抗HBs携带者母亲足月婴儿的低疫苗免疫预防失败率

StephenW

Infectious Disease Advisor Contributing Writer
September 28, 2018
Low Vaccine Immunoprophylaxis Failure Rates in Term Infants of Anti-HBs Carrier Mothers
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Infants born to anti-HBs carrier mothers who are given either monovalent or combination hepatitis B vaccines have low rates of immunoprophylaxis failure. Infants born to anti-HBs carrier mothers who are given either monovalent or combination hepatitis B vaccines have low rates of immunoprophylaxis failure.

Infants born to mothers with chronic hepatitis B who are given either monovalent or combination hepatitis B vaccines have shown low rates of immunoprophylaxis failure, according to a study recently published in the Journal of Paediatrics and Child Health.

This study included 330 newborn children, 177 of whom received monovalent hepatitis vaccine in 3 doses at age 0, 1, and 6 months (regimen A) and 115 of whom received 2 doses of monovalent vaccine at 0 and 1 months and 1 combination vaccine DTaP-IPV-Hib-Hepatitis B virus at 6 months (regimen B).

The vast majority of both regimens achieved full immunity. Regimen A experienced an immunoprophylaxis failure rate of 2.3%, while regimen B's failure rate was 2.6% (P =1.00). The mean amount of hepatitis B surface antibodies in titration were similar between regimens, with regimen A at 643±374 and regimen B at 561±396 (P =.08). Gender, birth weight, delivery type, and gestational age were similar between the two treatment arms.

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This study took place over 78 months and was conducted at 2 maternity units located in Singapore. Infants were born to mothers who were surface antigen-positive with chronic hepatitis B and who had completed the vaccination program. Infants whose mothers were taking antiviral therapy or who had concurrent HIV or hepatitis C were not included.

Immunoprophylaxis failure resulting in transmission of hepatitis B from mother to child was the primary measure of vaccine efficacy. Hepatitis B surface antibody levels were collected at 9 months of age to determine immunogenicity.

The study researchers conclude that “hepatitis B vaccine regimens using monovalent or combination vaccine for the third dose showed similarly high vaccine effectiveness and low immunoprophylaxis failure rate in term infants born to chronic hepatitis B carrier mothers.”

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Reference

Lee LY, Chan SM, Ong C, et al. Comparing monovalent and combination hepatitis B vaccine outcomes in children delivered by mothers with chronic hepatitis B [published online August 30, 2018]. J Paediatri Child Health. doi: 10.1111/jpc.14194

StephenW

传染病顾问特约撰稿人
2018年9月28日
抗HBs携带者母亲足月婴儿的低疫苗免疫预防失败率


抗-HBs携带者母亲所生的婴儿，如果给予单价或联合乙型肝炎疫苗，其免疫预防失败率较低。抗-HBs携带者母亲所生的婴儿，如果给予单价或联合乙型肝炎疫苗，其免疫预防失败率较低。

根据最近发表在“儿科和儿童健康杂志”上的一项研究显示，给予单价或联合乙型肝炎疫苗的慢性乙型肝炎母亲所生的婴儿的免疫预防失败率很低。

该研究包括330名新生儿，其中177名在0,1和6个月时接受3剂量的单价肝炎疫苗（方案A），其中115人在0和1个月接受2剂单价疫苗和1种联合疫苗DTaP -IPV-Hib-乙型肝炎病毒6个月（方案B）。

绝大多数两种方案都获得了完全的免疫力。方案A的免疫预防失败率为2.3％，而方案B的失败率为2.6％（P = 1.00）。滴定中乙型肝炎表面抗体的平均量在方案之间相似，方案A为643±374，方案B为561±396（P = .08）。两个治疗组的性别，出生体重，分娩类型和孕龄相似。



这项研究进行了78个月，并在新加坡的2个产科单位进行。婴儿出生于表面抗原呈阳性并患有慢性乙型肝炎并已完成疫苗接种计划的母亲。母亲正在接受抗病毒治疗或同时感染艾滋病毒或丙型肝炎的婴儿不包括在内。

导致乙型肝炎从母亲传染给儿童的免疫预防失败是疫苗效力的主要衡量标准。在9月龄时收集乙型肝炎表面抗体水平以确定免疫原性。

该研究的研究人员得出结论：“对于第三剂使用单价或联合疫苗的乙型肝炎疫苗方案在慢性乙肝携带者母亲所生的足月婴儿中表现出类似的高疫苗效率和低免疫预防失败率。”

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参考

Lee LY，Chan SM，Ong C，et al。比较由慢性乙型肝炎母亲分娩的儿童的单价和乙肝联合疫苗结果[在线发表于2018年8月30日]。 J Paediatri儿童健康。 doi：10.1111 / jpc.14194