CAJ | 학술논문

目的：探讨单项乙型肝炎（乙肝）病毒核心抗体（抗-HBc）阳性成年人接种乙肝疫苗（HepB）的免疫效果。方法筛选出HBsAg、抗-HBs阴性及抗-HBc阳性，既往无HepB免疫史的18～49岁者组成抗-HBc单项阳性组（单阳组），并按1∶1匹配原则选择对照组。依照“0-1-6”免疫程序对单阳组和对照组接种HepB，对两组无应答者再次按该免疫程序接种HepB，比较两组人群抗-HBs阳转率及其滴度。结果两组人群共调查228对。对照组和单阳组初次免疫抗体阳转率分别为91.23%和91.67%，差异无统计学意义（χ2＝0.00，P＞0.05）。对照组无应答率、低应答率、正常应答率和高应答率分别为8.77%、11.84%、31.14%和48.25%，单阳组分别为8.33%、30.70%、35.96%和25.00%，对照组低应答率低于单阳组（χ2＝22.28，P＜0.01），高应答率高于单阳组（χ2＝24.43，P＜0.01）。初次免疫后对照组抗-HBs几何平均浓度（534.07 mIU/ml）高于单阳组（183.99 mIU/ml），差异有统计学意义（u＝4.42，P＜0.01）；再次免疫1针后，对照组应答率（82.35%）高于单阳组（41.18%）（P＜0.05），再免疫3针后两组应答率分别达到90.00%和82.35%（P＝1.00）。结论抗-HBc单阳者HepB初次免疫可获得较好的免疫应答，但低于一般人群；初次免疫无应答的抗-HBc单阳者3剂次再免疫可获得较高阳转率。
목적：탐토단항을형간염（을간）병독핵심항체（항-HBc）양성성년인접충을간역묘（HepB）적면역효과。방법사선출HBsAg、항-HBs음성급항-HBc양성，기왕무HepB면역사적18～49세자조성항-HBc단항양성조（단양조），병안1∶1필배원칙선택대조조。의조“0-1-6”면역정서대단양조화대조조접충HepB，대량조무응답자재차안해면역정서접충HepB，비교량조인군항-HBs양전솔급기적도。결과량조인군공조사228대。대조조화단양조초차면역항체양전솔분별위91.23%화91.67%，차이무통계학의의（χ2＝0.00，P＞0.05）。대조조무응답솔、저응답솔、정상응답솔화고응답솔분별위8.77%、11.84%、31.14%화48.25%，단양조분별위8.33%、30.70%、35.96%화25.00%，대조조저응답솔저우단양조（χ2＝22.28，P＜0.01），고응답솔고우단양조（χ2＝24.43，P＜0.01）。초차면역후대조조항-HBs궤하평균농도（534.07 mIU/ml）고우단양조（183.99 mIU/ml），차이유통계학의의（u＝4.42，P＜0.01）；재차면역1침후，대조조응답솔（82.35%）고우단양조（41.18%）（P＜0.05），재면역3침후량조응답솔분별체도90.00%화82.35%（P＝1.00）。결론항-HBc단양자HepB초차면역가획득교호적면역응답，단저우일반인군；초차면역무응답적항-HBc단양자3제차재면역가획득교고양전솔。
Objective To compare the antibody response between adults with hepatitis B virus(HBV)core antibody(anti-HBc)single positivity and healthy adults after primary immunization and revaccination of hepatitis B vaccine(HepB). Methods Adults aged from 18 to 49 who were both negative for HBV surface antigen(HBsAg)and antibody to HBsAg(anti-HBs),but positive for anti-HBc and narrated no history of HepB immunization by themselves,were selected as single anti-HBc positive group(‘anti-HBc alone’). Adults who were negative for HBsAg,anti-HBs and anti-HBc,with age differences within 2 years,and same gender under the 1 ∶ 1 matching program, were selected to form the control group. Both groups were vaccinated on 0-1-6 schedule with the same HepB. Those who were non-response to HepB at primary immunization were revaccination on 0-1-6 schedule. Response rates and geometric mean concentrations(GMC)between the two groups were compared. Results In total,the number of anticipants were 228 pairs. Rates on non-response, low-response,normal-response and high-response after the primary immunization were 8.77%, 11.84%,31.14%and 48.25%in the control group respectively. The corresponding rates were 8.33%, 30.70%,35.96%and 25.00%in the‘anti-HBc alone’. The rate of low-response in the control group was lower than that in the‘anti-HBc alone’(χ2=22.28,P<0.01),while the rate of high-response was higher than that in the control group(χ2=24.43,P<0.01). GMC of anti-HBs in the control group (534.07 mIU/ml) was higher than that in the‘anti-HBc alone’(183.99 mIU/ml)(u=4.42,P<0.01). The anti-HBs conversion rates were 82.35% and 41.18% in the control group and in the‘anti-HBc alone’respectively after the first-dose revaccination,but increased to 90.00%and 82.35%after the third-dose revaccination. The anti-HBs conversion rates in the control group were higher than that in the‘anti-HBc alone’ after the first-dose revaccination (P<0.05),while there was no difference seen between the two groups after the third-dose revaccination (P>0.05). Conclusion Immune response in the anti-HBc positive adults after primary immunization was weaker than that in common adults. However,immune response induced by HepB was enough to prevent them from infecting HBV. The rates of response showed an obvious increase after revaccination,hence the same HepB immunization strategy could be used.