A Long-term Follow-up of Hepatitis B Vaccine Inoculated and HB Immunoglobulin Combinely Immunized Infants Born to HBsAg Positive Mothers
- VernacularTitle:乙型肝炎表面抗原阳性母亲的婴儿乙型肝炎疫苗单独及与乙型肝炎免疫球蛋白联合免疫后的长期随访研究
- Author:
Jianshe WANG
;
Qirong ZHU
- Publication Type:Journal Article
- From:
Chinese Journal of Vaccines and Immunization
2001;7(2):96-99
- CountryChina
- Language:Chinese
-
Abstract:
In order to investigate the occurrence of chronic hepatitis B virus(HBV) infection in HB vaccine inoculated infants born to HBsAg positive mothers and its affecting factors and also to study the effect of combined use of HB immunoglobulin (HBIG) and HB vaccine on the blocking of perinatal transmission of HBV, we divided 624 infants born to HBsAg positive mothers into two groups randomly. The first group of infants were simply vaccinated with HB vaccine 20μg at,0, 1, 6 months old. The second group of infants were inoculated with HBIG 100 IU at their birth and further vaccinated with HB vaccine 20μg at 1,2,7 months old. The HBsAg of the two groups of infants was tested at the age of 1,3,6,12,18,24 months old and every year by EIA. They were all followed up for 6.34±1.71 years averagely. The follow-up results showed that there were 89 childeren infected chronically by HBV, among them 82% appeared to be HBsAg positive, firstly seen before the age of 6 months mainly attributing to uterus infection. The HBV chronic infection rate of infants born to HBsAg, HBeAg positive mothers (HB vaccine immunized, 24.5%; HBIG+HB vaccine, 10.6%, P<0.005) was higher than that of infants born to HBsAg positive mothers (HB vaccine immunized, 10.7%; HBIG+HB vaccine 3.8%, P<0.025). Moreover, the chronicity rate of the infants whose HBsAg firstly appeared within 6 months and were born to HBsAg, HBeAg positive mothers was higher than that of the infants born to HBsAg positive months (68%,40% respertively in HB vaccine inoculated group, P<0.025). Infants immunized combinely with HBIG and HB vaccine had their chronic HBV infection decreased from 17.6% to 5.0% at l year old as compared with that of HB vaccine inoculated infants. The total chronic HBV infection rate in children born to HBsAg, HBeAg positive mothers decreased from 24.5% to 10.6% (P<0.005) and that in children born to HBsAg positive mothers decreased from 10.7% to 3.8% (P<0.025). The HBV chronicity rate of HBsAg positive infants born to HBsAg, HBeAg positive mothers also decreased and that of infants born with HBsAg negative, but became positive after 1-6 months decreased from 40.9% to 0% (P=0.0315). The HBsAg seronegative conversion rate in l month old infants born to HBsAg positive mothers increased from 26.4% to 58.8% (P<0.025). All these data indicated that infants born to HBsAg positive mothers, though had been HB vaccine immunized, still had chronic infection, that was chiefly due to chronic uterus infection by HBV. The single use of HB vaccine can not completely block the uterus infection of HBV, but when combinatively used with HBIG, the blocking effect is more efficient, the chronicity of HBV infection also can be avoided.
