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目的:探讨乙肝疫苗接种不产生抗体的原因及处理措施。方法:对首次接种乙肝疫苗,但没有形成乙肝表面抗体(抗-HBs)患者,再次进行疫苗接种,并在第7个月检测乙肝表面抗体,对仍然没有形成乙肝表面抗体患者,检测其乙肝5项、乙肝病毒核酸(HBV-DNA),以及谷丙转氨酶(ALT)水平。结果:30例患者2次接种乙肝疫苗,其中15例抗-HBs阳性、5例抗-HBs(±)、6例乙肝病毒核心抗体(HBcAb)阳性、4例乙肝病毒E抗体(HBeAb)阳性、HBcAb阳性。并且阳性结果与HBV-DNA阳性、ALT升高一致。结论:乙肝疫苗接种后不形成乙肝表面抗体可能与免疫应答迟缓、HBV的隐匿性感染、免疫耐受有关。
Objective: To investigate the reasons why hepatitis B vaccination does not produce antibodies and its treatment measures. Methods: The patients who were given hepatitis B vaccine for the first time but did not form hepatitis B surface antibody (anti-HBs) were vaccinated again and the HBsAg was detected at the 7th month. For patients who still did not have HBsAg, hepatitis B , Hepatitis B virus nucleic acid (HBV-DNA), and alanine aminotransferase (ALT) levels. Results: Thirty patients were vaccinated twice with HB vaccine, 15 were positive for anti-HBs, 5 were anti-HBs, 6 were positive for HBcAb and 4 were positive for HBeAb, HBcAb positive. And positive results and HBV-DNA positive, ALT increased consistent. Conclusion: Hepatitis B surface antibody could not be formed after hepatitis B vaccination, which may be related to delayed immune response, occult HBV infection and immune tolerance.