Antibody response of low birth weight infants to Haemophilus influenzae type b polyribosylribitol phosphate-outer membrane protein conjugate vaccine.
Antibody response of low birth weight infants to Haemophilus influenzae type b polyribosylribitol phosphate-outer membrane protein conjugate vaccine.
复制标题
低出生体重婴儿对 b 型流感嗜血杆菌聚核糖核糖醇磷酸外膜蛋白结合疫苗的抗体反应。
作者：
Angel Munoz;A. Salvador;N. Brodsky;A. Arbeter;R. Porat
目的
评价目前推荐的B型流感嗜血杆菌（HI B）结合疫苗免疫接种方案在低出生体重（LBW）婴儿中的有效性。
方法
我们量化了36名早产儿的抗体反应，这些早产儿的平均出生体重为1060 g，平均胎龄为28周。婴儿在出生后2个月和4个月时接种0.5 mL HIB疫苗。在每次免疫前即刻和最后一次免疫后2个月，对脐带血中的特异性HIB抗体进行定量。
结果
尽管在研究期间几何平均滴度显著增加，但仍显著低于足月婴儿中报告的值。第二次免疫后，只有24名婴儿（67%）达到抗体浓度超过0.25微克/毫升，定义为血清阳性。此外，只有53%的婴儿达到抗体浓度超过1.0微克/毫升，而在足月婴儿中报告的这一比例为92%。逐步Logistic回归分析确定胎龄27周或以下和静脉注射免疫球蛋白的量作为影响首次免疫后抗体应答的重要变量。副作用的发生率可以忽略不计。
结论
我们的结论是，LBW婴儿，特别是那些出生在27周或更少的妊娠，不作为有效的HIB疫苗的反应。我们推测，对极低出生体重婴儿可能需要重新评估目前的免疫接种计划。
OBJECTIVE
To evaluate the effectiveness in low birth weight (LBW) infants of the currently recommended immunization schedule for conjugated Haemophilus influenzae type b (HIB) vaccine.
METHODS
We quantified antibody responses in 36 preterm infants with a mean birth weight of 1060 g and a mean gestational age of 28 weeks. Infants were immunized with 0.5 mL of HIB vaccine at 2 and 4 months' postnatal age. Specific HIB antibodies were quantified on cord blood, immediately before each immunization and 2 months after the last immunization.
RESULTS
Even though the geometric mean titers increased significantly during the study period, they were still markedly lower than values reported in term infants. After the second immunization, only 24 infants (67%) attained antibody concentrations of more than 0.25 micrograms/mL, defined as seropositivity. Also, only 53% of infants achieved antibody concentrations of more than 1.0 micrograms/mL compared with 92% as reported in term infants. Stepwise logistic regression identified gestational age of 27 weeks or less and the amount of intravenous immunoglobulin received as the significant variables influencing the antibody response after the first immunization. The incidence of side effects was negligible.
CONCLUSIONS
We conclude that LBW infants, and especially those born at 27 or less weeks' gestation, do not respond as effectively to the HIB vaccine. We speculate that reevaluation of the current immunization schedule may be required for very LBW infants.