Hepatitis B vaccination and the risk of multiple sclerosis
Hepatitis B vaccination and the risk of multiple sclerosis
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DOI：
10.1056/nejm200102013440502
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发表时间：
2001-02-01
影响因子：
158.5
通讯作者：
Walker, AM
中科院分区：
文献类型：
--
作者：
Ascherio, A;Zhang, SM;Walker, AM
背景：有关乙型肝炎疫苗接种后发生多发性硬化症的报告引起了人们的担忧，即该疫苗可能是以前健康受试者患多发性硬化症的原因。方法：我们对美国的两组护士进行了一项巢式病例对照研究，即护士健康研究（自 1976 年以来跟踪了 121,700 名女性）和护士健康研究 II（自 1976 年以来跟踪了 116,671 名女性）。 1989）。对于每位患有多发性硬化症的女性，我们选择了五名健康女性和一名患有乳腺癌的女性作为对照。乙型肝炎疫苗接种信息通过邮寄问卷的方式获取，并通过疫苗接种证书确认。该分析包括 192 名多发性硬化症女性和 645 名匹配对照者（534 名健康对照者和 111 名乳腺癌患者），并使用条件逻辑回归进行分析。结果：与发病前任何时间接触乙型肝炎疫苗相关的多发性硬化症的多变量相对风险为 0.9（95% 置信区间，0.5 至 1.6）。发病前两年内接种乙型肝炎疫苗的相对风险为 0.7（95% 置信区间，0.3 至 1.8）。在引入重组乙型肝炎疫苗后开始的仅限于患有多发性硬化症的女性的分析中，结果相似。接种疫苗的剂量与多发性硬化症的风险之间也没有关联。结论：这些结果表明乙型肝炎疫苗接种与多发性硬化症的发展之间没有关联。 （N Engl J Med 2001；344：327-32。）版权所有 (C) 2001 马萨诸塞州医学会。
Background: Reports of multiple sclerosis developing after hepatitis B vaccination have led to the concern that this vaccine might be a cause of multiple sclerosis in previously healthy subjects.Methods: We conducted a nested case-control study in two large cohorts of nurses in the United States, those in the Nurses' Health Study (which has followed 121,700 women since 1976) and those in the Nurses' Health Study II (which has followed 116,671 women since 1989). For each woman with multiple sclerosis, we selected as controls five healthy women and one woman with breast cancer. Information about hepatitis B vaccination was obtained by means of a mailed questionnaire and was confirmed by means of vaccination certificates. The analyses included 192 women with multiple sclerosis and 645 matched controls (534 healthy controls and 111 with breast cancer) and were conducted with the use of conditional logistic regression.Results: The multivariate relative risk of multiple sclerosis associated with exposure to the hepatitis B vaccine at any time before the onset of the disease was 0.9 (95 percent confidence interval, 0.5 to 1.6). The relative risk associated with hepatitis B vaccination within two years before the onset of the disease was 0.7 (95 percent confidence interval, 0.3 to 1.8). The results were similar in analyses restricted to women with multiple sclerosis that began after the introduction of the recombinant hepatitis B vaccine. There was also no association between the number of doses of vaccine received and the risk of multiple sclerosis.Conclusions: These results indicate no association between hepatitis B vaccination and the development of multiple sclerosis. (N Engl J Med 2001;344:327-32.) Copyright (C) 2001 Massachusetts Medical Society.