通過增加乙型肝炎疫苗的劑量來減少嬰兒隱性HBV感染的發生

StephenW

Reduction of the occurrence of occult HBV infection in infants by increasing the dose of hepatitis B vaccine: A large prospective cohort study
Yi Li  1 , Zhixiu Liu  1 , Yarong Song  1 , Yiwei Xiao  1 , Jing Jiang  2 , Lili Li  1 , Xiangjun Zhai  3 , Jianxun Liu  4 , Zhongping Duan  5 , Feng Ding  1 , Jia Liu  1 , Hui Zhuang  1 , Liguo Zhu  3 , Jie Jiang  3 , Huaibin Zou  5 , Jie Wang  1 , Jie Li  1
Affiliations
Affiliations

    1
    Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100083, China.
    2
    Department of Clinical Research, First Hospital of Jilin University, Changchun 130021, China.
    3
    Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.
    4
    Zhengzhou Municipal Center for Disease Control and Prevention, Zhengzhou 450053, China.
    5
    Beijing Youan Hospital, Capital Medical University, Beijing 100054, China.

    PMID: 32779526 DOI: 10.1080/22221751.2020.1808533

Abstract

Occult hepatitis B virus (HBV) infection (OBI) has been observed among infants born to hepatitis B surface antigen (HBsAg)-positive mothers despite successful immunoprophylaxis. This study enrolled 549 infants born to HBsAg-positive mothers with HBV DNA load >6log10IU/mL [349 infants received a 10μg/dose of hepatitis B vaccine (HepB), and 200 infants received 20μg/dose HepB]. The rate of immunoprophylaxis failure, non-response, and immunoprophylaxis success in infants was 5.73%, 1.82%, and 92.55% in the 10μg group, and 4.50%, 0.00%, and 95.50% in the 20μg group, respectively. Moreover, the anti-HBs levels in the 10μg group were significantly lower than that in the 20μg group both at 7 [652.48 (564.05-754.82) vs. 1541.72 (1268.69-1873.51) mIU/mL, P<0.001] and 12 months old [257.44 (220.29-300.88) vs. 1073.41 (839.27-1372.78) mIU/mL, P<0.001]. The OBI incidence in the 10μg group was significantly higher than that in the 20μg group at both 7 [21.55% (25/116) vs. 7.56% (9/119), P=0.002] and 12 months old [17.07% (14/82) vs. 6.90% (6/87), P=0.041], and 76.19% (16/21) and 100.00% (7/7) OBI infants turned HBV DNA negative, and 16.39% (10/61) and 7.50% (6/80) non-OBI infants developed OBI at 12 months old, in the 10μg and 20μg groups, respectively. OBI incidence in infants with anti-HBs levels <100mIU/mL was higher than that of those with anti-HBs ≥100mIU/mL [35.71% (5/14) vs. 13.12% (29/221), P=0.036]. This study showed that increasing the immunisation dose from 10μg to 20μg significantly improved anti-HBs levels and decreased OBI incidence in infants with a high maternal viral load. We recommend 20μg HepB to treat this high-risk population.

Keywords: Hepatitis B vaccine; Hepatitis B virus; Mother-to-child transmission; Occult hepatitis B virus infection.

StephenW

通過增加乙型肝炎疫苗的劑量來減少嬰兒隱性HBV感染的發生：一項大型的前瞻性隊列研究
李莉1，劉志秀1，宋亞榮1，肖一薇1，靖江2，李莉莉1，翟向軍3，劉建勳4，段中平5，馮鼎1，劉佳1，回莊1，朱麗國3，介江3，鄒懷斌5，介王1，介麗1
隸屬關係
隸屬關係

    1個
    北京大學健康科學中心基礎醫學學院微生物與傳染病中心，北京100083
    2
    吉林大學第一醫院臨床研究室，長春130021
    3
    江蘇省疾病預防控制中心，江蘇南京210009
    4
    鄭州市疾病預防控制中心，鄭州450053
    5
    首都醫科大學附屬北京佑安醫院，北京100054

    PMID：32779526 DOI：10.1080 / 22221751.2020.1808533

抽象

儘管免疫預防成功，但在由乙型肝炎表面抗原（HBsAg）陽性母親出生的嬰兒中觀察到隱匿性乙型肝炎病毒（HBV）感染（OBI）。這項研究招募了549名HBsAg陽性母親出生的嬰兒，其HBV DNA負荷> 6log10IU / mL [349例嬰兒接受10μg/劑量的乙型肝炎疫苗（HepB），200例嬰兒接受20μg/劑量的HepB]。嬰兒的免疫預防失敗率，無應答率和免疫預防成功率在10μg組中分別為5.73％，1.82％和92.55％，在20μg組中分別為4.50％，0.00％和95.50％。此外，10μg組的抗HBs水平在7時分別為[652.48（564.05-754.82）和1541.72（1268.69-1873.51）mIU / mL，P <0.001]和12個月大時均顯著低於20μg組。 [257.44（220.29-300.88）vs. 1073.41（839.27-1372.78）mIU / mL，P <0.001]。 10μg組的OBI發生率分別為7 [21.55％（25/116）和7.56％（9/119），P = 0.002]和12個月大時[17.07％（14），均顯著高於20μg組。 / 82）比6.90％（6/87），P = 0.041]和76.19％（16/21）和100.00％（7/7）OBI嬰兒的HBV DNA陰性，而16.39％（10/61）和10μg和20μg組中有7.50％（6/80）的非OBI嬰兒在12個月大時出現OBI。抗HBs水平<100mIU / mL的嬰兒的OBI發生率高於抗HBs≥100mIU/ mL的嬰兒[35.71％（5/14）vs. 13.12％（29/221），P = 0.036]。這項研究表明，將高劑量孕婦的免疫劑量從10μg增加到20μg可以顯著提高抗HBs水平並降低OBI發生率。我們建議使用20μgHepB來治療這一高危人群。

關鍵詞：乙型肝炎疫苗；乙型肝炎病毒;母嬰傳播；隱匿性乙型肝炎病毒感染。

StephenW

https://www.tandfonline.com/doi/ ... 221751.2020.1808533