒感染,非新生儿人群接种HepB也能显著降低乙肝病毒感染率。     

Response to hepatitis B vaccine in family members of HBsAg carriers

The family members of HBsAg carriers have an increased risk of hepatitis B virus (HBV) infection. 214 subjects from 98 families with no HBV markers were randomized to receive hepatitis B vaccine: HEVAC B (Institute Pasteur) or GCC VAC (Green Cross Corporation) at 0, 1, and 5 months. Of those who completed the course, 87.8% had an anti-HBs response of greater than 10 mIU/ml at 6 months. The response rate was similar for both sexes. There was a decrease in response rate and anti-HBs titre with age. The response rate for HEVAC B was 92.5% and GCC VAC 84.3%. The offspring had comparable response to the spouses who were not blood relatives of the index carriers, but this could be related to their younger age. Discriminant analysis showed that a higher anti-HBs titre was associated with HEVAC B, younger age, and less direct relationship with the index carrier.     

重组酵母乙肝疫苗对新生儿免疫效果的评价

目的研究新生儿接种国产5μg重组酵母乙肝疫苗的免疫效果及影响因素。方法从东莞市石碣医院预防接种门诊登记的,2005年7～12月出生的,按规定接种程序完成乙肝疫苗接种的新生儿中随机抽取303名进行横断面调查研究。结果新生儿免疫后抗-HBs几何平均滴度（GMT）为（201.36±14.89）mIU/ml。母亲乙肝HBsAg阳性/阴性、母亲乙肝HBeAg阳性/阴性、男/女、是否出生低体重、是否早产、本地/外地的新生儿之间抗-HBs抗体GMT差别无统计学意义（P〉0.05）。抗-HBs阳转率为97.69%,达到卫生部规定的免疫成功率指标（85%）（t=6.19,P〈0.001）;母亲HBsAg阳性/阴性、HBeAg阳性/阴性的新生儿之间抗-HBs阳转率差别有统计学意义。新生儿HBsAg阳性率0.33%,母亲乙肝HBeAg阳性/阴性的新生儿HBsAg阳性率差别有统计学意义（P〈0.05）。免疫后母婴传播阻断保护率为96.16%。结论新生儿接种国产5μg重组酵母乙肝疫苗具有良好的免疫效果,与乙肝免疫球蛋白100 IU联合使用,有良好的母婴传播阻断保护作用。母亲乙肝感染状况（HBsAg、HBeAg阳性）是影响新生儿乙肝抗-HBs阳转率的危险因素;母亲乙肝HBeAg阳性是影响新生儿乙肝疫苗母婴传播阻断保护率的危险因素。     

Hepatitis B vaccination

As hepatitis B virus does not replicate in tissue culture systems, it was impossible to prepare a vaccine in the conventional way. However, the surface-antigen of the virus is present in abundance in the blood of certain virus carriers. This phenomenon has been used to develop plasma-derived hepatitis B vaccines and these vaccines are now available. In low incidence countries vaccination should be restricted to high-risk groups after initial screening for antibodies to hepatitis B virus. In areas where hepatitis B virus infection is highly endemic immunisation of the whole population, immediately after birth, is probably the most effective strategy. The high cost of the currently available plasma-derived vaccine is a constraint on the implementation of public health programmes for the prevention of hepatitis B. A second generation of vaccines — made by DNA recombinant technology — is expected to be available in the near future and could be the answer to these problems.     

Evaluation of Immune Response to Hepatitis B Vaccine in Healthcare Workers at a Tertiary Care Hospital

Purpose: Healthcare workers (HCWs) are at high risk of acquiring hepatitis B virus (HBV) infection through occupational exposure which is preventable through hepatitis B vaccination. In the current study, the response to HBV surface antigen (HBsAg) vaccine was assessed in a selected group of HCWs by testing for antibodies against HBsAg (anti-HBs). Methods: Blood samples were collected in all HCWs, who have received the complete schedule of hepatitis B vaccination and anti-HBs levels, were assessed quantitatively in sera using ELISA. Results: The age range of the study participants was 20–55 years. The mean months after the last dose of vaccination were 60.36. Among the 85 participants, 96.5% (n = 82) have protective immunity to hepatitis B. The anti-Hbs response was similar in both male and female (P > 0.05). There was a decline in immune response as the age was increasing (P < 0.05). The results of the study found a significant decline in the immune response with time (P < 0.05). The anti-Hbs response was declined with smoking habit (P < 0.05) and with increasing body mass index (P < 0.05). Conclusion: Post-HBsAg vaccination immunity to hepatitis B was 96.5% in HCW and was similar to that of global rates. Increasing age, time period, smoking habit, and overweight were associated with decreased immunity. Many studies are needed in developing newer HBV vaccines with very high immunogenicity. Giving highly immunogenic vaccine to HCWs will ensure safety at work by reducing nosocomial transmission which is very much desired in a resource-limited country.     

A mathematical model predicting anti-hepatitis B virus surface antigen (HBs) decay after vaccination against hepatitis B

The determination of serum levels of antibodies against hepatitis B virus surface antigen (anti-HBs) after hepatitis B vaccination is currently the only simple test available to predict the decay of protection and to plan the administration of booster doses. A total of 3085 vaccine recipients of plasma-derived and recombinant vaccine have been followed for 10 years to determine the kinetics of anti-HBs production and to construct a mathematical model which could efficiently predict the anti-HBs level decline. The anti-HBs peak level was reached 68 days after the last dose of recombinant vaccine and 138 days after the last dose of plasma-derived vaccines. The age of vaccinees negatively influenced the anti-HBs levels and also the time necessary to reach the anti-HBs peak. A bilogarithmic mathematical model (log10 level, log10 time) of anti-HBs decay has been constructed on a sample of recombinant vaccine recipients and subsequently validated on different samples of recombinant or plasma-derived vaccine recipients. Age, gender, type of vaccine (recombinant or plasma-derived), number of vaccine doses (three or four) did not influence the mathematical model of antibody decay. The program can be downloaded at the site: http:@www2.stat.unibo.it/palareti/vaccine.htm . Introducing an anti-HBs determination obtained after the peak, the program calculates a prediction of individual anti-HBs decline and allows planning of an efficient booster policy.     

Biodegradable Microspheres as Hepatitis B Vaccine Delivery Systems

Hepatitis is a very serious disease that influences humanhealth. Now, nearly 1/3 of the world population has beeninfected with hepatitis B virus (HBV). Among them, 3.5hundred million become the chronic carriers, and 1/4 ofthe carriers would die from the chronic infection of HBV.In China, approximately 7% 20% of the population hasbeen shown to carry HBsAg[1].Development of safe, effective and cheap vaccineswould be a main approach to control the HBV infection.The conventional recomb…     

重组IL-12对乙肝疫苗在小鼠诱导免疫应答的作用

目的:观察重组IL-12对乙肝疫苗在小鼠诱导应答的强度与性质的作用,探讨将重组IL-12用作乙肝治疗性疫苗分子佐剂的可能性.方法:将乙肝疫苗联合重组IL-12肌注免疫小鼠,检测小鼠产生的抗乙肝表面抗原特异性体液和细胞免疫应答.结果:乙肝疫苗联合重组IL-12能明显增强小鼠T淋巴细胞的增殖活性、促进分泌细胞因子IFN-γ和IL-2并提高IgG2a抗体水平.结论:重组IL-12可显著增强乙肝疫苗诱导的细胞免疫应答,并使免疫应答转向Th1型.