儿童甲乙型肝炎联合疫苗加强免疫效果评价

目的比较甲、乙型肝炎联合疫苗(hepatitis A and hepatitis B combined vaccine,HepA and HepB)加强免疫效果,为加强免疫决策提供依据。方法选择1周岁内完成乙型肝炎(乙肝)疫苗(hepatitis Bvaccine,HepB)基础免疫的5岁以上儿童1 387例,采集血清,使用化学发光法检测乙肝病毒表面抗原(HBsAg)、乙肝病毒表面抗体(抗-HBs)、乙肝病毒核心抗体(抗-HBc)、甲肝病毒抗体(抗-HAV),对儿童接种甲乙肝联合疫苗一剂次,免后1月采血检测抗-HBs、抗-HAV。结果加强免疫前、加强免疫一剂次甲乙肝联合疫苗后,抗-HBs阳性率分别为49.32%、93.58%,抗-HAV阳性率分别为63.52%、93.08%,加强免疫前后抗-HBs阳性率和抗-HAV阳性率差异均有统计学意义(P均<0.05)。加强免疫一剂次甲乙肝联合疫苗后,抗-HBs阳转率、抗-HAV阳转率分别为87.34%、81.03%,且5～14岁儿童抗-HBs阳转率、抗-HAV阳转率均随年龄增加呈下降趋势(P<0.05)。加强免疫一剂次甲乙肝联合疫苗后,抗-HBs、抗-HAV几何平均滴度(GMT)分别为1326.97U/L、11.11U/L。结论采用甲乙肝联合疫苗对小年龄儿童加强免疫一剂次免疫效果良好,对大年龄儿童建议增加加强免疫剂次。

Evaluation on booster immunization efficacy of hepatitis A and B combined vaccine of one dosage in children

Objective To analyze the efficacy of booster immunization with domestic Hepatitis A and B Vaccine of One dosage in children,in order to provide evidence for establishing immunization strategy.Methods A total of 1387 children aged over 5 years were selected,who had been finished the basic immunization of hepatitis B vaccine in age under 1 year,blood plasma specimens of all sampled children were detected for hepatitis B virus(HBV) surface antigen(HBsAg),antibodies to hepatitis B virus surface antigen(Anti-HBs),antibodies to hepatitis B virus core antigen(Anti-HBc) and antibodies to hepatitis A virus(Anti-HAV) by chemiluminescence.Then,they were immunized one dosage of Hepatitis A and B Vaccine(HepA and B).Their blood samples were collected after 1 month,and detected for Anti-HBs and Anti-HAV.Results The anti-HBs positive rates were 49.32%、93.58% respectively of pre-immunization,post-immunization with one dosage.The anti-HAV positive rates were 63.52%、93.08% respectively of pre-immunization,post-immunization with one dosage.There were statistical significant difference between any two rates of pre-immunization and post-immunization(P<0.05).The Anti-HBs and Anti-HAV positive conversion rate of post-immunization with one dosage were 87.34% and 81.03% respectively.After immunization with one dosage,the aged rates of Anti-HBs and Anti-HAV positive conversion were dropping with growth of age(P<0.05).The average Geometric means of titer(GMT) Anti-HBs and Anti-HAV negative of children immunized with one dosage HepA and B were 1326.97mIu/ml and 11.11mIu/ml respectively.Conclusions It will be suitable to useHepA and B for younger children with one dosage booster immunization,and for older children with more than one dosage booster immunization.