中国4个省乙型肝炎表面抗原阳性母亲出生的婴儿接种疫苗后

StephenW

Vaccine. 2017 Jun 23. pii: S0264-410X(17)30796-X. doi: 10.1016/j.vaccine.2017.06.019. [Epub ahead of print]
Post-vaccination serologic testing of infants born to hepatitis B surface antigen positive mothers in 4 provinces of China.Wang F1, Zhang G1, Zheng H1, Miao N1, Shen L2, Wang F2, Dong P3, Du F4, Chen C5, Zhang X6, Cui F7.
Author information
1Chinese Center for Disease Control and Prevention, Beijing, China.2Institute of Virology Disease Control, Chinese Center for Disease Control and Prevention, Beijing, China.3Henan Provincial Center for Disease Control and Prevention, Zhengzhou, China.4Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China.5Jilin Provincial Center for Disease Control and Prevention, Changchun, China.6Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China.7School of Public Health, Peking University, China. Electronic address: [email protected].

AbstractOBJECTIVE: To evaluate prenatal maternal hepatitis B virus (HBV) screening and post-vaccination hepatitis B surface antigen (HBsAg) and antibody to hepatitis B surface antigen (anti-HBs) status and titers of babies born to HBsAg positive mothers, and to provide evidence for development of standard postvaccination serologic testing (PVST) strategies for babies born to HBsAg positive mothers in China.
METHODS: In 2014, we conducted a baseline survey of HBV mother to child transmission (MTCT) interruption strategy implementation and PVST for babies born to HBsAg positive mothers after received 3 doses of hepatitis B vaccine (HepB) in 8 counties in 4 Provinces. Bivariate analysis and multivariable analyses modeled statistically significant predictor variables associated with infant HBsAg, anti-HBs positive, anti-HBs titer.
RESULTS: Among the 1563 infants born to HBsAg positive mothers, 1025 (65.6%) maternal-infant pairs were enrolled in PVST after receiving 3 doses of HepB. 38 infants tested HBsAg positive for an HBsAg positive rate of 3.7%. Maternal hepatitis B e antigen (HBeAg) status and age of infant were significantly associated with infant HBsAg positivity. A total of 932 infants were anti-HBs positive when tested at 7-24months of age, yielding an anti-HBs positivity rate of 90.9%. Maternal HBeAg status was the factor associated with infant anti-HBs status. Amount of antigen of HepB and infant's age were most associated with anti-HBs titers. PVST performed 1-2months after the 3rd dose of HepB was associated with the highest anti-HBs level and the anti-HBs Geometric Mean Concentration (GMC) decreased as the PVST intervals prolonged.
CONCLUSIONS: In China, perinatal HBV transmission is approaching the theoretical minimum possible with the current strategy of HepB coupled with HBIG administration for HBV-exposed newborns. PVST of infants born to an HBsAg positive mother is an essential strategy to ensure full protection for vaccine non-responders and appropriate medical care for those infected.

Copyright © 2017 Elsevier Ltd. All rights reserved.

KEYWORDS: Hepatitis B; Immunization; Mother-to-child transmission; Vaccine

PMID:28651839DOI:10.1016/j.vaccine.2017.06.019

StephenW

疫苗。 2017年6月23日。pii：S0264-410X（17）30796-X。 doi：10.1016 / j.vaccine.2017.06.019。 [提前印刷]
中国4个省乙型肝炎表面抗原阳性母亲出生的婴儿接种疫苗后血清学检测。
王F1，张G1，郑H1，苗N1，沉L2，王F2，董P3，杜F4，陈C5，张X6，崔F7。
作者信息

1
    中国北京疾病预防控制中心。
2
    中国疾病预防控制中心病毒病防治研究所，北京。
3
    河南省疾病预防控制中心，郑州，中国。
4
    四川省疾病预防控制中心，成都，中国。
五
    吉林省疾病预防控制中心，长春，中国。
6
    甘肃省疾病预防控制中心，兰州，中国。
7
    中国北京大学公共卫生学院。电子地址：[email protected]。

抽象
目的：

评估产前乙型肝炎病毒（HBV）筛选和接种后乙型肝炎表面抗原（HBsAg）和乙型肝炎表面抗原（抗HBs）的抗体状态和HBsAg阳性母亲出生的婴儿的滴度，并提供证据制定中国HBsAg阳性母亲出生婴儿的标准接种后血清学检测（PVST）策略。
方法：

2014年，我们对4个省8个县3例乙型肝炎疫苗（HepB）接种后，对HBsAg阳性母亲出生的婴儿HBV母婴传播（MTCT）中断策略实施和PVST进行了基线调查。双变量分析和多变量分析模拟与婴儿HBsAg，抗HBs阳性，抗HBs滴度相关的统计学显着预测变量。
结果：

在HBsAg阳性母亲出生的1563名婴儿中，接受3剂HepB后，1025名（65.6％）母婴对参加了PVST。 38名婴儿测试HBsAg阳性，HBsAg阳性率为3.7％。母亲乙型肝炎e抗原（HBeAg）的状况和婴儿年龄与婴儿HBsAg阳性显着相关。在7-24个月时测试，共有932例婴儿为抗HBs阳性，抗HBs阳性率为90.9％。母亲HBeAg状态是与婴儿抗HBs状态相关的因素。 HepB的抗原量和婴儿的年龄与抗HBs滴度最相关。 PVST在第三剂HepB与抗HBs水平最高的时候进行1-2个月，抗HBs几何平均浓度（GMC）随PVST间期延长而降低。
结论：

在中国，围产期HBV传播正在接近理论上的最低限度，目前的HepB联合HBIG治疗HBV疫苗新策略。 HBsAg阳性母亲出生的婴儿的PVST是确保疫苗无应答者的全面保护和感染者适当医疗的重要策略。

版权所有©2017 Elsevier Ltd.保留所有权利。
关键词：

乙型肝炎免疫接种;母婴传播;疫苗

结论：
    28651839
DOI：
    10.1016 / j.vaccine.2017.06.019