Reduced detection and levels of protective antibodies to hepatitis B vaccine in under 2-year-old HIV positive South African children at a paediatric outpatient clinic
Reduced detection and levels of protective antibodies to hepatitis B vaccine in under 2-year-old HIV positive South African children at a paediatric outpatient clinic
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DOI：
10.1016/j.vaccine.2008.10.004
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发表时间：
2009-01-01
期刊：
影响因子：
5.5
通讯作者：
Mphahlele, M. Jeffrey
中科院分区：
文献类型：
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作者：
Simani, Omphile E.;Leroux-Roels, Geert;Mphahlele, M. Jeffrey
这项研究评估和比较了来自扩大免疫计划诊所[EPI组]和儿科门诊[OPD组]的5至24个月大的南非婴儿接种疫苗后抗-HBs的流行率和接触乙肝病毒(HBV)的情况，结果根据艾滋病毒状况进行了分层。研究对象为303例婴幼儿，其中计划免疫组243例，门诊组60例。对所有血清进行抗-HBs、抗-HBc和抗-HBc检测，仅在HBs Ag和/或-HBc阳性的样本中检测IgM抗-HBc和HBVDNA。总体而言，EPI组和OPD组之间抗-HBs标志物的患病率存在显著差异。与门诊婴儿相比，计划免疫组的血清转换率(89.3%比81.7%；p=0.105)和血清保护率(86.0%比75.0%；p=0.038)更高。当总体结果按艾滋病毒状况分层时，艾滋病毒阴性者的血清保护率为85.7%，艾滋病毒阳性者的血清保护率为78.1%，尽管这在统计学上没有统计学意义(p=0.125)。在计划免疫接种组中，HIV阳性者(84.3%；n=51)和阴性者(86.5%；n=192)之间的血清保护率几乎相当(p=0.695)。相反，在门诊组中，艾滋病毒阳性者(63.6%；n=22)和艾滋病毒阴性者(81.6%；n=38)之间的血清保护率降低，尽管这在统计学上没有统计学意义(p=0.123)。有趣的是，OPD组未检测到HBs Ag或抗-HBc标志物，而EPI组总曝光率为4.9%(HBs Ag携带率为1.2%)。(C)2008爱思唯尔有限公司。保留所有权利。
The study evaluated and compared the prevalence of anti-HBs and exposure to hepatitis B virus (HBV) in vaccinated South African babies aged between 5 and 24 months from the Expanded Programme on Immunisation clinic [EPI group] and paediatric outpatient clinic [OPD group], and results were stratified by HIV status. A total of 303 (243 EPI group and 60 OPD group) babies were studied. All sera were tested for anti-HBs, HBsAg and anti-HBc, while IgM anti-HBc and HBV DNA were only tested in samples positive for HBsAg and/or and-HBc. Overall, there was a gross difference in the prevalence of anti-HBs marker between the EPI and OPD groups. The EPI group demonstrated higher levels of seroconversion (89.3% vs. 81.7%; p = 0.105) and seroprotection rates (86.0% vs. 75.0%; p = 0.038), compared to the OPD babies. When the overall results were stratified by HIV status, seroprotection was 85.7% for the HIV-negatives and 78.1% for the HIV-positives, although this was not statistically significant (p=0.125). The seroprotection rates were almost comparable between the HIV-positives (84.3%; n = 51) and the HIV-negatives (86.5%; it = 192) (p = 0.695) in the EPI group. In contrast, reduced seroprotection rates were observed between the HIV-positives (63.6%; n = 22) and HIV-negatives (81.6%; n = 38) in the OPD group, although this was not statistically significant (p=0.123). Interestingly, no HBsAg or anti-HBc marker was detected in the OPD group, compared to total exposure rate of 4.9% (HBsAg carriage was 1.2%) in the EPI group. (c) 2008 Elsevier Ltd. All rights reserved.