年龄对免疫反应的影响——liver411

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原文由liver411发表于英文版
The Effect of Age on Immunologic Response ...

Clinical Infectious Diseases 2002;35:000
© 2002 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2002/3511-00XX$15.00

The Effect of Age on Immunologic Response to Recombinant Hepatitis B
Vaccine: A Meta-analysis
对重组HBV疫苗免疫反应的年龄影响：后期分析
David N. Fisman,1,2 Deepak Agrawal,3 and Karin Leder4
1City of Hamilton Social and Public Health Services Department and
2Department of Clinical Epidemiology and Biostatistics, McMaster University,
Hamilton, Ontario, Canada;
3Massachusetts General Hospital, Charlestown; and
4Department of Epidemiology and Preventive Medicine, Monash University,
Victoria, Australia

Received 7 May 2002; accepted 8 August 2002; electronically published 12
November 2002.

Hepatitis B vaccine is a key tool for the prevention of hepatitis B
infection. Age-associated changes in immune function may contribute to
decreased vaccine efficacy in older individuals, although research related
to this topic has yielded contradictory findings. We performed a
meta-analysis of 24 published trials and studies that evaluated the
association of age with response to hepatitis B vaccine, using a
random-effects model. Pooling of study results suggested a significantly
increased risk of nonresponse to hepatitis B vaccine among older individuals (relative risk [RR], 1.76; 95% confidence interval [CI], 1.482.10). An elevated risk of nonresponse persisted even after exclusion of poor-quality studies (RR, 1.63; 95% CI, 1.232.15) and adjustment for publication bias (RR, 1.52; 95% CI, 1.261.83), and it was present even when "older"
individuals were defined as being as young as 30 years. These findings have important implications for individuals at risk for hepatitis B infection,
including health care workers and travelers.


HBV疫苗氏阻止HBV感染的关键武器。免疫功能的年龄相关变化会造成年长的个体疫苗效
果低下，虽然这个研究话题会带来争论。我们完成了一个对24项已发表的实验及研究的继
后分析，评估对HBV疫苗反应的年龄相关性。我们使用了随机抽样模型。汇集研究结果，
显示年长人中明显的对HBV无反应率在增加。（相关风险系数[RR]，1.76; 95%置信区间
[CI], 1.482.10）。在排除了低质量研究后无反应的风险系数甚至持续增加(RR, 1.63; 95% CI,
1.232.15)，同公布的偏差有调整(RR, 1.52; 95% CI, 1.261.83)，甚至将“年长”个体定义为
30岁仍会显现。这些发现会提醒有被HBV感染风险的人，包括医务工作者和旅行者。