国产血源性乙肝疫苗对HBsAg阳性母亲的新生儿6年免疫效果评价

目的　探讨乙肝疫苗对 HBs Ag阳性母亲及伴有 HBe Ag阳性母亲的新生儿免疫效果及持久性。　方法　对母亲仅 HBs Ag阳性组和伴有 HBe Ag阳性组的 198名新生儿在乙肝疫苗免疫后 ,每年定期进行随访一次 ,采血检测抗 -HBs和 HBs Ag。　结果　母亲仅 HBs Ag阳性的新生儿经全程免疫后 ,第 1年抗 - HBs阳性率达 97.8% ,到第 6年抗 -HBs阳性率仍达 92 .2 %。而母亲伴有 HBe Ag阳性的新生儿经 HBIG保护后 ,再经乙肝疫苗全程接种 ,第 1年抗 - HBs阳性率为 74 .4 % ,到第 6年抗 - HBs阳性率为 6 6 .0 %。抗 - HBs的 GMP,免疫后 1年达到水平最高 ,1～ 3岁间有所下降 ,3岁后相对稳定 ,两组基本相似。　结论　仅 HBs Ag阳性母亲的新生儿乙肝疫苗接种后能获得较强免疫力 ,伴有 HBe Ag阳性母亲的新生儿乙肝疫苗免疫后 ,大部分能获得免疫力 ,两组获得免疫力者 ,6年效果仍是完好 ,无需加强免疫 ,何时加强 ,尚需进一步随访。

Evaluation of Home-made Hematogenic Heptavax-B Effect on Infants with HBsAg-positive Mothers after Neonatal Immunity in Six Years

Objective To study immunologic effect and persistence of home-made hepatitis B vaccine on infants born to HBsAg-positive mothers or HBsAg- and HBeAg-positive mothers. Methods After the vaccination of hepatitis B vaccine, annual regular follow-up surveys were made and anti-HBs and HBsAg were detected by blood sampling for 198 infants who were classified into two groups: those with only HBsAg-positive mothers and those with both HBsAg and HBeAg positive mothers. Result In the first group, after the whole course of vaccination, the anti-HBs positive rate was 97.8% in the first year, 92.2% in the sixth year, while in the second group, after the protection of HBIG and whole course of heptavax-B vaccination, the anti-HBs positive rate was 74.4% in the first year and 66.0% in the sixth year. The GMP for anti-HBs was the highest one year after vaccination, slightly lower after that, but stable after three years, with much similarity between the two groups. Conclusion Almost all infants with only HBsAg-positive mothers and most infants with HBsAg- and HbeAg-positive mothers can acquire immunity after the vaccination of heptavax-B. In those who had acquired immunity, immunologic effect remained perfect in those six years, therefore no boost vaccination is needed. When it is needed depends on subsequent surveys.