以小鼠实验探讨新生儿乙肝疫苗接种方案的优化问题

The immune effect after a complete course of vaccination against hepatitis B is one of the concerns of public health in China. After the introductory of a compulsory neonatal hepatitis B virus (HBV) vaccination for more than 20 years by the Chinese government, there is a general increase in vaccination coverage and an enhancement in the immunity to HBV in the population. Therefore, anti-HBs conferred by hepatitis B vaccine can be found increasingly in pregnant women. Previous studies have shown that maternal anti-HBs can be passed through the placenta. Further, it is found that maternal anti-HBs passed to their neonates had the effect on the immune response of newborns towards hepatitis B vaccine conducted on 0,1,6 months after birth. It is reasonable to suggest postponing HBV vaccination in newborns of HBsAg-negative mothers, especially for those of anti-HBs high titers, to improve the effect of the infants’ active immune response. There have been few relative research reports worldwide. This study is aimed to prove the fact that the immune efficacy of inoculating hepatitis B vaccine in newborns could be diminished by maternal anti-HBs by comparing the mice’s anti-HBs levels between the mice given hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine and another group given vaccine only. It is expected that combined immunization affects the immunity to hepatitis B vaccine in mice. This study tries to suggest the first dose of hepatitis B vaccine at a later age in newborns and provide new ideas for a better vaccination programme.

新生儿乙肝疫苗全程接种后的免疫效果是我国公共卫生工作关注的问题之一。乙肝疫苗计划免疫政策实施20余年来，我国人群乙肝疫苗接种率及对乙型肝炎病毒（HBV）免疫力普遍提高，孕产妇群体中乙肝表面抗体（抗-HBs）阳性率逐年升高。前期研究发现孕产妇体内抗-HBs可通过胎盘传给胎儿，并影响按0,1,6月方案接种的乙肝疫苗的主动免疫效果。我们推测对非乙肝母亲，特别是体内抗-HBs 高滴度母亲的新生儿推迟接种乙肝疫苗会取得更好的主动免疫效果，但国内外相关研究较少。本研究拟通过小鼠实验对母体抗-HBs是否影响新生儿乙肝疫苗接种效果进行研究，比较注射乙肝免疫球蛋白（HBIG）及乙肝疫苗的小鼠与仅接种乙肝疫苗的小鼠抗-HBs阳转率及滴度，探讨联合免疫是否影响小鼠乙肝疫苗应答效果，为调整新生儿乙肝疫苗接种时间，优化接种方案提供依据。