文章摘要
杨志清,郝海昀,史晓红,付振东,张芳,王雪飞,许喜喜,王斌,温海秀,丰淑英,汪波,王素萍.HBsAg阳性母亲HBV感染状况与婴儿乙肝疫苗无/弱应答的关系[J].中华流行病学杂志,2018,39(6):805-809
HBsAg阳性母亲HBV感染状况与婴儿乙肝疫苗无/弱应答的关系
Relationship between the HBsAg-positive infection status of mothers and the non/low-response to hepatitis B vaccine of their infants
投稿时间:2017-11-13  
DOI:10.3760/cma.j.issn.0254-6450.2018.06.021
中文关键词: HBsAg阳性;HBV血清学标志物;HBV DNA;乙肝疫苗;应答
英文关键词: HBsAg-positive;Hepatitis B virus serologic marker;Hepatites B virus DNA;Hepatitis B vaccine;Response
基金项目:国家自然科学基金(81573212);传染病预防控制国家重点实验室自主研究开放课题(2017SKLID306)
作者单位E-mail
杨志清 030001 太原, 山西医科大学流行病学教研室  
郝海昀 030001 太原, 山西医科大学流行病学教研室  
史晓红 030001 太原, 山西医科大学流行病学教研室  
付振东 030001 太原, 山西医科大学流行病学教研室  
张芳 030001 太原, 山西医科大学流行病学教研室  
王雪飞 030001 太原, 山西医科大学流行病学教研室  
许喜喜 030001 太原, 山西医科大学流行病学教研室  
王斌 030001 太原, 山西医科大学流行病学教研室  
温海秀 030001 太原, 山西医科大学流行病学教研室  
丰淑英 030012 太原市第三人民医院妇产科  
汪波 030012 太原市第三人民医院妇产科  
王素萍 030001 太原, 山西医科大学流行病学教研室 supingwang@sxmu.edu.cn 
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中文摘要:
      目的 分析HBsAg阳性母亲HBV感染状况与婴儿乙肝疫苗无/弱应答的关系。方法 2011年6月至2013年7月采用前瞻性研究的方法选择225对HBsAg阳性母亲及其新生儿作为研究对象,新生儿按0-1-6免疫接种程序接种乙肝疫苗并随访至婴儿1周岁,采用电化学发光免疫分析法和荧光定量PCR检测母亲及婴儿外周血HBV血清学标志物和HBV DNA载量。结果 HBsAg阳性母亲共检测出6种HBV感染模式,常见模式"HBsAg(+)、HBeAg(+)、抗-HBc(+)"(模式一)与" HBsAg(+)、抗-HBe(+)、抗-HBc(+)"(模式二)所占比例最多(92.5%,208/225);母亲HBV感染为模式一时,婴儿乙肝疫苗无/弱应答率(11.3%)低于母亲HBV感染为模式二时的婴儿无/弱应答率(23.4%),差异有统计学意义(χ2=4.80,P=0.029),随着母亲HBeAg水平的升高,婴儿乙肝疫苗无/弱应答率呈现下降趋势(χ2=4.86,P=0.028);经非条件logistic回归模型控制其他因素影响后结果显示,母亲HBeAg与降低婴儿乙肝疫苗无/弱应答发生风险有关(OR=0.598,95%CI:0.378~0.947);HBsAg阳性母亲HBV DNA阳性率为54.2%,未发现母亲HBV DNA阳性与其婴儿乙肝疫苗无/弱应答率有关(χ2=0.22,P=0.640)。结论 HBsAg阳性母亲HBV感染模式以"HBsAg(+)、HBeAg(+)、抗-HBc(+)"与"HBsAg(+)、抗-HBe(+)、抗-HBc(+)"模式为主,且该2种模式下婴儿乙肝疫苗免疫应答情况有所不同;母亲HBeAg可能是其婴儿乙肝疫苗无/弱应答的保护因素;尚未发现HBsAg阳性母亲HBV DNA与婴儿乙肝疫苗无/弱应答有关联。
英文摘要:
      Objective To explore the relationship between the status of HBsAg-positive infection of mothers and the non/low-response to hepatitis B vaccine of their infants.Methods A total of 225 pairs of mothers and their infants were recruited in our cohort from June 2011 to July 2013. Infants were given three doses of hepatitis B vaccine at hour 24, first month and month 6th respectively and were followed up for one year after birth. HBV serological markers and HBV DNA in the peripheral blood of both mothers and infants were detected by Electro-chemiluminescence immunoassay and fluorescence quantitative Polymerase Chain Reaction.Results Six HBV infection models were detected in HBsAg-positive mothers, and "HBsAg (+), HBeAg (+), anti-HBc (+)"(model one) and "HBsAg (+), anti-HBe (+), anti-HBc (+)" (model two) accounted for 92.5%(208/225) of all the models. Rate of non/low-response to hepatitis B vaccine in infants born to mothers in model one was lower than those in model two, the differences are statistically significant (χ2=4.80, P=0.029). The rate of non/low-response to hepatitis B vaccine in infants showed a downward trend with the rising of HBeAg level in their mothers (χ2=4.86, P=0.028).Results from the unconditional logistic regression analysis showed that the HBeAg of the HBsAg-positive mothers was significantly correlated with the low risk of non/low-response to hepatitis B vaccine in infants (OR=0.598, 95% CI:0.378-0.947). The positive rate of serum HBV DNA in HBsAg-positive mothers was 54.2%, while the rate of non/low-response to hepatitis B vaccine in infants born to HBV DNA positive mothers was similar to those infants born to HBV DNA negative mothers (χ2=0.22, P=0.640).Conclusions "HBsAg (+), HBeAg (+), anti-HBc (+)" and "HBsAg (+), anti-HBe(+), anti-HBc (+)" were the common models seen in HBsAg-positive mothers, and the rate of non/low-response to hepatitis B vaccine was different between the two models. HBeAg of HBsAg-positive mothers might have positive effects on the immune response to hepatitis B vaccine in infants but the mechanisms remained not clear. HBV DNA of the HBsAg-positive mothers did not seem to be correlated with the immune response to hepatitis B vaccine in infants.
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