乙肝疫苗保护效应时间很长，但约1/5的人15年失去保护效应

肝胆速递

http://www.hivandhepatitis.com/hbv-prevention/hbv-vaccines/3775-icaac-2012-hepatitis-b-vaccine-effective-long-term-but-some-lose-protection-after-15-years

ICAAC 2012: Hepatitis B Vaccine Effective Long-term, but Some Lose Protection after 15  

乙肝疫苗保护效应时间很长，但约1/5的人15年失去保护效应

肝胆速递：乙肝疫苗保护效应并非终生，在对1129的儿童疫苗免疫效果追踪研究表明：约1/5的人抗体浓度下降至保护效应阈值之下，再次疫苗接种可恢复抗体浓度

Published on Tuesday, 11 September 2012  Written by Liz Highleyman               
                                                                                                 Gaston De Serres (Photo: Liz Highleyman)
                                       
               
               
                Nearly all children who received 3 doses of the Engerix-B hepatitis B vaccine achieved protective immunity, but about 20% fell below the protective antibody threshold by year 15 and could benefit from a booster shot, Canadian researchers reported at the 52nd Interscience Conference on Antimicrobials and Chemotherapy (ICAAC 2012) this weekin San Francisco.
         Widespread immunization against hepatitis B virus (HBV) has dramatically reduced the incidence of infection worldwide over the past 3 decades. Many countries now include HBV in their recommended infant vaccine series, and "catch up" vaccination is recommended for adolescents and older people at risk.
        Gaston De Serres and colleagues from the Quebec Public Health Institute and Laval University measured anti-HBs antibody levels and immune memory persistence over 15 years in people who were vaccinated prior to adolescence.
        Hepatitis B vaccines are highly immunogenic but do not always provide life-long protection, the researchers noted as background. At 1 to 6 months after vaccination, anti-HBs levels are 10- to 100-fold higher than the protective level. But by 5 to 15 years after vaccination, some individuals have antibody levels below the protective threshold -- and in some cases even undetectable. Nevertheless, despite the disappearance of antibodies, it is thought that immune memory ensures continued protection, though it is not known how long this lasts.
        This prospective analysis, started in 1995, enrolled 1129 children aged 8 to 10 years who had received the Engerix-B (GlaxoSmithKline) vaccine series in school according to the recommended dosing schedule of 10 mcg intramuscular injections at birth, 1 month, and 6 months.
        Participants were then randomly assigned (1:1:1) to receive a booster or challenge doses at either year 5, 10, or 15 of the study. Antibody levels were measured 1-2 months after the third primary vaccine dose, 1-2 months before and after the booster shot, and at 5, 10, and 15 years after initial vaccination. About 220 participants from each booster timing group were included in the final analysis.
        Results

•                 Nearly all participants in all arms had anti-HBs titres > 1 IU/L before they received their booster.
•                 Nearly 90% of children in the 5-year and 10-year booster arms had antibody levels > 10 IU/L -- generally considered the protective level -- prior to boosting, but the proportion fell to 77% for those who did not get their booster until year 15.
•                 68% of children in the 5-year booster arm and 61% in the 10-year booster arm had antibody titres > 100 IU/mL before boosting, falling to 37% in the 15-year booster arm.
•                 1 month after receiving their booster, 100% in all groups had antibody levels > 1 IU/L and > 10 IU/L; 98%, 97%, and 96%, respectively, reached >100 IU/L.
  

        "Vaccination of 8-10 year-old children with 3 doses of Engerix-B induces a protective immunity in nearly all (> 98%) vaccines for at least 15 years," the researchers concluded.
        "The strong antibody response to a challenge (booster) dose suggests the presence of an excellent immune memory in virtually all responders to primary vaccination," they continued. "The results indicate no need [for a] booster dose for at least 15 years post-primary vaccination" for this population.
        9/11/12
        Reference
        V Gilca, N Boulianne, M Dionne, G De Serres, et al. Antibody Persistence and the Effect of a Booster Dose Given 5, 10 or 15 Years After Vaccination With a Recombinant Hepatitis B Vaccine. 52nd Interscience Conference on Antimicrobials and Chemotherapy (ICAAC 2012). San Francisco. September 9-12, 2012. Abstract G-1047.
        

肝胆速递

ICAAC 2012年：长期有效的B型肝炎疫苗，但有些人失去了保护，15年后

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详细信息
    类别：乙肝疫苗
    发表于2012年9月11日（星期二）00:00
    作者：利兹Highleyman的

ALT

加斯东·德塞雷斯（图片：利兹Highleyman）

几乎所有的孩子谁收到3个剂量的ENGERIX-B乙肝疫苗获得保护性免疫，但约20％的保护性抗体阈值跌破15年，并可能受益于一个助推器拍摄，加拿大的研究人员报告在第52届跨领域研讨会抗微生物药物和化疗（ICAAC 2012年）旧金山这weekin。

广泛免疫接种B型肝炎病毒（HBV）感染的发生率大大降低了全球，在过去的三十年。目前许多国家包括HBV在他们推荐的婴幼儿疫苗系列，“追赶”疫苗接种建议为青少年和老年人的风险。

加斯东·德塞雷斯和他的同事从魁北克公共健康研究所和拉瓦尔大学测量超过15年的人到青春期前接种疫苗的抗-HBs抗体水平和免疫记忆的持久性。

B型肝炎疫苗是高度免疫原性，但并不总是提供终身保障，研究人员指出，作为背景。在疫苗接种后的1至6个月，抗-HBs的水平为10  - 〜100倍高于保护水平。但接种疫苗后的5至15年，有些人有抗体水平低于保护阈值 - 在某些情况下甚至测不到。然而，尽管抗体的消失，它被认为是免疫记忆，确保持续的保护，但不知道持续多久。

这个前瞻性的分析，自1995年开始，参加1129年儿童年龄在8至10年谁收到的的ENGERIX-B（葛兰素史克）的疫苗在学校的建议剂量10微克肌内注射时间表出生时，1个月，6个月。

参与者被随机分配（1:1:1）接受一个助推器或挑战剂量在任5年，10年或15的研究。 1-2个月后的第三个主剂疫苗的抗体水平，前1-2个月后的助推器拍摄，并在5年，10年和15年后初次接种。在最后的分析中，约220人被列入从每一个助推器定时组的。

结果

    所有武器几乎所有的参与者中有抗-HBs滴度> 1 IU / L之前，他们接受了他们的助推器。
    近90％的儿童在5年期和10年期的助推器武器抗体水平> 10 IU / L  - 通常被认为是防护等级 - 之前提高，但所占的比例下降到77％，对于那些谁没有得到直到15年他们的助推器。
    68％的儿童在5年的助推器手臂和61％，在10年的助推器臂的抗体滴度> 100 IU / mL的提高，在15年的助推器臂下降到37％。
    1个月后收到他们的助推器，100％，各组抗体水平> 1 IU / L和> 10 IU / L，98％，97％和96％，分别达到> 100 IU / L。

“接种疫苗的8-10岁的儿童有3个剂量的ENGERIX-B诱导的保护性免疫，在几乎所有（98％）至少15年疫苗，研究人员得出结论。”

“强烈的抗体反应是一个挑战剂量（增压）表明，在几乎所有的主要接种疫苗的反应，以良好的免疫记忆的存在，继续。” “结果显示没有需要至少15年后”对这个群体的主要疫苗接种[A]追加剂量。

12年9月11日

参考

Gilca V，M，N Boulianne迪翁，G塞雷斯等。抗体的持久性和影响的5年，10年或15年后的重组乙型肝炎疫苗的接种剂量的助推器。抗生素和化疗（ICAAC 2012年）第52届跨领域研讨会。旧金山。 9月9-12日2012年。文章摘要G-1047。

肝胆速递

http://www.hbvadvocate.org/news/HBJ9.9.htm

Despite Childhood Immunizations, Adult HBV Infections Slowly Increase after
Adolescence

Researchers who examined 1,214 blood samples found that despite hepatitis B
immunization during infancy and childhood, the number of people with HBV
infections, including infections with a strain of HBV with mutations in the
surface antigen, increases. According to the article published in the
journal Gastroenterology, Taiwanese children immunized during infancy were
protected from infection through adolescence, but beginning at age 18, the
number of vaccinated adults with HBV DNA in their blood stream began to
slowly increase. In the study, researchers measured hepatitis B surface
antigens and antibodies and hepatitis B core antibodies in Taiwanese
ranging from infants to adults older than 87. HBV DNA levels were measured
in HBV-vaccinated patients who tested positive for the core antibody
(meaning they had been infected at some point) and those who were infected
and tested positive for HBsAg. Patients born after Taiwan’s HBV
vaccination program began in 1984 had significantly lower HBsAg and core
antibodies compared to older participants (1% vs. 9.3% for HBsAg, and 2.3%
vs. 43.9% for core antibodies.) However, researchers noted over time that
even those who had been vaccinated during infancy had increasing rates of
core antibody and limited numbers of surface antibodies. Core antibodies
were found in 0.4% aged 10-14, 1.9% aged 14-18, and 8.1% of those 18-21.
HBV infection (evidenced by HBsAg) was found in 2% of those 18-21 compared
to a zero infection rates in younger participants. HBV DNA in the blood was
also more common among older patients (3% of those aged 18-21) compared
with 0.2% in younger participants. Among eight fully-vaccinated
participants who tested positive for HBV DNA, five had HBsAg mutations.
Investigators noted that this increase in surface mutations after
adolescence requires careful monitoring, because this “occult”
infection can also cause liver damage. “Universal vaccination effectively
controls HBV infection in children and adolescents,” the researchers
wrote. “However, after adolescence, there is a significant increase in
the seroprevalence of surface antibodies, core antibodies and HBV DNA,
indicating that new preventive strategies are needed for adults. Monitoring
the prevalence of HBV infection by sensitive HBV DNA assays in subjects
beyond adolescence in [the] postvaccination era is mandatory.”

肝胆速递

http://www.hbvadvocate.org/news/HBJ9.9.htm

尽管儿童免疫接种，成人HBV感染后慢慢增加
青春期

研究人员检查1,214血液样本发现，尽管B型肝炎
在婴幼儿和儿童的免疫接种，乙肝病毒的人数
感染，包括HBV突变的菌株的感染
表面抗原，增加。根据在发表的文章
胃肠病学杂志，台湾儿童在婴儿期免疫
免受感染到青春期，但在18岁开始，
数与HBV DNA接种疫苗的成年人在他们的血液流开始
缓慢增加。在这项研究中，研究人员测量了乙肝表面抗原（HBsAg）
抗原和抗体和乙肝核心抗体在台湾
从婴儿到成人年龄超过87。 HBV DNA水平测定
在HBV接种疫苗的患者，核心抗体测试呈阳性反应
（这意味着在某些时候，他们已经被感染）和那些谁被感染
并检测HBsAg阳性。患者出生后台湾的HBV
疫苗接种计划从1984年开始显着降低乙肝表面抗原和核心
抗体相比，年长者（1％和9.3％，乙肝表面抗原和2.3％
％和43.9％，核心抗体），但是，研究人员指出，随着时间的推移，
即使是那些已接种疫苗的婴儿时期曾率上升
核心抗体和表面抗体的数量有限。核心抗体
被发现在0.4％，10岁至14岁，14至18岁的1.9％，和8.1％的人18-21。
HBV感染（证明乙肝表面抗原）被发现在2％的那些18-21
到零感染率较年轻的参与者。在血液中的HBV DNA
也较常见的老年病人（18至21岁的3％）相比，
与0.2％，较年轻的参与者。在八个完全接种疫苗
检测呈阳性，HBV DNA，五，乙肝表面抗原突变。
研究人员指出，这一增长后，在表面突变
青春期需要仔细监测，因为这个“神秘”
感染也可引起肝损害。 “通用接种疫苗有效
控制乙肝病毒感染的儿童和青少年，“研究人员
写道。 “然而，在青春期后，是一种显着的增加
血清表面抗体，核心抗体和乙肝病毒DNA，
这表明新的预防战略需要的成年人。监控
HBV感染的流行敏感的HBV DNA检测的主题
超越青春期的[]接种后的时代是强制性的。“

咬牙硬挺

每隔十年打一次加强就好了