新生儿乙型肝炎疫苗诱导抗体阴转者对HBsAg的免疫记忆

观察乙型肝炎(乙肝)血源疫苗新生儿期接种9～10年后,疫苗诱导抗体转阴者是否仍对乙肝表面抗原(HBsAg)保持免疫记忆.采用RIA方法测定并比较乙肝疫苗加强免疫(加免)前后受试对象的抗HBs水平.结果48名受试儿童加免后1个月,抗HBs阳性率与滴度均明显高于免前(p<001),709%(34/48)的加免儿童保持免疫记忆,持续时间至少已3年.提示3针10μg乙肝血源疫苗新生儿期接种9～10年后,大部分诱导免疫抗体阴转的免疫儿童保持着免疫记忆.初免后10年仍未见有加强免疫的必要.     

乙型肝炎疫苗免疫后免疫回忆应答的观察

乙型肝炎(乙肝)疫苗免疫后,体液和细胞免疫回忆应答的状况和特点,是确定是否需要加强免疫及免疫方案的关键.为此,在湖南省湘潭市随机采样,抽取170名1986～1988年出生、完成了血源乙肝疫苗全程免疫后9～11年的儿童,用重组(酵母)乙肝疫苗进行1～3次加强免疫,观察其体液免疫应答.在浙江省杭州市,随机抽取28名血源乙肝疫苗母婴阻断免疫者、18名全程免疫儿童和11名未免疫的健康人,观察他们的外周血淋巴细胞(PBMC)对基因重组乙肝表面抗原(HBsAg)刺激的增殖反应.结果显示乙肝疫苗全程免疫后9～11年的儿童,完成1针、2针和3针法加强免疫后1年内,乙肝病毒表面抗体(抗-HBs)阳性率和几何平均滴度(GMT)均迅速升高,三组的GMT分别比加强免疫前提高了6.5、9.3、24.2倍,阳性率均上升至100%,加强免疫次数多抗体提高多,各组间GMT差异有非常显著的统计学意义(P＜0.01).完成加强免疫后,3次加强免疫组抗-HBs阳性率比＜3次组下降缓慢,至加强免疫后第3年,抗-HBs阳性率1针法降为71.2%,2针法降为79.2%,而3针法维持在92.5%.血源乙肝疫苗全程免疫者其PBMC对重组HBsAg刺激的特异性增殖反应强度和γ干扰素(INF-γ)水平明显高于对照组,细胞免疫反应的强度还与机体抗体水平相关.说明血源乙肝疫苗免疫后机体特异性体液和细胞免疫记忆均长期存在,回忆反应与免疫背景有关,反应强度与加强免疫的次数正相关,机体免疫记忆可能是维持乙肝疫苗长期保护效果的重要原因之一.     

国产重组酵母乙型肝炎疫苗人体免疫效果研究

[目的]为了进一步了解国产重组酵母乙肝疫苗的免疫效果.[方法]对219名HBV感染阴性卫校学生按0、1、6方案接种国产重组酵母乙肝疫苗,接种后7个月、12个月、24个月、36个月、48个月不同时间取静脉血,采用RIA法、ELISA法分别检测抗-HBs和HBsAg.同时与162名HBV感染阴性学生比较HBV感染率.[结果]全程免疫后,219人中200人抗-HBs>10mlU/ml,接种疫苗后4年中219人HBV感染率为1.37%(3/219).未接种疫苗组162人HBV感染率为6.17%(10/162).[结论]国产重组酵母乙肝疫苗有较好的免疫效果,抗-HBs阳转率可达91.32%.与对照组比较,接种疫苗组HBV感染率明显低于对照组,有差异显著性.因此,认为国产重组酵母乙肝疫苗具有较好的免疫源性和保护性免疫效果,可用于替代乙肝血源疫苗广泛使用.     

乙型肝炎疫苗不同接种程序的免疫效果

为探讨乙型肝炎疫苗不同接种程序的免疫效果 ,现将某校1998、1999级新生中“乙肝易感者”使用重组酵母乙肝疫苗分别按 0、1、2及 0、1、6两种不同程序免疫注射后的免疫效果报道如下。1　对象与方法1.1　对象　对某校 1998年入学的新生 10 48人及 1999年入学的新生 913人分别于入学后全部抽取静脉血 2ｍｌ ,用酶联法(ＥＬＩＳＡ)对乙肝表面抗原 (ＨＢｓＡｇ)、表面抗体 (抗 -ＨＢｓ)及核心抗体 (抗 -ＨＢｃ)做定性检测。试剂为深圳月亮湾生物制品研究所生产 ,按说明进行操作。 3项指标均阴性的乙肝易感者中分别随机抽取 1998级学生 2 6 9人 ,…     

新生儿乙型肝炎疫苗免疫接种效果分析

目的 观察新生儿应用乙型肝炎疫苗接种的免疫效果,为该地区儿童乙型肝炎预防提供参考.方法 选取2009年5月-2012年8月进行乙型肝炎疫苗接种的0～3岁婴幼儿1187例,根据年龄分为＜1岁组276例、1～2岁组302例、2～3岁组298例和＞3岁组311例,采用ELISA法检测4组新生儿血清中乙型肝炎病毒表面抗原(HBsAg)和乙型肝炎病毒表面抗体(抗-HBs)两项指标,比较不同年龄阶段新生儿免疫情况.结果 1187例婴幼儿抗-HBs阳性率为84.08％,其中＜1岁组为94.57％、1～2岁组为87.75％、2～3岁组为81.54％、＞3岁组为73.63％,4组的抗-HBs阳性率差异有统计学意义(P＜0.05);1187例婴幼儿HBsAg阳性率为0.34％,＜1岁组和1～2岁组均为0、2～3岁组为0.34％、＞3岁组0.96％,4组的HBsAg阳性率差异无统计学意义.结论 接种过乙型肝炎疫苗的新生儿免疫水平随年龄增长开始降低,有必要对≥3周岁儿童再次进行乙型肝炎血清标志物检测,及时采取乙型肝炎预防措施.     

新生儿接种乙型肝炎疫苗免疫效果的长期观察

新生儿接种乙型肝炎疫苗是预防乙型肝炎病毒感染的重要措施,但接种后若干年对乙型肝炎病毒的免疫和感染情况报道尚少。为此,我们对无锡市138名新生儿接种乙型肝炎疫苗后3～8年的免疫情况进行了调查,并同人群中对乙型肝炎病毒的免疫和感染情况进行了比较。     

隆安县乙型肝炎疫苗免疫模式的研究

１９８９～１９９２年，在广西肝癌肝炎高发区隆安县开展乙肝疫苗纳入计划免疫规划（ＥＰＩ）的模式研究，乙肝疫苗纳入ＥＰＩ每两个月运转一次，不筛检孕妇，全体新生儿接种１０μｇ×３剂量疫苗，首针疫苗室温保存，由接生员注射；第２、３针纳入ＥＰＩ，与ＯＰＶ，ＤＰＴ或ＭＶ联合接种。研究结果证明，该免疫模式可提高接种率，１、２、３针乙肝疫苗接种率分别为９７．９％、９６．２％和９３．６％，较纳入ＥＰＩ前的１９８７年提高１５％，大规模免疫后４年，４岁以下儿童ＨＢｓＡｇ阳性率平均为１．５％，与免疫前本底对照的１１．９％比较，下降８８．１％，有效地预防了ＨＢＶ的感染和慢性携带状态，研究结果还表明乙肝疫苗可直接，灵活纳入ＥＰＩ，在交通不便和冷藏条件不足的地区，乙肝血源疫苗可室温保存，满足新生儿在家中及时接种。该免疫模式可能是我国乙肝高发区控制乙型肝炎的最有效和易行的策略。     

中国隆安县乙型肝炎疫苗免疫模式研究

课题来源:WHO国际合作课题研究起至时间:1989年1月～1994年6月成果登记号:项目负责人:王树声完成单位:广西壮族自治区卫生防疫站(现广西疾病预防控制中心)协作单位:上海医科大学和广西隆安县卫生防疫站等主要完成人员:王树声,杨进业,李荣成,徐志一,农运志等获奖情况:1994年广西科技进步二等奖,1994年广西医药卫生科技进步一等奖内容提要:本研究通过在广西肝炎肝癌高发区隆安县农村地区首次将乙肝疫苗纳入现行的儿童扩大计划免疫规划(EPI),对全体新生儿实施大规模乙肝疫苗接种,探讨乙肝疫苗纳入EPI的可行性、技术性和最有效的方法,评价乙…     

乙型肝炎疫苗初次免疫正常应答和高应答婴儿初次免疫5年后免疫记忆持久性随访观察

目的 探讨乙型肝炎(乙肝)疫苗初次免疫(初免)正常应答和高应答新生儿在初免后5年免疫记忆情况及其影响因素。方法 对初免正常应答和高应答新生儿于初免后5年检测其抗-HBs,其中低于保护水平(10 mIU/ml)者接种1剂次乙肝疫苗(激发剂次)并于接种后14 d采集血标本,再次检测抗-HBs,并计算激发剂次后抗-HBs阳转率(≥10 mIU/ml)和GMT。将检测的初免抗体、随访抗体和激发剂次后抗体均从低到高分成不同等级,分析激发剂次后抗体的影响因素。结果 37.98%(980/2 580)初免正常应答和高应答新生儿在初免后5年抗-HBs已降至保护水平以下,其中激发剂次后98.95%(757/765)出现抗体阳转,GMT为2 811.69(95%CI:2 513.55～3 145.19) mIU/ml。激发剂次后抗体滴度随初免抗体水平和随访抗体水平的升高而升高(F值分别为5.46、10.23,均P<0.000 1)。多因素分析显示,激发剂次后抗体滴度与性别、出生体重、早产等无关(P>0.05),而与初免抗体和随访抗体水平独立相关(OR=1.001,95%CI:1.000～1.002,P<0.001;OR=1.28,95%CI:1.81～1.39,P<0.001)。结论 新生儿乙肝疫苗初免后5年存在较强的免疫记忆;免疫记忆的强度与初免抗体及激发剂次前抗体水平有关。     

天津市初一学生乙型肝炎疫苗免疫现状及加强免疫后记忆反应研究

目的 了解初中一年级学生(12～14岁)对出生时接种的乙肝疫苗免疫现状、感染乙型肝炎病毒(HBV)现状以及进行乙肝疫苗加强免疫的效果.方法 按整群分层后单纯随机抽样方法,根据Epi Info3.3.2软件计算样本量,依抗-HBs阳性率最低可接受度53%,计算其95%的可信限样本量至少为218名,而免疫现状检测的实际样本量为250名,加强免疫的实际样本量为236名;HBsAg、抗-HBs和抗-HBc IgG均采用酶联免疫吸附试验(ELISA)法检测,试剂分别由Abbott公司、Diasorin公司和北京万泰药业科技公司生产;HBV DNA用荧光定量PCR法检测.结果 加强免疫前免疫现状:抗-HBs阳性率为62.80%(157/250),几何平均滴度(GMT)为73.79 IU/L;现时期HBV自然感染(HBsAg和抗-HBc IgG阳性)率为2.80%(7/250).加强免疫效果:抗-HBs阳性率94.92%(224/236),较加强免疫前明显提高,差别有统计学意义(x=73.92,P=0.00),GMT为521.15 IU/L,较加强免疫前有显著提高,差别有统计学意义(t=15.98,P=0.00);在加强免疫前抗体消失的人群(86名)中加强免疫后的抗-HBs阳转率为91.86%(79/86);对加强免疫1针次的11名无应答者行第2针加强后,有8名产生了抗体.结论 对初中一年级学生实施乙肝疫苗加强免疫可有效提高机体免疫水平,防止免疫记忆丧失.     

Presence of immune memory and immunity to hepatitis B virus in adults after neonatal hepatitis B vaccination

Neonatal vaccination against hepatitis B virus (HBV) infection was launched in the 1980s in Qidong, China, where HBV and hepatocellular carcinoma were highly prevalent. Presence of immune memory and immunity against HBV in adults needs to be clarified. From a cohort of 806 who received plasma-derived Hep-B-Vax as neonates and were consecutively followed at ages 5, 10, and 20 years, 402 twenty-four-year-old adults were recruited for booster test. Among them 4 (1%) were found to be HBsAg(+), 27 (6.7%) were HBsAg(−)anti-HBc(+), 121 (30.2%) were HBsAg(−)anti-HBc(−)anti-HBs(+), and 252 (62.4%) were HBsAg(−)anti-HBc(−)anti-HBs(−). Of them, 141 subjects with HBsAg(−)anti-HBc(−) were boosted with 10-μg recombinant HBV vaccine on day-0 and 1-month. The conversion rates of anti-HBs ≥10 mIU/ml on D10-12 and 1-month post-booster were 71.4% and 87.3% respectively in the vaccinees who were anti-HBs(+) at age 5, higher than in those who were anti-HBs(−) at age 5, 57.5% and 80.0% respectively, but no statistically significant. After the second dose of booster, all subjects with anti-HBs(+) at age 5 had anti-HBs >500 mIU/ml. However, 6/40 subjects, with anti-HBs(−) at age 5, had anti-HBs <10 mIU/ml, geometric mean concentration was 3.6 (95% CI 2.0-7.7). Of the subjects received booster, 44 subjects were determined the presence of T cell immunity on D10-12, 41 had HBsAg-specific T cells detectable, including 7/10 subjects whose anti-HBs were <10 mIU/ml 10-12 days post-booster. Among 27 HBsAg(−)anti-HBc(+) subjects, 19 had detectable serum HBV-DNA, and an “a” epitope mutation was found in 1/5 HBV isolates. One subject who was anti-HBc(+) at age 20 converted into HBsAg(+) 4 years later. The adults received neonatal HBV vaccination had immune memory and immunity against HBV infection. However, 31.9% of neonatal HBV vaccinees who responded weakly at an early age might be susceptible to HBV infection after childhood.     

Antibody levels and immune memory 23 years after primary plasma-derived hepatitis B vaccination: results of a randomized placebo-controlled trial cohort from China where endemicity is high

The duration of protection of hepatitis B vaccine remains incompletely understood. To assess the long-term protection provided by a primary vaccine series, the current study again recruited all subjects of a previous randomized placebo-controlled trial cohort 23 years after vaccination. Two hundred and sixty-one healthy children aged 5-9 years living in a highly HBV-endemic country were enrolled in the primary trial and received three doses of plasma-derived vaccine or placebo. The primary placebo receivers who did not receive any immunization against hepatitis B were used as non-vaccinated controls in the current study. After eliminating the interference of an early booster dose and vaccines outside the study, 48.1% (39/81) vaccinees still maintained anti-HBs titers ≥10 mIU/mL at Year 23, higher than 34.7% (26/75) in non-vaccinated controls (P = 0.088). 75-100% of vaccinees with anti-HBs titer <10 mIU/mL at Year 23 in different sub-groups divided according to early immune backgrounds developed a rapid and robust antibody anamnestic response after a booster dose, highly significantly different from non-vaccinated controls who received the same dose of vaccine (7.5%, P < 0.01). No case of clinically significant HBV infection was found in the primary cohort during the whole 23 years, but 10 transient HBsAg seroconversions in the primary placebo group and one in the primary vaccine group were determined. Anti-HBc positive rate obviously tended to be lower in vaccinees compared with non-vaccinated controls at Year 23. These results suggest a persisting immune memory and certain protection for 23 years after primary vaccination in children living in highly HBV-endemic areas. Clinically insignificant infections, which cannot be avoided and may often occur in vaccinees, play a positive role in the maintaining of immunity to HBV. Booster doses should be unnecessary for more than 20 years after a full primary immunization in children (as catch-up vaccination) and, also likely, in newborns living in highly HBV-endemic areas.     

Persistence of antibodies and immune memory to hepatitis B vaccine 20 years after infant vaccination in Thailand

Booster vaccination against hepatitis B (HBV) is not currently recommended, although debate continues on the duration of protection after priming. We assessed antibody persistence and immune memory to hepatitis B 20 years after priming with a recombinant HBV-vaccine during infancy. Infants were vaccinated at birth, 1, 2 and 12 months of age. A subset received a booster dose at Year 5. Antibody persistence was measured approximately yearly until Year 20. Immune memory was assessed by administration of HBV booster dose. At Year 20, anti-HBs seroprotection rates and GMCs tended to be higher in Year 5 boosted than unboosted recipients (83.9% versus 60.5%). After the Year 20 booster dose, anti-HBs anamnestic responses were within the same range 95.8% of subjects in both groups. Primary and booster vaccination with HBV-vaccine in infants induces sustained seroprotection and immune memory against hepatitis B for up to 20 years. Higher persisting seroprotection rates in subjects boosted at Year 5 did not translate into apparent differences in immune memory in a high endemic country.     

国产血源性乙肝疫苗在健康儿童中全程接种后23年的效果

目的 评价国产血源性乙型肝炎疫苗（乙肝疫苗）接种23年后的免疫原性和预防感染的保护效果。方法 1986年在西安市两所乡村小学筛检了261名5～9岁学生,按照分层随机分为疫苗组（126名）和对照组（135名）。2009年进行随访,剔除自行接种者后,疫苗组和对照组分别有81名和75名。对乙型肝炎病毒表面抗体（抗-HBs）＜10 mIU/ml及乙型肝炎病毒表面抗原(HBsAg)、乙型肝炎病毒核心抗体（抗-HBc）和乙肝病毒(HBV) DNA阴性者复种1针5μg国产重组疫苗,复种后1个月再次采血检测抗-HBs。结果 消除早期复种和自行接种的影响后,在第23年时,疫苗组48.1％(39/81)的研究对象抗-HBs仍保持在10 mIU/ml以上,高于对照组的阳性率[34.7％(26/75)]。疫苗组中84.0％ (21/25)的抗-HBs和抗-HBc均阴性的研究对象复种后产生了较强的回忆应答,而对照组中相似的抗-HBs阳性率为7.5％ (3/40)。本次随访未发现乙肝临床病例,但疫苗组和对照组的抗-HBc阳性率分别为16.0％( 13/81)和30.7％ (23/75)(x2=4.687,P＜0.05)。结论 国产血源性乙肝疫苗在健康儿童中全程接种后23年,免疫效果仍维持良好或有免疫记忆;疫苗仍有较好的保护效果。     

2789例10岁以上儿童重组乙型肝炎疫苗加强免疫效果评价

目的 比较不同重组乙型肝炎(乙肝)疫苗加强免疫效果.方法 选择1周岁内完成血源乙肝疫苗基础免疫的10岁以上儿童2789例,分别接种4种国内常用的不同重组乙肝疫苗,分为A、B、C、D4组,采集血清,使用化学发光法检测HBsAg、抗-HBs、抗-HBc,仅抗-HBs阳性者接种1剂次、抗-HBs阴性者接种3剂次相应疫苗,免疫1个月后采血检测抗-HBs.结果 加强免疫前、免疫1剂次及3剂次后A、B、C、D 4组抗-HBs阳性率分别为36.43%、37.59%、42.91%、46.46%;89.20%、91.52%、90.96%、85.45%;99.12%、99.47%、98.87%、98.85%;加强免疫前、免疫1剂次及3剂次后两两之间抗-HBs阳性率差异均有统计学意义(P值均＜0.05).抗-HBs阴性者加强免疫1剂次、3剂次后,抗-HBs阳转率分别为83.01%、86.41%、84.16%、72.82%;98.62%、99.16%、98.03%、97.84%;与抗-HBs阳性者加强免疫1剂次相比,4组抗-HBs阳转率差异均有统计学意义(P＜0.05).抗-HBs阳性者加强免疫1剂次后几何平均滴度(GMT)分别为2853.21、6254.23、3581.40、3021.32 mIU/ml.抗-HBs阴性者加强免疫1剂次、3剂次后4组GMT分别为273.08、648.52、387.87、245.36 mIU/ml;632.30、2341.14、563.97、394.08 mIU/ml.结论 采用上述4种重组乙肝疫苗对抗-HBs阳性的10岁以上儿童加强免疫1剂次、对抗-HBs阴性的10岁以上儿童加强免疫3剂次,免疫效果良好.

Abstract：

Objective To study the efficiency of booster immunization with different recombinant hepatitis B vaccines.Methods 2789 children aged over 10 years who had completed the basic immunization of hepatitis B vaccine under 1 year old were selected.All the sampled children were classified into four groups (A,B,C and D) and immunized with different hepatitis B vaccines produced by different campanies respectively.Before booster immunization,their blood plasma specimens were detected for hepatitis B virus (HBV) surface antigen (HBsAg),antibodies to HBV surface antigen (anti-HBs) and antibodies to HBV core antigen (anti-HBc) by chemiluminescence.In each group,the anti-HBs positive children were immunized with one dosage and anti-HBs negative children were immunized three dosages of the same vaccine.Their blood specimens were collected again after 1 month,and detected for anti-HBs.Results The anti-HBs positive rates of A,B,C and D group were 36.43%,37.59%,42.91% and 46.46% respectively before immunization while 89.20%,91.52%,90.96% and 85.45% respectively after immunization with one dosage,99.12%,99.47%,98.87% and 98.85% respectively after immunization with three dosages.The differences of anti-HBs positive rates in the four respective groups showed statistical significances between any two rates of pre-immunization,post-immunization with one dosage and post- immunization with three dosages (all P＜0.05).The anti-HBs positive conversion rates of four groups were 83.01%,86.41%,84.16% and 72.82% respectively after immunization with one dosage.The anti-HBs positive conversion rate of four groups were 98.62%,99.16%,98.03% and 97.84% respectively after immunization with three dosages and the difference of positive conversion rates in each group showed statistical significances between booster immunization with one dosage and booster immunization with three dosages.The average GMTs in anti-HBs positive children in the four groups were 2853.21,6254.23,3581.40 and 3021.32 mIU/ml respectively after immunization with one dosage.The average GMTs of anti-HBs negative children in the four groups were 273.08,648.52,387.87 and 245.36 mIU/ml respectively after immunization with one dosage,and were 632.30,2341.14,563.97 and 394.08 mIU/ml respectively after immunization with three dosages.Conclusion Our data showed that it would be suitable to anyone to use the four vaccines for anti-HBs positive children aged over 10 years with one dosage and for anti-HBs negative children aged over 10 years with three dosage booster immunization.     

贺州市1—6岁儿童乙型肝炎疫苗免疫效果分析

目的评价1～6岁儿童乙型肝炎重组酵母疫苗（HepB）的免疫效果。方法贺州市五县区,每个县区调查约150名儿童,检测乙型肝炎病毒表面抗原（HBsAg）和乙型肝炎病毒表面抗体（HBsAb）。结果HBsAg、HBsAb阳性率分别为0．51％、77．76％。男性HBsAg阳性率为0．50％,HBsAb阳性率为79．55％;女性HBsAg阳性率为0．53％,HBsAb阳性率为75．85％;不同性别之间的HBsAg、HBsAb阳性率比较,差异无统计学意义（P〉0．05）。各年龄组间HBsAb阳性率差异有统计学意义（x2=45．977,v=6,P〈0．01）;1岁组HBsAb阳性率95．62％,6岁组HBsAb阳性率67．42％,差异有统计学意义（P〈0．05）。完成基础免疫儿童的HBsAb阳性率75．77％,经过加强免疫的儿童HBsAb阳性率95．24％,两者之间差异有统计学意义（P〈0．05）。结论贺州市儿童接种Heps免疫效果显著,随着年龄的增长HBsAb阳性率呈下降趋势,在完成基础免疫的情况下进行加强免疫能使乙型肝炎疫苗的保护效果更好。     

血源性乙型肝炎疫苗接种后11年效果及免疫记忆

目的 探讨乙型肝炎疫苗接种１０年后远期效果,为确定复种时间提供依据。方法 按随机、双盲、安慰剂对照严格设计,对乙型肝炎疫苗接种１１年后效果及免疫记忆进行观察。结果 １１年疫苗免疫原性和保护率仍好,对ＨＢＶ感染保护率７３．５％,但９～１１年观察时段ＨＢＶ感染率疫苗组和安慰剂组差异已无显性（７．８９％与１３．２５％）;１１年有免疫记忆存在,但较１０年内明显减弱。结论 接种后１１年疫苗效果已开始下降。     

Impact of maternal carrier status on immunologic markers for protection after hepatitis B vaccination in infancy: A meta-analysis

Better protection against hepatitis B infection in offspring of carrier mothers has been postulated because of a booster effect by close maternal contact. Empirical evidence, however, is inconclusive. Immunologic markers for protection against hepatitis B are anti-HBs≥10mIU/ml or response to booster in case anti-HBs had fallen below 10mIU/ml. The objective of this paper was to asses whether immunologic markers suggest a higher protection after hepatitis B vaccination in offspring of carrier mothers. A systematic review was performed in order to identify all studies in offspring of carrier and non-carrier mothers reporting the proportions of individuals with anti-HBs≥10mIU/ml after infant hepatitis B vaccination with a presently recommended dose in children aged 5years or older or response to a booster dose in case anti-HBs was below 10mIU/ml. Associations between carrier status and the proportions of anti-HBs≥10mIU/ml or booster response were analysed by random effects models with adjustment for age and potential confounders. We identified 19 studies providing proportions of anti-HBs≥10mIU/ml with explicit information regarding the maternal carrier status. These studies reported 3245 children of carrier mothers aged up to 20years and 4602 children of non-carrier mothers aged up to 14years. Antibody titres≥10mIU/ml were detected in 75.8% of children of carrier and 63.6% of non-carrier mothers. A random effects model with adjustment for confounding yielded an odds ratio of 2.43 (95% CI 1.24-4.75) suggesting a markedly higher probability of anti-HBs≥10mIU/ml in offspring of carrier compared to non-carrier mothers. The distribution of proportions of individuals with post booster increase of anti-HBs titres≥10mIU/ml stratified by age at booster (≤10years and >10years) showed no differences between offspring of carrier and non carrier mothers up to the age of 10years and only marginal differences thereafter. In conclusion the proportions of anti-HBs≥10mIU/ml were clearly higher in offspring of carrier mothers years after infant vaccination but there appeared to be no clinically relevant difference in response to booster. It is unclear to which extent higher proportions of breakthrough infections contribute to the higher proportions of protective antibody titres in offspring of carrier mothers.     

乙型肝炎病毒感染免疫耐受机制的研究进展

HBV感染后容易形成慢性化,多数学者认为其主要机制是宿主对HBV各种抗原产生免疫耐受。宿主在对HBV免疫应答过程中的各个环节都可能形成免疫耐受。此文就近年来慢性HBV感染的患者体内免疫耐受机制的研究进展进行综述。