The effect of age on immunologic response to recombinant hepatitis B vaccine: A meta-analysis
The effect of age on immunologic response to recombinant hepatitis B vaccine: A meta-analysis
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DOI：
10.1086/344271
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发表时间：
2002-12-01
影响因子：
11.8
通讯作者：
Leder, K
中科院分区：
文献类型：
--
作者：
Fisman, DN;Agrawal, D;Leder, K
乙型肝炎疫苗是预防乙型肝炎感染的关键工具。尽管与该主题相关的研究得出了相互矛盾的发现，但与年龄相关的免疫功能变化可能会导致老年人疫苗功效下降。我们使用随机效应模型对 24 项已发表的试验和研究进行了荟萃分析，这些试验和研究评估了年龄与乙型肝炎疫苗反应之间的关系。汇总研究结果表明，老年人对乙型肝炎疫苗无反应的风险显着增加（相对风险 [RR]，1.76；95% 置信区间 [Cl]，1.48-2.10）。即使排除了质量较差的研究（RR，1.63；95% Cl，1.23-2.15）并调整了发表偏倚（RR，1.52；95% Cl，1.26-1.83），无应答风险仍然升高，即使“老年”个体被定义为年轻至 30 岁，这种风险仍然存在。这些发现对有乙型肝炎感染风险的个人（包括医护人员和旅行者）具有重要意义。
Hepatitis B vaccine is a key tool for the prevention of hepatitis B infection. Age-associated changes in immune function may contribute to decreased vaccine efficacy in older individuals, although research related to this topic has yielded contradictory findings. We performed a meta-analysis of 24 published trials and studies that evaluated the association of age with response to hepatitis B vaccine, using a random-effects model. Pooling of study results suggested a significantly increased risk of nonresponse to hepatitis B vaccine among older individuals (relative risk [RR], 1.76; 95% confidence interval [Cl], 1.48-2.10). An elevated risk of nonresponse persisted even after exclusion of poor-quality studies (RR, 1.63; 95% Cl, 1.23-2.15) and adjustment for publication bias (RR, 1.52; 95% Cl, 1.26-1.83), and it was present even when "older" individuals were defined as being as young as 30 years. These findings have important implications for individuals at risk for hepatitis B infection, including health care workers and travelers.