HBeAg 阳性母亲所生高危新生儿乙型肝炎免疫球蛋白和乙型肝

StephenW

HBeAg 阳性母亲所生高危新生儿乙型肝炎免疫球蛋白和乙型肝炎疫苗接种的结果
Chen-Hsuan Wu 1 , Wei-Cheng Huang 2 , Chien-Hung Chen 3 , Sheng-Nan Lu 4
隶属关系
隶属关系

    1
    台湾高雄长庚大学医学院临床医学研究所；台湾高雄长庚纪念医院及长庚大学医学院妇产科。
    2
    台湾嘉义长庚医院嘉义分院老年科。
    3
    台湾高雄长庚纪念医院及长庚大学医学院内科肝肠胃病科。
    4
    台湾高雄长庚纪念医院及长庚大学医学院内科肝肠胃病科。电子地址：[email protected]。

    PMID：34801765 DOI：10.1016/j.bj.2021.11.007

抽象的

背景：评估台湾乙型肝炎（HB）疫苗接种计划对高危儿童的保护效果。

材料和方法： 2001 年至 2010 年 HBeAg 阳性母亲所生的孩子被邀请回来。采集了乙型肝炎病毒 (HBV) 血清标志物的血液样本，并对儿童进行了肝胆超声检查。从他们的医疗记录中收集围产期因素，包括分娩方式和疫苗接种史。根据 HBV 血清学标志物的结果，这些儿童最初分为 5 组：HBV 初治、HB 疫苗应答者、HBsAg 携带者、HBV 感染康复和抗 HBc 单独阳性。 HBV 初治和抗 HBc 阳性单独组中的儿童在接种 HB 加强疫苗后出现回忆反应，分别被重新分配到疫苗反应组并从感染组中恢复。

结果：纳入的196名儿童均接受了出生后乙型肝炎免疫球蛋白（HBIG）和乙肝疫苗接种，其中1名未感染HBV（0.5%）、109名疫苗应答者（55.6%）、21名携带者（10.7%）和65名从感染中恢复（33.2%）。 21 例携带者中，14 例（66.7%）处于免疫耐受期。剖腹产是携带者 (5.3%) 和感染康复者 (37.7%) 之间唯一重要的围产期因素 (p=0.007)。

结论：在这项研究中，即使在接种 HBIG 和 HB 疫苗后，台湾高危儿童的 HBV 感染率和 HBsAg 携带率仍为 43.9% 和 10.7%。剖宫产可以保护新生儿免于成为 HBsAg 携带者，而 HBV 基因型和 HBIG 注射时间对 HBV 携带率没有贡献。

关键词：乙肝抗体；乙型肝炎e抗原；大规模接种。

版权所有 © 2021 长庚大学。由 Elsevier B.V. 出版。保留所有权利。

StephenW

Outcomes of Hepatitis B Immunoglobulin and Hepatitis B Vaccination in High-Risk Newborns Born to HBeAg-positive Mothers
Chen-Hsuan Wu  1 , Wei-Cheng Huang  2 , Chien-Hung Chen  3 , Sheng-Nan Lu  4
Affiliations
Affiliations

    1
    Graduate Institute of Clinical Medical Sciences, Chang Gung University, College of Medicine, Kaohsiung, Taiwan; Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
    2
    Department of Geriatrics, Chang Gung Memorial Hospital Chiayi Branch, Chiayi, Taiwan.
    3
    Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
    4
    Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. Electronic address: [email protected].

    PMID: 34801765 DOI: 10.1016/j.bj.2021.11.007

Abstract

Background: To evaluate the protective efficacy of a hepatitis B (HB) vaccination program in Taiwan among high-risk children.

Material and methods: Children born to HBeAg-positive mothers from 2001 to 2010 were invited back. Blood samples for hepatitis B virus (HBV) seromarkers were taken and the children underwent hepatobiliary ultrasonography. Perinatal factors including delivery mode and vaccination history were collected from their medical records. According to the results of HBV serological markers, the children were initially classified into five groups: HBV naïve, HB vaccine responder, HBsAg carrier, recovered from HBV infection, and anti-HBc-positive alone. Children in the HBV naïve and anti-HBc-positive alone groups who presented with an anamnestic response after a booster HB vaccine were re-assigned to the vaccine responder and recovered from infection groups, respectively.

Results: All of the 196 enrolled children received postnatal hepatitis B immunoglobulin (HBIG) and HB vaccinations, of whom one was HBV naïve (0.5%), 109 were vaccine responders (55.6%), 21 were carriers (10.7%), and 65 recovered from infection (33.2%). Among the 21 carriers, 14 (66.7%) presented in the immunotolerant phase. Cesarean section was the only significant perinatal factor between the carriers (5.3%) and those who recovered from infection (37.7%) (p=0.007).

Conclusions: In this study, there was a 43.9% HBV infection rate and 10.7% HBsAg carrier rate in high-risk Taiwanese children even after receiving HBIG and HB vaccinations. Cesarean section may protect newborns from becoming HBsAg carriers, while HBV genotype and time of HBIG injection did not contribute to the HBV carrier rate.

Keywords: Hepatitis B Antibodies; Hepatitis B e Antigens; Mass Vaccination.

Copyright © 2021 Chang Gung University. Published by Elsevier B.V. All rights reserved.

StephenW

https://www.sciencedirect.com/sc ... 21001670?via%3Dihub