1岁儿童标准免疫接种后乙肝免疫情况的纵向监测及疫苗接种策略的优化

E. O. Kochetova, V. F. Balikin, O. Shamsheva, I. V. Polesco, V. F. Uchaykin, V. Konev, O. A. Mayorova, V. Belyakova, V. V. Gorev, L. B. Kononov
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摘要

对62例10 ~ 17岁儿童(0 ~ 1 ~ 6个月)严格按照国家预防接种日历标准剂量(10微克重组HBsAg)接种单组分乙肝疫苗,按标准方案(0 ~ 1 ~ 6个月)接种一岁乙肝疫苗进行临床和实验室检查。大多数儿童(58%)有HBsAg -anti - hbs抗体血清转化指标。这表明,根据标准方案,以标准剂量及时接种3倍乙肝疫苗(在出生后第一年接种10微克重组乙肝表面抗原,在随后的年龄阶段没有伍斯特免疫(重新接种)),包括有负担的发病前背景的儿童(观察到的儿童中占87.1%)后,10 - 17年存在持久的Grund免疫。由于观察到的儿童中有接受侵入性医疗干预的儿童(50%),因此既定的事实反映了标准的地面免疫接种即使对有风险的儿童也有保护作用-有积极的肠外注射史。同时,血清学和分子生物学结果的总评估发现,在出生后第一年按照标准方案进行乙肝三联免疫接种后,62名10-17岁儿童中,血清阴性比例为42%。43%的病例检测到低水平抗体(10-100 IU/l), 15%的病例检测到高水平抗体(100-1000 IU/l)。没有儿童抗体水平超过1000 IU/l。这些结果要求开发新的方法对儿童进行乙型肝炎免疫接种,并在年龄较大时强制重新接种。
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Longitudinal monitoring of post-vaccination immunity against hepatitis B in children after standard immunization in the first year of life and optimization of vaccination strategy
A clinical and laboratory examination of 62 children aged 10—17 years vaccinated against hepatitis B according to the standard scheme (0—1—6 months) in the first year of life strictly according to the National Calendar of preventive vaccinations in a standard dose (10 micrograms of recombinant HBsAg) with a monocomponent vaccine was carried out.The majority of children (58%) had indicators of seroconversion of HBsAg — anti-HBs-antibodies. This indicates the fact of long-lasting Grund immunity — 10—17 years after timely 3-fold immunization against hepatitis B according to the standard scheme at a standard dose (10 mcg of recombinant HBsAg in the first year of life in the absence of Wooster immunization (revaccination) in subsequent age periods, including children with a burdened premorbid background (87.1% among those observed). Since among those observed were children with invasive medical interventions (50%), the established fact reflects the protective effect of standard Grund immunization even in children at risk — with a positive parenteral history. At the same time, the total assessment of serological and molecular biological results found that after triple immunization against hepatitis B according to the standard scheme in the first year of life, out of 62 children aged 10—17 years, the proportion of seronegative was 42%. Low levels of antibodies (10—100 IU/l) were detected in 43% of cases, high (100—1000 IU/l) — in 15% of cases. No child had an antibody level exceeding >1000 IU/l. These results require the development of new approaches to immunization of children against hepatitis B with mandatory revaccination at an older age.
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