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目的:了解母亲分娩前乙型肝炎病毒核糖核酸(hepatitis B virus DNA,HBV DNA)载量对婴儿经过乙型肝炎疫苗联合乙型肝炎免疫球蛋白(hepatitis B immunoglobulin,HBIG)预防接种后免疫应答的影响。方法:选择2008年2月至2010年2月在东南大学附属第二医院住院分娩,母亲为乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)阳性,婴儿出生时HBV DNA及HBsAg均为阴性者128例,按照母亲分娩时HBV DNA载量分A、B、C 3组,选择母亲为HBsAg阴性的婴儿21例为对照组即D组,各组婴儿行相同的预防接种,相同时段实验室检测乙型肝炎表面抗体(hepatitis B surface antibody,HBsAb)浓度。结果:A、B、C、D 4组婴儿在1个月时HBsAb平均浓度分别是(240.19±79.34)、(248.58±57.07)、(240.87±61.97)、(266.03±70.93)mU/ml,各组比较差异无统计学意义(F=0.666,P=0.574);2个月时各组HBsAb平均浓度分别是(155.87±97.78)、(155.72±141.11)、(196.90±141.51)、(175.26±105.34)mU/ml,各组比较差异无统计学意义(F=0.884,P=0.451);7个月时各组HBsAb平均浓度分别是(766.86±314.27)、(754.30±363.56)、(687.18±326.45)、(888.68±247.83)mU/ml,各组比较差异无统计学意义(F=0.857,P=0.466)。结论:母亲产前HBV DNA载量对婴儿1、2、7个月时HBsAb平均浓度无影响;各组婴儿经过联合预防接种后在1个月时都出现了具有保护性的HBsAb,2个月时HBsAb平均浓度均有下降,婴儿对乙型肝炎疫苗联合免疫的免疫应答不受母亲分娩前HBV DNA载量的影响。
Objective: To investigate the effect of hepatitis B virus DNA (HBV DNA) on the immune response of infants after vaccination with hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) influences. Methods: From February 2008 to February 2010 at the Second Affiliated Hospital of Southeast University, hospital delivery, the mother was hepatitis B surface antigen (HBsAg) positive, the baby was born HBV DNA and HBsAg were negative 128 cases were divided into groups A, B and C 3 according to the HBV DNA load of the mother during childbirth. 21 infants whose mothers were HBsAg-negative were selected as the control group, Group D, and the infants in each group received the same vaccination. The same period of laboratory tests Hepatitis B surface antibody (HBsAb) concentration. Results: The mean concentrations of HBsAb at 1 month in the groups A, B, C and D were (240.19 ± 79.34), (248.58 ± 57.07), (240.87 ± 61.97) and (266.03 ± 70.93) mU / ml respectively (F = 0.666, P = 0.574). At 2 months, the average concentrations of HBsAb in each group were (155.87 ± 97.78), (155.72 ± 141.11), (196.90 ± 141.51), (175.26 ± 105.34 (766.86 ± 314.27), (754.30 ± 363.56) and (687.18 ± 326.45), respectively. There was no significant difference between the two groups (F = 0.884, P = 0.451) ), (888.68 ± 247.83) mU / ml, there was no significant difference between each group (F = 0.857, P = 0.466). Conclusion: The prenatal HBV DNA load of mothers had no effect on the average concentration of HBsAb at 1, 2, and 7 months of infants. The protective HBsAbs appeared in all infants at 1 month after the combination vaccination, When the average concentration of HBsAb decreased, the immune response to the combined immunization of hepatitis B vaccine in infants was not affected by the HBV DNA load of the mother before childbirth.