阿拉斯加原著民接受HBV疫苗者获得保护达15年（2005.3.18）

zasxz

In Alaskan Natives, Hepatitis B Vaccination Strongly Protected Against Infection for at Least 15 Years

The duration of protection afforded by hepatitis B vaccination is unknown. The objective of the present study was to determine antibody persistence and protection from hepatitis B virus (HBV) infection.

This was a prospective cohort study conducted in 15 villages in southwest Alaska. The study participants were 1578 Alaska natives vaccinated at age 6 months or older.

During 1981?982, participants received 3 doses of plasma-derived hepatitis B vaccine. This cohort was followed annually over the first 11 years, and 841 (53%) persons were tested at 15 years. The measurements were antibody to hepatitis B surface antigen (anti-HBs), markers of HBV infection, and testing to identify HBV variants.

Findings

Levels of anti-HBs in the cohort decreased from a geometric mean concentration of 822 mIU/mL after vaccination to 27 mIU/mL at 15 years.

Initial anti-HBs level, older age at vaccination, and male sex were associated with persistence of higher anti-HBs levels at 15 years when analyzed by a longitudinal linear mixed model.

After adjustment for initial anti-HBs level and sex, those vaccinated at age 6 months to 4 years had the lowest anti-HBs level at 15 years.

Asymptomatic breakthrough infections were detected in 16 participants and occurred more frequently in persons who did not respond to vaccination than those who responded (P = 0.01).

Among infected persons with viremia, 2 were infected with wild-type HBV and 4 had HBV surface glycoprotein variants, generally accompanied by wild-type HBV.

Limitations of the study

The loss of participants to follow-up at 15 years was 47%. However, characteristics of persons tested were similar to those of persons lost to follow-up.

In conclusion the authors write, 揌epatitis B vaccination strongly protected against infection for at least 15 years in all age groups. Antibody levels decreased the most among persons immunized at 4 years of age or younger.

03/18/05

Reference B J McMahon and others. Hepatitis B vaccination strongly protected against infection for at least 15 years in all age groups. Annals of Internal Medicine 142: 333-341. March 2005.

梅山鹤

在医学论坛上看到！