上海市新生儿接种重组酵母乙型肝炎疫苗后低(无)应答情况及影响因素的研究

黎健; 吴寰宇; 潘引君; 曹卫中; 钱杰; 任宏; 施阳; 李燕婷

Abstract

黎健,吴寰宇,潘引君,曹卫中,钱杰,任宏,施阳,李燕婷.上海市新生儿接种重组酵母乙型肝炎疫苗后低(无)应答情况及影响因素的研究[J].Chinese journal of Epidemiology,2011,32(9):877-881

上海市新生儿接种重组酵母乙型肝炎疫苗后低(无)应答情况及影响因素的研究

Study on the non-and-low response and its determinants to recombinant yeast-derived hepatitis B vaccines among neonates after primary immunization in Shanghai

Received:April 02, 2011

DOI：

KeyWord: 乙型肝炎疫苗新生儿低（无）应答决定因素

English Key Word: Recombinant hepatitis B vaccine Infants Non and low response Determinant

FundProject:国家“十一五”科技重大专项（2008ZX10002-001）

Author Name	Affiliation	E-mail
LI Jian	Department of Acute Infectious Disease, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200036, China
WU Huan-yu	Department of Acute Infectious Disease, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200036, China
PAN Yin-jun	Qingpu District Center for Disease Control and Prevention
CAO Wei-zhong	Chongming Gounty Center for Disease Control and Prevention
QIAN Jie	Jiading District Center for Disease Control and Prevention
REN Hong	Department of Acute Infectious Disease, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200036, China
SHI Yang	Department of Acute Infectious Disease, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200036, China
LI Yan-ting	Department of Acute Infectious Disease, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200036, China	ytli@scdc.sh.cn

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Abstract:

目的了解上海市新生儿接种重组酵母乙型肝炎（乙肝）疫苗后的低（无）应答情况，并探讨其影响因素。方法对上海市3个区2008-2009年出生的2047名新生儿，按“0-1-6”免疫程序接种乙肝疫苗。采用化学发光微粒子免疫分析法检测抗-HBs，并对家长进行问卷调查。通过单因素分析并拟合多因素logistic回归模型探讨婴儿低（无）应答的影响因素。结果新生儿乙肝疫苗初次免疫后，血清抗-HBs滴度最大值为14 982.7 mIU/ml，最小值为0.52 mIU/ml，几何平均浓度为408.04 mIU/ml。低（无）应答率为17％，其中无应答率为1.86％,低应答率为15.14％。经综合考虑单因素分析和有序多分类logistic回归分析，性别、月龄、是否早产、乙肝疫苗种类和母亲HBsAg、HBeAg是否双阳性5个因素是婴儿低（无）应答的影响因素，其OR值分别为1.365（男性）、3.133（13～18月龄）、2.824(早产)、4.540（接种5μg疫苗）和2.298（母亲HBsAg、HBeAg双阳性）。结论男性、13～18月龄、早产、接种5μg疫苗和母亲HBsAg、HBeAg双阳性婴儿的免疫应答水平较低，应加强抗-HBs滴度的监测。

English Abstract:

Objective To evaluate the non-and-low response to primary immunization of recombinant yeast-derived hepatitis B vaccines (YDVs) among neonates and to probe its determinants, in Shanghai. Methods Two thousand and forty-seven infants, born during 2008-2009 in three districts of Shanghai and administered with 3 dosages of YDVs according to 0-1-6 month schedule, were selected as subjects. Anti-HBs titers were evaluated by Chemiluminescence Microparticle Immuno Assay and related information was collected from parents through questionnaires. Univariate analysis and logistic regression model were used to probe the determinants among those infants with non-and-low response. Results The max-titer of anti-HBs in 2047 subjects was 14 982.7 mIU/ml, whereas the min-titer was 0.52 mIU/ml. The GMC was 408.04 mIU/ml after primary immunization of YDVs. The proportion of infants with titers of ＜100 mIU/ml (non-and-low response) was 17％, in which the proportion with titers of ＜ 10 mIU/ml (non response)was 1.86％ and the proportion with titers of 10-99 mIU/ml (low response) was 15.14％. Data from both univariate analysis and Ordinal logistic regression suggested that gender, age, premature labor,type of vaccines, double positive for both HBsAg and HBeAg were determinants of non-and-low response for infants, with the OR value of 1.365 for male infants, 3.133 for infants with 13-18 months old, 2.824 for prematured infants, 4.540 for infants administered by 5 μg YDVs and 2.298 for infants whose mother was double positive for both HBsAg and HBeAg. Conclusion Male infants,infants with 13-18 months old, prematured infants, infants administered by 5 μg YDVs and infants whose mother were double positive for both HBsAg and HBeAg had comparatively worse response for YDVs, suggesting that the anti-HBs titer surveillance programs set for these infants should be strengthened.

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