文章摘要
王斌,许喜喜,温海秀,郝海昀,杨志清,史晓红,付振东,王雪飞,张芳,汪波,王素萍.HBsAg阳性母亲所生婴儿乙型肝炎疫苗无/弱应答的影响因素研究[J].中华流行病学杂志,2017,38(7):911-915
HBsAg阳性母亲所生婴儿乙型肝炎疫苗无/弱应答的影响因素研究
Influencing factors for non/low-response to hepatitis-B vaccine in infants of HBsAg positive mothers
收稿日期:2016-11-14  出版日期:2017-07-15
DOI:10.3760/cma.j.issn.0254-6450.2017.07.013
中文关键词: 乙型肝炎疫苗;婴儿;无/弱应答
英文关键词: Hepatitis B vaccines;Infant;Non/low response
基金项目:国家自然科学基金(81072341,81573212)
作者单位E-mail
王斌 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
许喜喜 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
温海秀 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
郝海昀 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
杨志清 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
史晓红 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
付振东 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
王雪飞 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
张芳 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
汪波 030001 太原市第三人民医院妇产科  
王素萍 030001 太原, 山西医科大学公共卫生学院流行病学教研室 spwang88@163.com 
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中文摘要:
      目的 探讨HBsAg阳性母亲所生婴儿乙型肝炎(乙肝)疫苗无/弱应答的影响因素。方法 收集2011年7月至2013年1月在太原市第三人民医院妇产科分娩的HBsAg阳性母亲及其新生儿286对,按我国0-1-6月免疫接种程序对新生儿进行乙肝疫苗接种并随访至12月龄。检测母亲、新生儿及婴儿外周血HBV血清标志物及HBV DNA;探讨HBsAg阳性母亲所生婴儿乙肝疫苗无/弱应答的影响因素。结果 286例婴儿中,乙肝疫苗无/弱应答率为18.53%(53/286)。非条件logistic回归显示,母亲HBV DNA ≥ 1×107 copies/ml时其婴儿发生乙肝疫苗无弱应答的风险是HBV DNA阴性的2.592倍(OR=2.592,95%CI:1.121~5.996);分娩方式为阴道产时其婴儿发生乙肝疫苗无/弱应答的风险是剖宫产的1.932倍(OR=1.932,95%CI:1.021~3.654)。二者既不存在相乘交互作用(OR=1.055,95%CI:0.209~5.321),也不存在相加交互作用(RERI=1.617,95%CI:-4.038~7.272;AP=0.364,95%CI:-0.527~1.225;SI=1.195,95%CI:0.270~13.135)。将母亲HBV DNA分组后,剖宫产与阴道产对婴儿发生乙肝疫苗无/弱应答之间差异无统计学意义。结论 HBsAg阳性母亲HBV DNA ≥ 1×107 copies/ml时,其婴儿易发生乙肝疫苗无/弱应答。
英文摘要:
      Objective To investigate the influencing factors for non/low-response to hepatitis B vaccine in infants of HBsAg-positive mothers. Methods A total of 286 HBsAg-positive pregnant women and their infants were recruited from the Third People's Hospital of Taiyuan during July 2011 to January 2013. The infants were immunized with hepatitis B vaccine according to the 0-1-6 month vaccination schedule and followed up for 12 months. The serum HBV DNA level of mothers, neonates and infants were detected by electro chemilum inescence immunoassay kits and fluorescene quantiative polymerase chain rection. Results Among 286 infants, the rate of non/low-response to hepatitis B vaccine was 18.53% (53/286). Non-conditional logistic regression analysis indicated that the mother's HBV DNA level ≥ 1×107 copies/ml (OR=2.592, 95%CI:1.121-5.996) and natural birth (OR=1.932, 95%CI:1.021-3.654) were the risk factors for non/low-response to hepatitis B vaccine, the risks were 2.592 times and 1.932 times higher compared with the infants whose mothers were HBV DNA negative and the infants whose mothers had cesarean delivery. There was no multiplicative or additive interaction between high HBV DNA load and natural birth (OR=1.055, 95%CI:0.209-5.321), (RERI=1.617, 95%CI:-4.038-7.272; AP=0.364, 95%CI:-0.527-1.225; SI=1.195, 95%CI:0.270-13.135). After stratified analysis of mother's HBV DNA level, delivery mode of mothers was not associated with non/low-response of their infants. Conclusion The mother's load of HBV DNA ≥ 1×107 copies/ml might be the factor for non/low-response to hepatitis B vaccine in infants of HBsAg positive mothers.
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