成人医护人员接种乙肝病毒疫苗耐久性

StephenW

  Oxford Journals
    Medicine & Health
    Clinical Infectious Diseases
    Advance Access
    10.1093/cid/ciu867



Durability of Antibody Response Against Hepatitis B Virus in Healthcare Workers Vaccinated as Adults

    Naveen Gara1,a,
    Adil Abdalla1,a,
    Elenita Rivera1,
    Xiongce Zhao2,
    Jens M. Werner1,b,
    T. Jake Liang1,
    Jay H. Hoofnagle3,
    Barbara Rehermann1, and
    Marc G. Ghany1

+ Author Affiliations

    1Liver Diseases Branch
    2Biostatistics, Intramural Research
    3Liver Disease Research Branch, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland

    Correspondence: Marc G. Ghany, MD, MHSc, Liver Diseases Branch, NIDDK, National Institutes of Health, 10 Center Drive, Bldg 10, Rm 9B-16, Bethesda, MD 20892-1800 ([email protected]).

    ↵a N. G. and A. A. contributed equally to this work.

    ↵b Present affiliation: Klinik and Poliklinik für Chirurgie, Universitätsklinikum Regensburg, Germany.

Abstract

Background. Follow-up studies of recipients of hepatitis B vaccine from endemic areas have reported loss of antibody to hepatitis B surface antigen (anti-HBs) in a high proportion of persons vaccinated at birth. In contrast, the long-term durability of antibody in persons vaccinated as adults in nonendemic areas is not well defined. We aimed to assess the durability of anti-HBs among healthcare workers (HCWs) vaccinated as adults and response to a booster among those without protective levels of antibody.

Methods. Adult HCWs aged 18–60 at the time of initial vaccination were recruited. All were tested for hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti-HBc), and anti-HBs level. HCWs with anti-HBs <12 mIU/mL were offered a booster and levels were measured 1, 7, and 21 days afterward.

Results. Anti-HBs levels were <12 mIU/mL in 9 of 50 (18%), 13 of 50 (26%), and 14 of 59 (24%) HCWs 10–15, 16–20, and >20 years postvaccination, respectively, (P = ns). Four HCWs were anti-HBc positive; none had HBsAg. By logistic regression, older age at vaccination was the only predictor of inadequate anti-HBs level (P = .0005). Thirty-four of 36 subjects with inadequate anti-HBs levels received a booster and 32 (94%) developed levels >12 mIU/mL within 3 weeks.

Conclusions. Anti-HBs levels decrease after 10–31 years and fall below a level considered protective in approximately 25% of cases. The rapid and robust response to a booster vaccine suggests a long-lasting amnestic response. Hepatitis B vaccination provides long-term protection against hepatitis B and booster vaccination does not appear to be necessary in HCWs.

StephenW

牛津期刊
    医药与健康
    临床传染病
    高级访问
    10.1093/ CID/ ciu867



的抗体应答对乙肝病毒的医护人员接种疫苗耐久性成人

    纳温Gara1，一，
    阿迪尔Abdalla1，一，
    Elenita Rivera1，
    Xiongce Zhao2，
    延斯·M. Werner1，B，
    T.杰克亮1，
    周杰伦H. Hoofnagle3，
    芭芭拉Rehermann1和
    马克·G. Ghany1

+作者所属机构

    1Liver疾病科
    2Biostatistics，院内研究
    3Liver疾病研究科，消化疾病和营养，糖尿病研究所，消化和肾脏病科，美国国立卫生研究院，马里兰州贝塞斯达

    函授：马克·G. Ghany，MD，MHSC，肝病科，NIDDK，国家卫生研究院，10个中心车道，10号楼，RM9B-16，马里兰州贝塞斯达20892-1800（[email protected] ）。

    ↵aNG和AA同等贡献这项工作。

    ↵b目前隶属关系：KLINIK和Poliklinik献给Chirurgie，Universitätsklinikum德国雷根斯堡。

抽象

背景。从流行地区乙肝疫苗接种者的随访研究已经接种出生的人比例高报抗体损失乙肝表面抗原（抗-HBs）。与此相反，抗体在非流行地区接种作为成年人的人的长期耐久性没有很好地限定。我们的目的是评估抗-HBs医护人员（医护人员）接种作为成年人和响应于在那些没有抗体的保护水平的升压之间的耐久性。

方法。在初次接种时间18-60岁成人医务人员被招募。所有被测试为乙肝表面抗原（HBsAg），抗体对乙型肝炎核心抗原（抗-HBc），和抗-HBs的水平。用抗HBs<12 MIU/ mL的医护人员被提供一个助推器和水平测定1,7，21天之后。

结果。抗-HBs水平<12 MIU/ mL的在9 50（18％），1350（26％），和59（24％）医护人员10-15，16-2014，和>20年接种后，分别，（P = NS）。四是卫生保健工作者抗-HBc阳性;没有了乙肝表面抗原。 logistic回归，年龄在接种疫苗是不充分的抗-HBs水平（P=0.0005）的唯一指标。三十四个36受试者不足抗-HBs水平接收的助推器和32（94％）开发水平>12 MIU/ mL的3周内。

结论。抗-HBs水平后10-31年减少和低于在箱子的约25％认为是保护性的水平。到一个助推器疫苗的快速和强大的响应表明长效遗忘响应。接种乙肝疫苗提供长期保护，防止乙肝和加强免疫似乎没有必要在医务人员。

王震宇

早在2005年，我的这项研究就已经完成了