乙型肝炎血源疫苗皮内接种4年效果观察

为了解乙型肝炎血源疫苗皮内接种的持久效果,选ＨＢｓＡｇ、抗－ＨＢｓ和抗－ＨＢｃ均（－）的９～１１岁儿童１０３名,随机分成４组,分别皮内接种１μｇ×４和３μｇ×４（均按０,１,２,５月程序）和肌肉接种１０μｇ×３和３０μｇ×３（各按０,１,２月程序）。首针后４８月时,１μｇ、３μｇ、１０μｇ和３０μｇ组抗－ＨＢｓ≥１０ｍＩＵ／ｍＩ者各为６９．２％,８０．０％、９２．３％和８１．８％;ＧＭＴ则为１４．５,７９．０,４４．８和７０．９ｍＩＵ／ｍｌ,３μｇ×４皮内免疫的近期和远期效果与肌肉组３０μｇ×３相似,宜于某些人群采用     

含前S蛋白乙肝疫苗免疫人群效果观察

为考核含前Ｓ蛋白乙肝血源疫苗的人群免疫效果,对９６８名ＨＢＶ标志阴性的少年人群以１０μｇ×３的免疫剂量及０、１、２月免疫程序进行接种。全程免疫后一月采血检测其抗－ＨＢｓ免疫应答。结果表明抗－ＨＢｓ阳性率达９６．６％。并对另２９１名抗－ＨＢｃ及ＨＣＶ阳性的少年人群以同样的剂量、同样的免疫程序进行免疫接种,免疫后抗－ＨＢｓ阳性率为９４．１６％,且有２３．９８％的人接种后抗－ＨＢｃ由接种前的阳性转为阴性,全部观察对象无一例检出ＨＢｓＡｇ和其它异常指标     

国产和美国产乙型肝炎血源疫苗五年效果比较

母亲ＨＢｓＡｇ和ＨＢｅＡｇ均阳性者所生之婴儿，随机接种国产和美国产乙肝疫苗，免疫后５年婴儿ＨＢｓＡｇ携带率分别为１５．４％和１８．２％；抗－ＨＢｓ阳性率各为７６．９％和７７．３％，两组均无显著性差别。     

新生儿接种小剂量乙肝疫苗后3-5年随访观察

本文对９３８例初生婴儿接种小剂量（１０ｕｇ×３）乙肝疫苗后３－５年的预防效果进行了随访观察,并以２５３例初生儿未接种疫苗者作为对照,结果表明,接种组３－５年后抗－ＨＢｓ阳性率显著高于对照组,ＨＢｓＡｇ阳性率则较对照组显著为低。感染保护率８６．７％。结果还表明,接种乙肝疫苗３年后加强１次,比不加强者Ｐ／Ｎ均值显著增高。文章认为初生儿接种小剂量乙肝疫苗有长期免疫效果;接种后３年加强接种１次,可保持较高免疫力。     

少年人群接种乙肝疫苗后七年随访观察

对７９名ＨＢＶ标志阴性少年人群,以乙肝疫苗１０μｇ×３的免疫剂量和０、１、２月的免疫程序进行接种,对其抗－ＨＢｓ免疫应答和临床保护效果作了为期７年的定人随访。结果表明,抗－ＨＢｓ阳转率在免后三个月时为１００％,均值为３０８４ＭＩＵ／ｍｌ。至免后８４个月时疫苗接受者中仍有５５．７％的抗－ＨＢｓ水平≥１０ＭＩＵ／ｍｌ。６例检出抗－ＨＢｓ,其中５例的抗－ＨＢｓ持续处于高水平。全部观察对象无一例检出ＨＢｓＡｇ或发生临床肝炎。少年接种乙肝血源疫苗至少７年内可具有保护性抗体。故在此期内不需加强免疫。     

乙型肝炎病人重叠感染丙型肝炎的评价

应用ＥＬＩＳＡ和ＰＣＲ法检测５０２例乙肝病人血清,４０１例ＨＢｓＡｇ阳性血清中,有１１４例（２８．４％）抗－ＨＣＶ和ＨＣＶＲＮＡ双项阳性,２５例（６．２％）ＨＣＶＲＮＡ单项阳性;２１例（５．２％）抗－ＨＣＶ单项阳性。将ＨＢｓＡｇ乙肝病人分成ＨＢＶＤＮＡ,ＨＢｅＡｇ阳性组和ＨＢＶＤＮＡ,ＨＢｅＡｇ阴性组。前者抗－ＨＣＶ阳性率为１１．６％～２０．５％,ＨＣＶＲＮＡ阳性率为１６．２％～２０．５％。后者抗－ＨＣＶ阳性率为２０．２％～５５．６％,ＨＣＶＲＮＡ阳性率为２３％～６０．３％。结果说明长期携带ＨＢＶ者和慢性乙肝病人均可重叠ＨＣＶ感染。ＨＢＶＤＮＡ阳性组抗－ＨＣＶ和ＨＣＶＲＮＡ阳性率明显高于ＨＢＶＤＮＡ阳性组     

重组HCV NS5区蛋白抗原在丙型肝炎检测中的应用

对ＨＣＶ ＮＳ５区部分基因进行了克隆表达,获得优质ＮＳ５区蛋白抗原。通过对不同人群抗－ＮＳ５检测表明,随访３年和６年的输血后丙肝病例抗－ＮＳ５阳性率分别为７０．５％和８０．９％,随访８年和１１年慢性丙肝病例分别为５０．７％和８２．４％。一般人群阳性率仅为１．７％,正常献血员中未检出阳性。     

ELISA技术筛选200种中草药抗HBsAg的实验研究

使用ＥＬＩＳＡ技术对２００种中草药水提取物进行抗ＨＢｓＡｇ的实验研究,共筛出有效药物７种（占总数的３．５％）。若按５种不同剂量（０．３、０．６、１．２、２．５、５．０ｍｇ／１００μｌ）的药物、２种不同浓度的ＨＢｓＡｇ（１０．９２、１４．２６Ｐ／Ｎ值）与３种不同接触时间（立即、１ｈ、２ｈ）的１０项Ｐ／Ｎ值均数来综合评价药效指数时,７种有效药物的次序为青蒿（１．６７Ｐ／Ｎ值）、大蒜（２．１９Ｐ／Ｎ值）、红孩儿（２．３１Ｐ／Ｎ值）、仙鹤草（２．３１）、魔芋（２．３２Ｐ／Ｎ值）、冬瓜皮（２．６３Ｐ／Ｎ值）和猕猴桃（２．８９Ｐ／Ｎ值）。     

恩拉霉素抗乙型肝炎病毒的体外实验研究

以ＨｅｐＧ２．２．２．１５细胞株为模型,以其分泌的ＨＢｓＡｇ、ＨＢｅＡｇ、ＨＢＶＤＮＡ及细胞存活率为观察指标,综合评价天然多肽类抗生素恩拉霉素体外抗ＨＢＶ效果。结果表明恩拉霉素对ＨＢｓＡｇ和ＨＢｅＡｇ的５０％抑制浓度ＩＣ５０分别为２７μｇ／ｍＬ和３４μｇ／ｍＬ,治疗指数（ＴＩ）分别为５．９和４．６。Ｓｏｕｔｈｅｒｎ结果显示,５０μｇ／ｍＬ恩拉霉素对细胞内游离ＨＢＶＤＮＡ抑制率为５６．８％。     

抗心律失常药UK－68798对家兔心脏房室结区不同细胞的电生理作用

在离体家兔ＡＶＮ区标本上,用微电极技术研究了Ⅲ类抗心律失常新药ＵＫ－６８７９８对ＡＮ,Ｎ,ＮＨ,Ｈ４种细胞的电生理效应。浓度５×１０－９至５×１０－６ｍｏｌ／Ｌ的ＵＫ－６８７９８对４种细胞的动作电位幅值（ＡＰＡ）、静息膜电位（ＲＰ）皆无影响。对ＡＶＮ的自搏率有剂量依赖性减慢作用,但不改变Ａ－Ｈ传导时间。在５×１０－８－５×１０－６ｍｏｌ／Ｌ剂量范围,此药使动作电位时程（ＡＰＤ５０）和（ＡＰＤ９０）发生剂量依赖性延长。４种细胞中以Ｎ细胞的ＡＰＤ５０和ＡＰＤ９０延长百分率最高。各种细胞ＡＰＤ９０延长百分率的排列次序为Ｎ＜ＡＮ＜Ｈ＜ＮＨ,当浓度为５×１０－６ｍｏｌ／Ｌ时的延长百分率分别为９５±２６％（Ｎ）,７５±２２％（ＡＮ）,６３±２６％（Ｈ）,４６±２６％（ＮＨ）。在ＵＫ－６８７９８的作用下,４种细胞的有效不应期（ＥＲＰ）也发生剂量依赖性延长,但不存在像ＡＰＤ延长百分率那样的差别。此外,４种细胞ＥＲＰ所相当的复极化膜电位未受药物影响,从而避免了由于兴奋性恢复的不均一性,使ＡＶＮ区成为折返性心律失常的发源地．     

The positive rates of hepatitis B surface antibody in youth after booster vaccination: a 4-year follow-up study with large sample

Background: Hepatitis B virus (HBV) infection is still a public issue in the world. Hepatitis B vaccination is widely used as an effective measure to prevent HBV infection. This large-sample study aimed to evaluate the positive rates of hepatitis B surface antibody (anti-HBs) in youth after booster vaccination.Methods: A total of 37788 participants were divided into two groups according to the baseline levels of anti-HBs before booster vaccination: the negative group (anti-HBs(−)) and the positive group (anti-HBs(+)). Participants were tested for anti-HBs levels after receiving a booster vaccine at 1 and 4 years.Results: The positive rates of anti-HBs were 34.50%, 73.80% and 67.32% before booster vaccination at 1 and 4 years after vaccination, respectively. At 4 years after the booster vaccination, the positive rates of 13–18 years were 47.54%, which was the lowest level among all youth age groups. In the anti-HBs(−) group, the positive conversion rates of anti-HBs were 74.62% at 1 year after receiving a booster vaccine, and 67.66% at 4 years after vaccination. In the anti-HBs(+) group, the positive maintenance rates of anti-HBs were 70.16% after 1 year, and 66.66% after 4 years. Compared with the baseline anti-HBs (+) group, the positive rates of the baseline anti-HBs(−) group were higher at 1 and 4 years after receiving the booster vaccine.Conclusion: The positive rates of anti-HBs declined over time, especially the positive maintenance rates were the lowest at age of 13–18 years.     

Evaluation of the immune response to hepatitis B vaccination in children aged 1-3 years in Malatya, Turkey

By the end of 1998, Turkey had launched the routine vaccination of infants against hepatitis B. The purpose of the study is to evaluate the immune response in a sample of vaccinated children aged 1-3 years in the city of Malatya. A total of 210 vaccinated children 12 to 48 months old were selected for the study with 30 cluster sampling in the city of Malatya, Turkey. The children were visited at their homes during January-April 2002. The information on demographic characteristics, family's and child's medical history was gathered, childrens' weight and height were measured and blood samples were taken. Anti-HBs, HbsAg and anti-HBc titers were assayed by micro-ELIZA from the sera. The mean age of the children was 26.3 months, 100 (47.6%) were male and 110 (52.4%) were female. Overall, 203 (96.7%) children had protective anti-HBs levels (> or = 10 IU/l), 0.5% showed evidence of natural infection (with positive anti-HBc and anti-HBs titers), 0.5% had acute or chronic infection (with positive HbsAg and anti-HBc titers) and 2.3% were seronegative. Geometric mean titer of anti-HBs among vaccinated children except those who had positive anti-HBc titers was 138.7 mIU/ml (95% CI:124.7-154.2) and seroconversion rates did not differ by age, sex, anthropometric measurements, time after third dose and place of vaccine administered (P > 0.05). The high seroprotection rate over 95% showed that routine infant vaccination program for hepatitis B was successfully carried out in the city Malatya.     

钦南区1～6岁儿童乙肝及白喉疫苗免疫效果分析

目的分析钦南区儿童乙肝及白喉疫苗接种后的免疫效果,为该地区儿童免疫规划工作提供科学依据。方法采用整群随机抽样方法,选取5个乡镇1~6岁常住儿童151名为调查对象,进行病毒性乙型肝炎(乙肝)、白喉血清学检测,并对结果进行分析。结果 HBsAg阳性2人,阳性率1.32%;抗-HBs阳性112人,阳性率74.17%。白喉IgG阳性142人,阳性率94.04%。抗-HBs中位数21.32 mIU/mL,白喉IgG中位数0.14 mIU/mL,乙肝疫苗首针及时接种率83.44%;男女抗-HBs阳性率、白喉IgG阳性率、抗体中位数差异均无统计学意义(P0.05),抗-HBs阳性率、白喉IgG阳性率随年龄的增长而下降(P0.01)。结论钦南区1~6岁儿童乙肝疫苗接种率、首针及时接种率均达到了国家免疫规划的目标,白喉IgG阳性率维持较高的水平,但HBsAg阳性率略高于国家免疫规划的目标,儿童免疫规划工作仍需进一步加强。     

婴儿围产期感染乙型肝炎病毒后各项血清学指标的动态变化

本文观察了102名新生儿出生后至18月龄的HBV血清学指标的动态变化,婴儿分成乙型肝炎疫苗按种组(63人)和对照组(39人), 观察期间HBsAg始终阴性的70名婴儿,出生后6、12和18月龄的抗-HBc阳性率依次为90％、30％和4.3％;而HBsAg阳转的27名婴儿,18月龄时抗-HBc全都阳性,但仅有6名婴儿在6月龄时测出IgM抗-HBc,疫苗接种组婴儿出生后1、3、6、12和18月龄的抗-HBs阳性率,依次为28.6％、76.2％、77。8％、82.5％和82.5％;对照组婴儿18月龄时抗-HBs阳性率仅为12.8％。     

Transplacentally acquired maternal antibody against hepatitis B surface antigen in infants and its influence on the response to hepatitis B vaccine

Background

Passively acquired maternal antibodies in infants may inhibit active immune responses to vaccines. Whether maternal antibody against hepatitis B surface antigen (anti-HBs) in infants may influence the long-term immunogenicity of hepatitis B vaccine remains unknown.

Methodology/Principal Findings

Totally 338 pairs of mothers and children were enrolled. All infants were routinely vaccinated against hepatitis B based on 0-, 1- and 6-month schedule. We characterized the transplacental transfer of maternal anti-HBs, and compared anti-HBs response in children of mothers with or without anti-HBs. In a prospective observation, all 63 anti-HBs positive mothers transferred anti-HBs to their infants; 84.1% of the infants had higher anti-HBs concentrations than their mothers. One and half years after vaccination with three doses of hepatitis B vaccine, the positive rate and geometric mean concentration (GMC) of anti-HBs in 32 infants with maternal anti-HBs were comparable with those in 32 infants without maternal antibody (90.6% vs 87.5%, P = 0.688, and 74.5 vs 73.5 mIU/ml, P = 0.742, respectively). In a retrospective analysis, five and half years after vaccination with three doses vaccine, the positive rates of anti-HBs in 88 children of mothers with anti-HBs ≥1000 mIU/ml, 94 children of mothers with anti-HBs 10–999 mIU/ml, and 61 children of mothers with anti-HBs <10 mIU/ml were 72.7%, 69.2%, and 63.9% (P = 0.521), respectively; anti-HBs GMC in these three groups were 38.9, 43.9, and 31.7 mIU/ml (P = 0.726), respectively.

Conclusions/Significance

The data demonstrate that maternal anti-HBs in infants, even at high concentrations, does not inhibit the long-term immunogenicity of hepatitis B vaccine. Thus, current hepatitis B vaccination schedule for infants will be still effective in the future when most infants are positive for maternal anti-HBs due to the massive vaccination against hepatitis B.     

甘肃省1～59岁人群乙型肝炎病毒感染的血清流行病学调查

为了解甘肃省现阶段乙型肝炎病毒感染的现状,分析乙肝病毒感染血清学指标的变化,采用多阶段整群抽样的方法,抽取5个县区1~59岁人群共2200人进行调查。以ELISA方法对血清标本统一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)。结果显示,甘肃省1~59岁调查人群HBsAg阳性率为3.59%,抗-HBs和抗-HBc阳性率分别为49.45%、16.33%;HBV总感染率为27.50%。比1992年HBV总感染率下降了36.48%,HBsAg阳性率下降了45.94%;1~4岁儿童HBsAg阳性率仅为1.13%,比1992年(5.34%)下降78.84%。甘肃省1~59岁人群乙肝病毒感染率下降,抗-HBs阳性率升高,尤其在1~4岁儿童变化更为明显;甘肃省乙肝感染逐步呈现由中高流行转向低流行区的趋势;乙肝疫苗免疫取得显著效果。     

Anti-pre-S2 antibody response in subjects vaccinated against hepatitis B and in naturally immunized subjects

Serum samples from individuals immunized with a pepsinized or non-pepsinized vaccine and from patients who had recovered from acute hepatitis B or who developed a chronic form of the disease, were analysed for the presence of antibody against the pre-S2 epitope of the hepatitis B virus.Anti-pre-S2 antibody was absent in all but one individual immunized with the pepsinized vaccine. Thirty-eight percent of the subjects who responded by anti-HBs production to the non-pepsinized preparation showed anti-pre-S2 antibody one year after complete vaccination. Among subjects who did not produce anti-HBs after immunization with this vaccine, 1 single individual produced anti-pre-S2 antibody. Anti-preS2 antibody was detectable after one year in 38% of the patients who recovered from acute hepatitis B, but in none of those with chronic hepatitis B. The kinetics of anti-pre-S2 antibody response to a booster injection was also analysed 1 month and 1 year after the 3rd injection and 1 month after the 4th injection of the non-pepsinized vaccine.     

Immunogenicity of Hepatitis B Virus Vaccine (Heptavax-B)—Response of Healthy Adults

We vaccinated 30 healthy adults who were susceptible to hepatitis B virus with 20 μg of Merck Sharp & Dohme vaccine at zero, one and six months and measured their antibody (anti-HBs) response weekly for four weeks and monthly for at least seven months. A month following the first dose 40% had antibodies and 90% were positive for anti-HBs a month following the second dose. The third dose raised the response rate to 93.3% but its major effect was to substantially raise the titer of virtually all of the vaccinees. Two persons had no antibody response to vaccination and four others were hyporesponders. No complications or significant side effects were observed.     

Seropositivity for hepatitis B virus, vaccination coverage, and vaccine response in dentists from Campo Grande, Mato Grosso do Sul, Brazil

This study investigated the seropositivity for hepatitis B virus (HBV), the vaccination index, and the vaccine response index in dentists from Campo Grande, MS. Blood samples from 474 dentists (63.7% women and 36.3% men), with a mean age of 38.5 +/- 10.5 years were analyzed by enzyme-linked immunosorbent assay to detect the serological markers: HBsAg, anti-HBs, and anti-HBc. The HBsAg positive samples were tested for anti-HBc IgM, HBeAg, and anti-HBe. A total of 51 (10.8%) dentists showed seropositivity for HBV. Three (0.6%) were HBsAg/anti-HBc/anti-HBe positive, 43 (9.1%) were anti-HBc/anti-HBs positive, and 5 (1.1%) had only anti-HBc. Viral DNA was detected by polymerase chain reaction in 9 (17.6%) out of 51 HBV seropositive samples. A vaccination index of 96.6% (458/474) was observed, although 73.1% (335/458)completed the three-dose schedule. Excluding 46 HBV seropositive individuals from 458 that reported vaccination, 412 were analyzed for vaccine response index. It was observed that 74.5% (307/412) were anti-HBs positive; this percentage increased to 79.1% when three doses were administered. The results showed a high vaccination index and a good rate of vaccine response; however, the failure in completing the three-dose schedule and the occurrence of HBV infection reinforce the need for more effective prevention strategies.