学龄前儿童乙型肝炎疫苗无应答者HBV感染风险的前瞻性队列研究

黄荟森; 韦娜; 蓝梅丹; 岑祚洁; 蒙婞婞; 蒋金泰; 杨路; 谢志春

doi:10.16462/j.cnki.zhjbkz.2019.01.004

学龄前儿童乙型肝炎疫苗无应答者HBV感染风险的前瞻性队列研究

doi: 10.16462/j.cnki.zhjbkz.2019.01.004

1.
530021 南宁, 广西医科大学公共卫生学院流行病学教研室
2.
530031 南宁, 广西南宁市江南区疾病预防控制中心传染病防制科
3.
530031 南宁, 广西南宁市江南区亭子卫生院公共卫生科

基金项目:

国家自然科学基金 81460512

详细信息

通讯作者:
谢志春, E-mail: 357154887@qq.com

中图分类号: R181.23
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- 被引次数: 0
出版历程
- 收稿日期: 2018-07-28
- 修回日期: 2018-10-02
- 刊出日期: 2019-01-10

A prospective cohort study on the risk of HBV infection in preschool children without immune response to hepatitis B vaccine

1.
Department of Epidemiology, School of Public Health, Guangxi Medical University, Nanning 530021, China
2.
Department of Infectious Disease Control and Prevntion, Jiangnan District Center for Disease Prevention and Control, Nanning 530031, China
3.
Department of Public Health, Tingzi Health Center, Jiangnan District, Nanning 530031, China

Funds:

Natural Science Foundation of China 81460512

More Information

Corresponding author: XIE Zhi-chun, E-mail: 357154887@qq.com

摘要

摘要: 目的评估学龄前儿童乙肝疫苗无应答者未来感染乙肝病毒（hepatitis B virus，HBV）的风险。方法采用前瞻性队列研究的方法，选取南宁市江南区64家幼儿园内、已经按照0、1、6程序全程接种了三针乙肝疫苗的2~5岁儿童，在2015年3~5月期间抽血检测乙肝病毒表面抗原（hepatitis B surface antigen，HBsAg）和乙肝病毒表面抗体（hepatitis B surface antibody，抗-HBs），HBsAg阴性儿童为本次研究对象。根据儿童抗-HBs是否阳性，分成暴露组（抗-HBs阴性）和对照组（抗-HBs阳性）。研究开始于2015年6月1日，结束于2016年6月1日，在2016年6月1~30日对儿童进行随访检测血清HBsAg阳性率，比较两个组的HBsAg阳性率。结果纳入队列的无应答组人数1 907名，排除随访期间再次接种乙肝疫苗的83人，该队列人数实际为1 824，研究结束时失访151人，实际随访到的人数是1 673人，期间共有5名小孩HBsAg转成阳性，感染率为0.30%（5/1673）；纳入队列的应答组人数2 054名，研究结束时失访140人，随访到人数为1914，他们均未检测出HBsAg；研究结束时无应答组HBsAg阳性率高于应答组（P=0.023）。结论乙肝疫苗无应答者未来存在感染HBV的风险。
- 乙肝疫苗 /
- 免疫无应答者 /
- 前瞻性队列研究 /
- HBsAg阳性率
Abstract: Objective To evaluate the risk of hepatitis B virus(HBV) infection among preschool children who were the non-responders to hepatitis B vaccine in future. Methods A prospective cohort study was conducted. Children aged 2 to 5 years were selected from 64 kindergartens.These children were inoculated three doses of hepatitis b vaccine at 0, 1 and 6 months after birth. Hepatitis B surface antigen (HBsAg) and Hepatitis B surface antibody (anti-HBs) were detected during the period from March to May 2015. The children who were HBsAg negative were enrolled in the study. The subjects were divided into exposure group (anti-HBs negative) and control group (anti-HBs positive). The follow-up began on June 1, 2015 and ended on June 1, 2016. Serum HBsAg of children in the cohort was then collected and detected from June 1 to 30, 2016. At the end of the study, the HBsAg positive rates between two groups were compared. Results 83 children who received hepatitis B vaccine again during the follow-up period were excluded from 1 907 non-responders. The actual number in non-responders group was 1 824. 151 children were lost at the end of the study. The actual number of follow-up was 1 673 and 5 children were found to be positive for HBsAg and the infection rate was 0.30% (5/1673). In the respondent goup, 2 054 were enrolled and followed. Finally, 140 children were lost and none of the remaining 1 914 people were HBsAg positive at the end of the study. HBsAg positive rate was higher in the non-responder group than in the responder group (P=0.023). Conclusion There is a risk of HBV infection in the children who are non-responders to hepatitis B vaccine in future.
- Hepatitis B vaccine /
- Immune nonresponders /
- Prospective cohort study /
- HBsAg positive rate

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表 1 纳入队列儿童的一般情况

Table 1. General situation of children in the beginning of study

年龄(岁)	无应答组			应答组			纳入队列的总人数
年龄(岁)	男	女	合计	男	女	合计	纳入队列的总人数
2~	95	63	158	65	73	138	296
3~	346	264	610	289	251	540	1 150
4~	365	273	638	428	315	743	1 381
5~6	228	190	418	379	254	633	1 051
合计	1 034	790	1 824	1 161	893	2 054	3 878

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表 2 研究结束时队列儿童随访的一般情况

Table 2. General situation of children at the end of follow-up

年龄(岁)	无应答组			应答组			研究结束时总人数	纳入队列时总人数	失访人数
年龄(岁)	男	女	合计	男	女	合计	研究结束时总人数	纳入队列时总人数	失访人数
2~	85	58	143	49	62	111	254	296	42
3~	326	238	564	263	239	502	1 066	1 150	84
4~	345	253	598	417	297	714	1 312	1 381	69
5~6	204	164	368	359	228	587	955	1 051	96
合计	960	713	1 673	1 088	826	1 914	3 587	3 878	291

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