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目的 探讨甲型肝炎 (甲肝 )减毒活疫苗接种后的病毒水平传播。方法 在昆明市安宁县 2个观察点筛选出丙氨酸转氨酶 (ALT)正常、甲肝病毒 (HAV)抗体 (抗 HAV)阴性的 4～ 7岁儿童 199人 ,按 1∶1 4比例分接种组 (82人 )和接触组 (117人 )进行H2株甲肝减毒活疫苗病毒的水平传播观察 ;另外 ,取接种者和接触者HAV检测阳性的粪便悬液上清 ,分别静脉接种于 8只普通狨猴 (Callithrixjacchus)体内 ,观察粪便HAV毒力水平。结果 接种组接种后 6周抗体阳转率为 97 6 % (80 /82 ) ,接触组 9周时抗体阳转率为 13 7% (16 /117) ,两组儿童肝功能均未见异常 ;接种组和接触组的粪便HAV检出率分别为 89 5 % (34/38)和 70 7% (5 3/75 ) ;以 2株接种者粪便HAV和 2株接触者粪便HAV感染的8只狨猴 ,均未检出血清酶升高和肝脏组织病理学改变 ,抗 HAV阳转时间延迟且效价低。结论 H2株甲肝减毒活疫苗安全性及免疫原性良好 ,疫苗病毒在人体内增殖活跃 ,且保持减毒性能稳定 ,能在人群中造成水平传播 ,但不会引发甲肝。
Objective To investigate the level of virus transmission after live attenuated hepatitis A (Hepatitis A) vaccination. Methods A total of 199 children aged 4 to 7 years old with normal alanine aminotransferase (ALT) and negative HAV antibody (anti-HAV) were screened at 2 observation points in Anning County, Kunming. (N = 82) and exposure group (n = 117). The supernatant of the HAV positive stool suspension was inoculated intravenously in 8 normal Tail monkey (Callithrixjacchus) in vivo, observe the level of fecal HAV virulence. Results The antibody positive rate was 97 6% (80/82) in the vaccinated group 6 weeks after inoculation, and 13 7% (16/117) in the contact group 9 weeks after vaccination. There was no abnormal liver function in the vaccinated group. The detection rates of stool HAV in the vaccinated group and the exposed group were 89 5% (34/38) and 70 7% (5 3/75), respectively. Eight infected with two vaccinated stool HAVs and two contagious stool HAVs Tail monkey, were not detected elevated serum enzymes and liver histopathology, anti-HAV Yang delayed transfer time and low titer. Conclusions The live attenuated live attenuated hepatitis A virus vaccine is safe and immunogenic. Vaccine virus is active in human body and maintains stable attenuating activity. It can cause horizontal transmission in the human population but does not cause hepatitis A virus.