广东省乙型肝炎病毒表面抗原携带者配偶感染乙型肝炎危险性研究

目的探讨广东省乙型肝炎（乙肝）病毒（HBV）表面抗原（HBsAg）携带者配偶感染HBV的危险性,为成人乙肝防控工作策略提供参考依据。方法采用病例对照方法,选择广东省2006年乙肝血清流行病学调查发现的20。45岁HBsAg携带者及配偶作为病例组,按居住地、性别、年龄及婚龄等因素配比选择当年HBsAg阴性者及配偶为对照组。进行问卷调查和乙肝血清学指标检测。利用PCR方法分析夫妻双方均HBsAg阳性的HBV基因型。结果病例组配偶HBsAg阳性率13．71％,对照组配偶HBsAg阳性率8．06％。结婚5年以上者HBsAg携带者配偶抗一HBc阳性率高于结婚5年以下者,差异有统计学意义（x。=4．88,P〈0．05）,其中女性HBsAg携带者配偶抗一HBc阳性率更为显著（xz=6．39,P〈O．05）。性生活不使用安全套的夫妻配偶HBsAg阳性率（15．56％）高于性生活使用安全套的配偶（8．82％）。16对HBsAg均阳性的夫妻中,8对PCR扩增HBV阳性,7对（87．50％）HBV基因型相同;其中5对HBV为B型,2对为C型,仅1对夫妻HBV基因型不同。结论HBsAg携带者配偶感染HBV风险比普通人群增高;在今后的成人乙肝防控工作中,需要加强对HBsAg携带者配偶HBV感染的监测及乙肝疫苗的接种,同时需要加强宣教,提倡安全性行为。     

西湖区8—15岁学生乙肝表面抗原、表面抗体检测结果分析

目的了解南昌市西湖区8～15岁学生中乙型肝炎表面抗原（HBsAg）携带及保护性抗体HBsAb（抗-HBs）产生情况。探讨预防乙肝的对策与措施。方法通过门诊采样,检测我区城乡8-15岁学生中乙肝血清标志物HBsAg、抗-HBs。结果HBsAg阳性率1．55％,性别、城乡不存在差异（P〉0．05）;抗-HBs阳性率21．5％,性别与城乡均不存在差异（P〉0．05）;于计划免疫程序外补种过至少一次乙肝疫苗与从未补种的抗-HBs阳性率存在显著差异（P〈0．01）。结论乙肝疫苗接种率的提高使乙型肝炎表面抗原携带率HBV明显减少,有必要对适龄对象进行补种。     

乙肝免疫球蛋白与乙肝疫苗联合免疫对新生儿预后的影响

目的探讨乙肝免疫球蛋白（HBIG）与乙肝疫苗联合免疫对HbsAg、HbeAg单阳性及双阳性孕妇所生新生儿预后的影响。方法试验组孕妇自怀孕28w起每4w注射HBIG 200IU,新生儿出生8h内、15天各注射HBIG 200IU,同时按0、1、6月顺序接种乙肝疫苗（每次剂量5μg）。对照组新生儿仅按0、1、6月顺序接种乙肝疫苗。观察两组中新生儿HBV感染情况。结果HBV病毒携带者中,HbeAg阴性的试验组与对照组新生儿HBV感染差异无显著性;HbeAg阳性的试验组与对照组新生儿HBV感染差异有显著性。结论应用乙肝免疫球蛋白与乙肝疫苗联合免疫能有效阻断HBV母婴传播的产前和产后感染,并降低宫内感染率,对新生儿预后较好。     

北京市朝阳区居民乙肝知信行调查分析

目的 了解北京重大传染病防控示范区即北京市朝阳区居民乙型肝炎的相关知识、态度、行为等情况,为制定有效干预措施和评估干预实施效果提供依据.方法 根据朝阳区的地区特点进行分层分阶段整群随机抽样,采用自编调查表对抽取对象进行调查.结果 乙肝三大传播途径(血液传播、母婴传播、性传播)知识正确知晓率分别为:69.7％、53％、42.3％,乙肝预防措施乙肝疫苗、安全套的知晓率分别为71.3％、26.6％,且不同特征人群认知情况存在差异；49.5％调查对象介意与乙肝感染者一起生活工作,仅26.3％的调查者接种过乙肝疫苗.结论 朝阳区居民乙肝正确防护知识与行为有待加强与提高:需分层次、有重点的针对不同需求实施健康教育,提高乙肝疫苗接种率,提高居民乙肝知识正确认知、转变态度,从而改善相关行为.     

广州某高等医学院校研究生乙肝疫苗接种情况调查

目的了解广州某高等医学院校研究生乙肝疫苗接种情况，为乙肝防治工作提供依据。方法对广州某高等医学院校2006年入学的1139名研究生进行入学体检现况调查，采集血标本用ELISA法检测乙型肝炎表面抗原（HBsAg）和表面抗体（HBsAb）。同时发放乙肝疫苗接种情况调查表，调查乙肝疫苗接种的年代、次数，是否加强接种及时间。用SAS统计软件包对结果进行X^2检验分析。结果广州某高等医学院校06级研究生HBsAg阳性率为2．90％，曾注射乙肝疫苗组，HBsAg阳性率显著低于从未注射疫苗组（1．15％ vs． 21．69％，P〈0．0001），而HBsAb阳性率则显著高于从未注射疫苗组（81．54％ vs．44．58％，P〈0．0001）。有17．31％曾接种乙肝疫苗者未能达到预期预防效果。不同年龄研究生乙肝疫苗接种效果有差异（P=0．0462），随着年龄的增加，HBsAb阳性率有下降趋势。女性乙肝疫苗接种效果较男性好（80．0％ vs．84．87％，P=0．0468）。接种年限在3年内者，HBsAb阳性率较其他年限高（0—3年 vs．4—6年，P=0．0089；0—3年 vs．7—9年，P=0．0172；0—3年 vs．〉9年，P=0，0474）。注射大于3针（即加强接种）免疫效果较注射3针者好，差异有统计学意义（P=0．0093）。结论随着年龄的增加，乙肝疫苗接种效果（HBsAb阳性率）逐渐降低。男性群体较女性群体更易成为乙型肝炎病毒的易感人群。对接种年限大于3年者，可进行抗-HBs监测，及时进行加强免疫。     

HBIG联合乙肝疫苗对单个核细胞感染HBV婴儿垂直传播的阻断

目的研究高效价乙肝免疫球蛋白（HBIG）联合乙肝疫苗对单个核细胞（PBMC）感染乙型肝炎病毒（HBV）的新生儿母婴垂直传播的阻断效果。方法选择HBV257例感染产妇，检测新生儿脐血血清和脐血单个核细胞（UBMC）中的HBV—DNA；所有新生儿出生24h内和生后2w分别注射HBIG 200IU，1月时按0、1、6方案注射乙肝疫苗。并在1岁时检测血清HBsAb和HBV—DNA。结果正规注射HBIG和乙肝疫苗后，UBMC中HBVDNA阳性的婴儿1岁时HBsAb阳转率明显低于血清HBV—DNA阳性、UBMC阴性者（50．00％vs．77．78％，P〈0．05）。而且，UBMC阳性组有15．79％的婴儿1岁时血清HBVDNA阳性。结论HBIG联和乙肝疫苗能够阻断PBMC感染HBV新生儿HBV的垂直传播，但存在部分病例的阻断失败。     

阻断乙型肝炎病毒父婴传播的研究

目的探讨阻断乙型肝炎（乙肝）病毒父婴垂直传播的有效方法。方法将在北京市海淀区妇幼保健院乙肝母婴阻断门诊就诊的配偶为HBV携带者的孕妇共例61例作为观察对象,22例配偶为乙肝表面抗原和乙肝e抗原双阳性及乙肝病毒脱氧核糖核酸阳性。其中28例孕妇也为乙肝病毒携带者,仅1例孕妇为HBsAg和HBeAg双阳性。对33例本人未检出HBV抗原的孕妇检测乙肝表面抗体定量,对定量较低或阴性的孕妇在孕前或孕期接种国产（基因重组酵母）乙肝疫苗10μg,根据定量接种1—2次。对孕妇也为HBV携带者和孕妇在孕末期前检验血中尚未达到高滴定度保护性抗体乙肝表面抗体者,在孕末期28、32、36w各肌肉注射乙肝免疫球蛋白400IU。观察新生儿生后12h内静脉血乙肝表面抗原和乙肝e抗原及乙肝表面抗体定性,采用酶联免疫法定性测定。结果所有观察新生儿61例生后12h内静脉血乙肝表面抗原和乙肝e抗原均为阴性,以后3、6、12个月复查乙肝表面抗原和乙肝e抗原未发现阳转者。33例母亲未检出HBV的新生儿生后12h内静脉血乙肝保护性抗体乙肝表面抗体均为阳性,28例母亲也为乙肝病毒携带者的新生儿乙肝表面抗体均为阴性。结论对配偶为乙肝病毒携带者的孕妇在孕前或孕期接种乙肝疫苗;对孕妇也为HBV携带者或孕妇在孕末期前检验血中尚未达到高滴定度保护性抗体乙肝表面抗体者,在孕末期肌肉注射较大剂量乙肝免疫球蛋白的措施可基本阻断乙肝病毒父婴垂直传播。     

儿童乙型肝炎病毒感染状况临床分析

目的了解深圳市盐田区4—10岁儿童乙型肝炎病毒（HBV）感染状况及影响因素，为减少乙肝患病率提供帮助。方法所有儿童均抽空腹静脉血3ml采用酶联免疫吸附实验（ELISA法）检测HBsAg，抗-HBs，HBeAg，抗-HBe，抗-HBc谷丙转氨酶（CPT）及谷草转氨酶（ALT）。结果3455名儿童HBsAg阳性率为3．82％，HBsAg阳性儿童中，以HBsAg（＋），HBeAg（＋），抗-HBc（＋）伴GPT，ALT正常者所占比例最高，为76％。不同性别之间HBsAg阳性率比较无显著差异（P〉0．05）。6岁以下儿童HBsAg阳性率较低，6—10岁组阳性率明显升高。全程接种乙肝疫苗儿童的HBsAg阳性率明显低于未接种组，结果有显著性差异（P〈0．01）。父亲或母亲是HBsAg阳性者所占比例明显高于家庭成员中无HBsAg阳性者（132例中占105例，占79.3％）。结论儿童乙型肝炎病毒感染率较低，且年龄组越小其感染率越低，因乙肝疫苗全程免疫后抗体持续时间长，建议对儿童进行全面预防接种策略，进-步减少乙肝患病率。     

中山市健康人群乙肝血清学监测情况分析

目的 了解乙肝疫苗接种效果情况，进而探讨如何更好地实行免费接种乙肝疫苗，确保接种质量。方法 随机抽取152名新生儿和1岁以上健康人群2495名，应用酶联免疫法对其血清进行HBsAg和anti．HBsAg检测。结果 152名新生儿，抗-HBs阳性141人，阳性率为92．7％。HBsAg阳性0人。2495名1岁以上健康人群，抗-HBs阳性1199人，阳性率为48．1％，HBsAg阳性259人，阳性率为10．4％。1～18岁844人，HBsAg阳性10人，阳性率为1．2％。18岁以上1651人，HBsAg阳性249人，阳性率为15．1％。结论 对新生儿及时进行乙肝疫苗全程免疫，能提高新生儿对乙肝的免疫力，预防乙肝。接种乙肝疫苗、提高接种质量能提高易感人群对乙肝的免疫力。降低人群乙肝感染率。1岁以上健康人群抗-HBs阳性率偏低，存在感染乙型肝炎病毒的危险。     

秦皇岛市5739名孕产妇乙肝五项定量检测结果分析

目的 讨论2013年本院建卡孕产妇的乙肝流行情况,以及各个年龄组乙肝表面抗体的含量,及时接种乙肝疫苗,为孕产妇的乙肝防护提供数据支持.方法 采集孕产妇空腹静脉血,采用荧光免疫分析法（TRFIA）进行乙肝五项定量检测.结果 乙肝表面抗体的阳性率为51.93％,高免疫应答阳性率平均为30.49％,低免疫应答阳性率平均为21.43％.结论 在孕妇中存在着一定比例的HBV感染者和易感者,进行乙肝定量检测能够更好地反应机体乙肝感染动态免疫情况,预防HBV感染,阻断母婴传播,对优生优育、提高人口素质有重要意义.     

Seroprevalence of Hepatitis-B infection amongst Taiwanese university students 18 years following the commencement of a national Hepatitis-B vaccination program

In Taiwan, the nation-wide Hepatitis-B virus (HB) vaccination program was first launched in July 1984 and was directed to those infants born to hepatitis B surface antigen (HBsAg) carrier mothers in Taiwan. From July 1986 onwards, all infants born in Taiwan were immunized against HB. This study examined the HB-infection status amongst students at a Taiwanese university 18 years subsequent to the implementation of universal HB vaccination. A total of 1,969 new university entrants in 2005 were grouped into 1 of 3 distinct birth cohorts according to their HB-vaccination schedule (cohort-1 students born prior to July 1, 1984; cohort-3 students born subsequent to June 30, 1986) and were examined for their serum HBsAg, antibody to hepatitis B surface antigen (anti-HBs), and antibody to hepatitis B core antigen (anti-HBc) status. Immunity arising from vaccination was defined as an anti-HBs level 10 mIU/ml. We observed a trend toward a decreasing anti-HBc-positive rate and a decreasing HBsAg carrier rate from, respectively, 26.5 and 8.7% for cohort-1 to 4.7 and 1.7% for cohort-3 students. The prevalence of students featuring seronegativity for all three HB markers increased from 12.3% for cohort-1 to 48.8% for cohort-3 individuals. Amongst the 1,695 subjects revealing seronegativity for HBsAg and anti-HBc, their anti-HBs level was analyzed according to their birth year. The prevalence of students featuring a non-protective anti-HBs level increased from 11.9% for birth-year 1984 individuals to 48.2% for birth-year 1987 students. The introduction of HB vaccine has effectively reduced the transmission of HBV infection in Taiwan, 18 years subsequent to the commencement of the universal HB-vaccination program. A "waning-off" effect of anti-HBs seropositivity acquired from the HB vaccination program has also been observed.     

国产乙型肝炎血源疫苗免疫持久性观察

对１０６９名儿童乙型肝炎血源疫苗免疫后抗乙型肝炎病毒表面抗原的抗体水平进行检测，结果表明，抗－ＨＢｓ阳转率为９４．３％；初免后５年抗－ＨＢｓ阳转率仍可保持为９２．３％不同初免年龄免疫后抗－ＨＢｓ阳转率和持续时间未见明显差异。提示：为减少我国乙型肝炎发病率和乙型肝炎病毒携带者，用乙肝疫苗免疫接种是防止ＨＢＶ传播最有效的措施，经过正确接种疫苗后的９５％的接种者可具有免疫力；新生儿和婴幼儿接种乙型肝炎疫     

Hepatitis B vaccination of immunosuppressed heart transplant recipients with the vaccine Hepa Gene 3 containing pre-S1, pre-S2, and S gene products

The antibody response of immunosuppressed heart transplant recipients to vaccination with the hepatitis B (HB) virus vaccine Hepa Gene 3 (HG-3), containing HB virus pre-S1, pre-S2, and S gene products, was examined. Three heart transplant recipients who had been vaccinated preoperatively against HB responded well to the vaccination. Five of 38 patients (13.2%) vaccinated postoperatively before HG-3 vaccination with the second-generation vaccine Gen-H-B-Vax-D (37 without and 1 with detectable anti-HBs response) and 3 of 24 (12.5%) without previous HB vaccination developed protective anti-HBs titers (greater than 10 U/1) after immunization with the HG-3 vaccine. The l low response rate (8/62, 12.9%) found for postoperatively vaccinated patients indicates that heart transplant recipients should be vaccinated against HB before immunosuppressive medication.Abbreviations HB hepatitis B - HG-3 Hepa gene 3     

HLA-DRB1*07,13等位基因对乙肝疫苗免疫效果影响的研究

目的:探讨机体HLA-DRB1*07,13等位基因对基因重组乙肝疫苗免疫效果的影响.方法:选取完成基因重组乙肝疫苗全程接种(10 μg/次,0、1、6月)的广西籍汉族健康大学生896名,于末次接种疫苗后的第6个月采血检测血清抗-HBs水平,对无或低应答者再次接种基因重组乙肝疫苗20 μg,4周后筛选出无或低应答者99名及初次检测中或强应答者136名作为研究对象,应用PCR-SSP技术对研究对象外周血HLA-DRB1*07,13等位基因进行检测.结果:HLA-DRB107在无或低应答组中的表达频率为16.16%,显著高于中或强应答组的表达频率(4.41%)(P＜0.05);HLA-DRB1*13在无或低应答组和中或强应答组的表达频率分别为1.01%和3.68%,两组比较无统计学差异(P＞0.05).结论:基因重组乙肝疫苗无或低应答与HLA-DRB1*07基因密切相关;而HLA-DRB1*13对乙肝疫苗的免疫应答无明显影响.     

Successful postexposure vaccination against hepatitis B in chimpanzees

To study the effect of postexposure vaccination, four chimpanzees were vaccinated with hepatitis B (HB) vaccine 4, 8, 48, and 72 hr, respectively, after intravenous injection of an infectious hepatitis B virus (HBV) inoculum. The second and third vaccine inoculations were given 2 and 6 weeks later, i.e., at considerably shorter intervals than recommended either for ordinary prophylactic vaccination or for postexposure vaccination in combination with hepatitis B immune globulin (HBIG). The chimpanzees were followed for 1 year. None showed HBs-antigenemia, liver enzyme elevation (ALT), or histopathological alterations in liver biopsies. Late appearance of anti-HBc was observed only in the serum of the animal whose series of vaccination started 72 hr after HBV inoculation. An unvaccinated control chimpanzee, which received the HBV inoculum only, developed clinical hepatitis B with ALT-elevations and HBs-antigenemia within 2 months of the experimental HBV inoculation. These results indicate that postexposure vaccination against hepatitis B begun within 48 hr after HBV exposure, with short intervals between the vaccine injections, can protect against hepatitis B infection also when concomitant HBIG-prophylaxis is not given.     

MiR-18a and miR-17 are positively correlated with circulating PD-1<Superscript>+</Superscript>ICOS<Superscript>+</Superscript> follicular helper T cells after hepatitis B vaccination in a chinese population

Background

While vaccination remains the most effective method to control hepatitis B virus (HBV) infection, 5–10% of recipients exhibit non-responsiveness to the HB vaccine. Immunological analysis of strong, weak or absent protective antibody responses to the HB vaccine should provide insights into the mechanisms that contribute to non-responsiveness.

Results

We investigated the potential involvement of follicular helper T (Tfh) cells in the immune response to HB vaccine, and associations between the miR-17–92 cluster and Tfh cells. We recruited 12 adults who had completed the HB vaccination course during childhood. Following a booster dose of HB vaccine, hepatitis B surface antibody (HBsAb) titers, percentage of PD-1+ICOS+ circulating Tfh (cTfh) and plasma cells, and expression of miR-17–92 were assessed at baseline (before immunization) and after vaccination on days 7 and 14. Notably, the HBsAb level gradually increased after HB vaccination while the proportion of PD-1+ICOS+ cTfh cells was significantly increased on day 7 relative to baseline, so as plasma cells. Expression of miR-18a and miR-17 within the miR-17–92 cluster and HBsAb titers in CD4+ T cells were positively correlated with the PD-1+ICOS+ cTfh cells proportions after HB vaccination.

Conclusions

The increase in HBsAb titers was positively associated with expression of all the components of the miR-17–92 cluster except miR-19a. Our findings indicate that the miR-17–92 cluster contributes to antibody production, and miR-18a and miR-17 are involved in Tfh cells differentiation after HB vaccination.

     

Active pre-exposure immunisation against hepatitis B virus: immunogenicity of hepatitis B vaccine in healthy Thai adults and children

The immunogenicity of plasma derived hepatitis B vaccine (Hevac B) was studied for active pre-exposure immunisation in 176 healthy volunteer adults and 162 randomised children who had no hepatitis B virus markers. All subjects received three injections of 5 micrograms of hepatitis B vaccine intramuscularly at one month intervals. Seroconversion at 2 months after the third dose of vaccine was 96.30 percent in the children and 92.00 percent in the adults with mean anti-HBs titres of 800 mlU/ml and 353 mlU/ml respectively. The difference of anti-HBs levels between these two groups was statistically significant (p less than 0.05). Female adults had exhibited higher immune response to HB vaccine than male adults but there was no seroconversion difference between boys and girls. There were no serious local or systemic side effects of hepatitis B vaccination. It was concluded that active immunisation with plasma derived hepatitis B vaccine in non-immune children and adults is highly effective without any serious side effects or complications. The prevention of horizontal transmission of hepatitis B virus should be done by vaccination in children since they have a much better immune response to hepatitis B vaccine than adults.     

Comparative evaluation of the immunogenicity of yeast-derived (recombinant) and plasma-derived hepatitis B vaccine in infants.

The immunogenicity of plasma-derived (HB Vax,MSD) and recombinant hepatitis B virus (Engerix B, SK&F) vaccines was evaluated in infants born to hepatitis B virus carrier mothers. The vaccination was carried out at 1 day, 1 month, and 6 months of age using 10 micrograms of the vaccine given intramuscularly. A total of 83/88 (94.3%) and 74/79 (93.6%) of the infants receiving the plasma-derived vaccine and yeast-derived vaccine showed antibody to hepatitis B surface antigen (anti-HBs). None of the maternal factors studied apart from the HBeAg positivity corellated with vaccine failure. The yeast-derived vaccine gives marginally lower antibody titre than the plasma-derived vaccine. The group-specific anti-"a" antibody was less than 10% of the total anti-HBsAg titre. It was observed that the vaccine alone without prior administration of hepatitis B immunoglobulin is effective in perinatal infection.     

Hepatitis B vaccination status in an at-risk adult population: long-term immunity but insufficient coverage

In France, hepatitis B (HB) vaccine has been offered to all infants since 1994, and was proposed to all children aged 11 years from 1994 to 1998. Nevertheless, HB vaccine hesitancy may result in low vaccination coverage in present-day at-risk adults. We aimed to determine HB vaccination coverage in adults attending a free testing center for sexually transmitted infections (STI). As part of routine care, three classes of data were anonymously collected from attendees over a 3-month period: results of HB serologic tests; date and number of past anti-hepatitis B virus (HBV) immunization(s) (if any) according to health records; and the risk of STI and blood-transmitted infections (BTI). The study included 735 participants (age 27.9?±?9.2; 59.9% men). According to available health records (341 participants), 56.6% had received at least three and 67.2% at least one vaccine injection(s); 57.7% had received their last injection between 1994 and 1998, reflecting the strong vaccine policy during these years. Serologic testing (in 705 participants) showed evidence of a past or active HBV infection for 33 participants; of the remaining patients, 55.3% had anti-HBs antibody titers ≥10 IU/L. This rate was not higher in participants considered at risk for STI/BTI. Of the participants who received their last vaccine injection more than 15 years previously, 90.5% had anti-HBs antibody concentrations ≥10 and 60.3% ≥100 IU/mL. HB vaccination coverage is low in this population. Most of the vaccinated participants were immunized between 1994 and 1998, suggesting a failure of catch-up immunization of adolescents and at-risk adults. Long-term seroprotection persisted among vaccinated participants.