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目的评价不同剂量(10μg×3和5μg×3)重组乙型肝炎(乙肝)疫苗(HepB)(酵母)主动免疫阻断乙肝病毒(HBV)母婴传播的效果。方法在北京市、甘肃省、浙江省宁波市选择1997～2005年孕期或住院分娩时检测乙肝病毒表面抗原(HBsAg)阳性的母亲及其儿童,采用问卷调查和血清学检测(固相放射免疫法)方法,比较不同剂量(10μg×3和5μg×3)重组HepB(酵母)主动免疫阻断HBV母婴传播的效果。结果接种10μg×3重组HepB(酵母)儿童HBsAg阳性率为2.30%,疫苗保护率为97.29%。其中母亲HBsAg和乙肝病毒e抗原(HBeAg)双阳性的儿童HBsAg阳性率为4.44%,疫苗保护率为94.77%;母亲HBsAg单阳性的儿童HBsAg阳性率为1.17%,疫苗保护率为98.62%。接种5μg×3重组HepB(酵母)儿童HBsAg阳性率为17.50%,疫苗保护率为79.41%。其中母亲HBsAg和HBeAg双阳性的儿童HBsAg阳性率为37.70%,疫苗保护率为55.65%;母亲HBsAg单阳性的儿童HBsAg阳性率为12.74%,疫苗保护率为85.01%。结论接种10μg×3重组HepB(酵母)阻断HBV母婴传播的效果优于5μg×3重组HepB(酵母)。对于母亲HBsAg阳性儿童,特别是母亲HBsAg和HBeAg双阳性的儿童,主动免疫时采用10μg×3的重组HepB(酵母)为宜。
Objective To evaluate the effect of different doses (10μg × 3 and 5μg × 3) recombinant hepatitis B (HepB) (yeast) active immunization against hepatitis B virus (HBV) mother to child transmission. Methods The mothers and their children who tested positive for hepatitis B virus surface antigen (HBsAg) during pregnancy during pregnancy in 1997-2005 or in hospital were selected in Beijing, Gansu and Ningbo, Zhejiang Provinces by questionnaires and serological tests (solid phase radioimmunoassay ) Methods were used to compare the effects of different doses (10μg × 3 and 5μg × 3) of recombinant HepB (yeast) active immunization blocking HBV mother-to-infant transmission. Results The positive rate of HBsAg in vaccinated 10μg × 3 recombinant HepB (yeast) children was 2.30%, and the vaccine protection rate was 97.29%. The positive rate of HBsAg in children with positive HBsAg and HBeAg was 4.44%, and the vaccine protection rate was 94.77%. The positive rate of HBsAg in children with single HBsAg was 1.17% and the vaccination rate was 98.62%. The positive rate of HBsAg in vaccinated 5μg × 3 recombinant HepB (yeast) children was 17.50%, and the vaccine protection rate was 79.41%. Among them, the positive rate of HBsAg in mother with HBsAg and HBeAg positive children was 37.70% and the vaccine protection rate was 55.65%. The positive rate of HBsAg in mother with HBsAg positive children was 12.74% and vaccine protection rate was 85.01%. Conclusion Inoculation of 10μg × 3 recombinant HepB (yeast) is superior to 5μg × 3 recombinant HepB (yeast). For mothers with HBsAg-positive children, especially mothers with HBsAg and HBeAg-positive children, 10 μg × 3 recombinant HepB (yeast) is recommended for active immunization.