两种不同剂量的乙型肝炎免疫球蛋白联合乙型肝炎疫苗预防

StephenW

Vaccine. 2017 Nov 28. pii: S0264-410X(17)31601-8. doi: 10.1016/j.vaccine.2017.11.037. [Epub ahead of print]
The efficacy of two different dosages of hepatitis B immunoglobulin combined with hepatitis B vaccine in preventing mother-to-child transmission of hepatitis B virus: A prospective cohort study.Wei KP1, Zhu FC2, Liu JX3, Yan L1, Lu Y1, Zhai XJ2, Chang ZJ3, Zeng Y4, Li J5, Zhuang H6.
Author information
1Department of Microbiology and Center of Infectious Diseases, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China.2Department of Infectious Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.3Department of Major Projects, Zhengzhou Municipal Center for Disease Control and Prevention, Zhengzhou 450053, China.4Shenzhen Kangtai Biological Products Co., Ltd, Shenzhen 518057, China.5Department of Microbiology and Center of Infectious Diseases, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China. Electronic address: [email protected].6Department of Microbiology and Center of Infectious Diseases, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China. Electronic address: [email protected].

AbstractBACKGROUND/AIMS: A birth dose of hepatitis B immunoglobulin (HBIG), in combination with hepatitis B vaccine (HepB), is recommended for infants born to hepatitis B surface antigen (HBsAg)-positive mothers. However, the optimal dosage of HBIG remains to be resolved. This prospective cohort study aimed to compare the efficacy of two dosages of HBIG combined with HepB to prevent mother-to-child transmission (MTCT) of HBV.
METHODS: From 2009 to 2011, we prospectively enrolled mother-infant pairs with positive maternal HBsAg in China. Infants were assigned to receive one dose of 100 IU or 200 IU HBIG within 12 h of birth according to maternal numbering, followed by completion of the 3-dose 10 μg HepB series. At 7 months, post-vaccination serologic testing (PVST) was performed in 545 and 632 infants in 100 IU and 200 IU HBIG groups, respectively, among whom, 451 and 529 were followed up to 12 months.
RESULTS: Maternal and birth characteristics were comparable between infants in 100 IU and 200 IU HBIG groups. At 7 months, the rates of perinatal infection were 1.5% (8/545) and 1.9% (12/632) in 100 IU and 200 IU HBIG groups, respectively (p = .568). One non-responder infant in 200 IU HBIG group became newly infected at 12 months. The antibody to hepatitis B surface antigen (anti-HBs) positive rates were 98.5% (529/537) and 98.2% (609/620) in 100 IU and 200 IU HBIG groups at 7 months, respectively (p = .704), and the corresponding figures were 98.2% (431/439) and 97.1% (496/511) at 12 months (p = .266). The anti-HBs geometric mean concentrations were comparable between two groups at 7 months (707.95 mIU/mL vs. 602.56 mIU/mL, p = .062) and 12 months (245.47 mIU/mL vs. 229.09 mIU/mL, p = .407).
CONCLUSIONS: One birth dose of 100 IU HBIG, combined with the HepB series, might be enough for preventing MTCT of HBV in infants born to HBsAg-positive mothers.

Copyright © 2017 Elsevier Ltd. All rights reserved.

KEYWORDS: Antibody to hepatitis B surface antigen; Hepatitis B immunoglobulin; Hepatitis B vaccine; Hepatitis B virus; Mother-to-child transmission

PMID:29195717DOI:10.1016/j.vaccine.2017.11.037

StephenW

疫苗。 2017年11月28日。pii：S0264-410X（17）31601-8。 doi：10.1016 / j.vaccine.2017.11.037。 [电子版提前打印]
两种不同剂量的乙型肝炎免疫球蛋白联合乙型肝炎疫苗预防乙型肝炎病毒母婴传播的疗效：前瞻性队列研究。
Wei KP1，Zhu FC2，Liu JX3，Yan L1，Lu Y1，Zhai XJ2，Chang ZJ3，Zeng Y4，Li J5，Zhuang H6。
作者信息

1
    北京大学医学部基础医学院微生物学与传染病研究中心，北京100191
2
    江苏省疾病预防控制中心传染病科，南京210009
3
    郑州市疾病预防控制中心重大项目科，郑州450053
4
    深圳康泰生物制品有限公司，深圳518057
五
    北京大学医学部基础医学院微生物学与传染病研究中心，北京100191电子地址：[email protected]。
6
    北京大学医学部基础医学院微生物学与传染病研究中心，北京100191电子地址：[email protected]。

抽象
背景/目的：

建议乙肝表面抗原（HBsAg）阳性母亲所生婴儿出生时接种乙肝免疫球蛋白（HBIG）联合乙肝疫苗（HepB）。然而，HBIG的最佳剂量仍有待解决。该前瞻性队列研究旨在比较两种剂量的HBIG联合HepB预防HBV母婴传播（MTCT）的效果。
方法：

从2009年到2011年，我们前瞻性招收了母婴HBsAg阳性的母婴在中国。婴儿在出生后12小时内根据母亲的编号接受一剂100IU或200IU HBIG，随后完成3剂10μgHepB系列。在7个月时，分别对100IU和200IU HBIG组545和632名婴儿进行接种后血清学检测（PVST），其中451名和529名随访至12个月。
结果：

100IU和200IU HBIG组的母亲和出生特征相当。在7个月时，100IU和200IU HBIG组围产期感染率分别为1.5％（8/545）和1.9％（12/632）（p = 0.568）。 200IU HBIG组中的一名无反应婴儿在12个月内新感染。乙肝表面抗原（抗-HBs）抗体阳性率分别为100IU和200IU HBIG组在7个月时分别为98.5％（529/537）和98.2％（609/620）（p = 0.704）， ，相应的数字在12个月时分别为98.2％（431/439）和97.1％（496/511）（p = .266）。两组在7个月时的抗-HBs几何平均浓度相当（707.95mIU / mL比602.56mIU / mL，P = 0.062）和12个月（245.47mIU / mL比229.09mIU / mL，p = 407）。
结论：

100IU HBIG联合HepB系列的出生剂量可能足以预防HBsAg阳性母亲所生婴儿HBV的MTCT。

版权所有©2017 Elsevier有限公司保留所有权利。
关键词：

乙肝表面抗原抗体;乙肝免疫球蛋白;乙肝疫苗;乙型肝炎病毒;母婴传播

结论：
    29195717
DOI：
    10.1016 / j.vaccine.2017.11.037

newchinabok

表面抗体到多少才有保护力？

antiHBVren

回复 newchinabok 的帖子

一般需要100以上才能有保护力；
低于100就应该打疫苗；

从这个文章看，母亲为携带者，其乙肝抗体下降也是非常快的；5个月平均下降60%