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目的 掌握我国新生儿单纯接种乙型肝炎血源疫苗后的免疫持久性和远期预防效果 ;观察新生儿免疫较长时间后是否需加强免疫。方法 在湖南湘潭市等 4个乙型肝炎疫苗试点区内 ,对 1 986～ 1 988年出生并接种乙型肝炎血源疫苗的新生儿 ,连续 1 4～ 1 5年按免疫儿年龄分层随机抽样采血随访 ,累计随访 2 1 680人次 ,观察免疫儿HBsAg、抗 HBs和抗 HBc的动态变化。结果 新生儿单纯乙型肝炎血源疫苗全程基础免疫后 ,在 1 5年随访中没有加强免疫 ,各试点区免疫儿童HBsAg携带率低于 1 66 % ,携带率没有随免疫后年限的延长而增加 ;阻断HBV慢性感染的效果持续在 90 %左右(95 %可信限为 :83 1 %～ 97 2 % ) ;免疫后不同年限间HBsAg携带率、HBV感染率和保护效果差异均无显著性 (P >0 0 5)。免疫儿抗 HBs阳性率随免疫后年限延长而逐年明显下降 ,至第 9～ 1 0年下降为 40 %～ 50 % ,之后数年内下降幅度不大 ,至免疫后 1 3～ 1 4年抗 HBs阳性率维持在 30 %～ 42 % ;抗 HBs滴度下降了 90 %。结论 新生儿单纯乙型肝炎疫苗接种后抗 HBs阳性率与滴度的下降不影响其远期预防效果 ;就群体而言 ,新生儿及时完成全程免疫后 ,无需加强免疫可有效阻断HBV感染后成为HBsAg慢性携带者 ,而很有可能终生受益
Objective To understand the immune persistence and long-term preventive effects of neonatal hepatitis B virus vaccine alone in our country and to observe whether immunization should be strengthened after a long time of immunization. Methods In the pilot area of 4 hepatitis B vaccines in Xiangtan City of Hunan Province, newborns born from 1988 to 1988 and vaccinated with Hepatitis B vaccine were randomly divided into four groups according to the age of immunized children for 14 to 15 years Blood samples were followed up for a total of 21 680 visits to observe the dynamic changes of HBsAg, anti-HBs and anti-HBc in immunized children. Results There was no booster immunization after 15 days of follow-up of neonatal Hepatitis B vaccine alone. The carrier rate of HBsAg in immunized children in each experimental area was less than 166%. The carrier rate did not increase with the prolongation of immunization ; The effect of blocking chronic HBV infection persisted at about 90% (95% confidence interval: 83 1% -97 2%). There were no significant differences in the carrier rates of HBsAg, HBV infection and protection between different years after immunization (P> 0 0 5). The positive rate of anti-HBs in immunized children decreased year by year with the prolongation of immunization, and decreased from 40% to 50% from the 9th to the 10th year. However, the decreasing rate within a few years afterwards was not significant until anti-HBs The positive rate maintained at 30% ~ 42%; anti-HBs titer decreased by 90%. Conclusion Neonatal hepatitis B vaccination with anti-HBs positive rate and titer decline does not affect its long-term preventive effect; in groups, the newborn complete immunization in a timely manner, without strengthening the immune can effectively block the HBV infection Being a chronic carrier of HBsAg is likely to benefit for the rest of your life