Abstract

Occult hepatitis B virus (HBV) infection (OBI) has been observed among infants born to hepatitis B surface antigen (HBsAg)-positive mothers despite successful immunoprophylaxis. This study enrolled 549 infants born to HBsAg-positive mothers with HBV DNA load >6log₁₀IU/mL [349 infants received a 10μg/dose of hepatitis B vaccine (HepB), and 200 infants received 20μg/dose HepB]. The rate of immunoprophylaxis failure, non-response, and immunoprophylaxis success in infants was 5.73%, 1.82%, and 92.55% in the 10μg group, and 4.50%, 0.00%, and 95.50% in the 20μg group, respectively. Moreover, the anti-HBs levels in the 10μg group were significantly lower than that in the 20μg group both at 7 [652.48 (564.05-754.82) vs. 1541.72 (1268.69-1873.51) mIU/mL, P<0.001] and 12 months old [257.44 (220.29-300.88) vs. 1073.41 (839.27-1372.78) mIU/mL, P<0.001]. The OBI incidence in the 10μg group was significantly higher than that in the 20μg group at both 7 [21.55% (25/116) vs. 7.56% (9/119), P=0.002] and 12 months old [17.07% (14/82) vs. 6.90% (6/87), P=0.041], and 76.19% (16/21) and 100.00% (7/7) OBI infants turned HBV DNA negative, and 16.39% (10/61) and 7.50% (6/80) non-OBI infants developed OBI at 12 months old, in the 10μg and 20μg groups, respectively. OBI incidence in infants with anti-HBs levels <100mIU/mL was higher than that of those with anti-HBs ≥100mIU/mL [35.71% (5/14) vs. 13.12% (29/221), P=0.036]. This study showed that increasing the immunisation dose from 10μg to 20μg significantly improved anti-HBs levels and decreased OBI incidence in infants with a high maternal viral load. We recommend 20μg HepB to treat this high-risk population.

摘要

尽管免疫预防成功，但在由乙型肝炎表面抗原（HBsAg）阳性母亲出生的婴儿中观察到隐匿性乙型肝炎病毒（HBV）感染（OBI）。这项研究招募了549名HBsAg阳性母亲出生的婴儿，其HBV DNA负荷> 6log ₁₀ IU / mL [349例婴儿接受了10μg/剂量的乙型肝炎疫苗（HepB），200例婴儿接受了20μg/剂量的HepB]。婴儿的免疫预防失败率，无应答率和免疫预防成功率在10μg组中分别为5.73％，1.82％和92.55％，在20μg组中分别为4.50％，0.00％和95.50％。此外，10μg组的抗HBs水平均显着低于20μg组的7 [652.48（564.05-754.82）vs. 1541.72（1268.69-1873.51）mIU / mL，P<0.001]，12个月老[257.44（220.29-300.88）与1073.41（839.27-1372.78）MIU /毫升，P <0.001]。10μg组的OBI发生率显着高于20μg组，分别为7 [21.55％（25/116）和7.56％（9/119），P = 0.002]和12个月大[17.07％（14） / 82）对6.90％（6/87），P= 0.041]，而76.19％（16/21）和100.00％（7/7）的OBI婴儿转为HBV DNA阴性，而16.39％（10/61）和7.50％（6/80）的非OBI婴儿在25岁时发展了OBI 12个月大，分别在10μg和20μg组中。抗HBs水平<100mIU / mL的婴儿的OBI发生率高于抗HBs≥100mIU/ mL的婴儿[35.71％（5/14）vs. 13.12％（29/221），P = 0.036]。这项研究表明，将高剂量孕妇的免疫剂量从10μg增加到20μg可以显着提高抗HBs水平并降低OBI发生率。我们建议使用20μgHepB来治疗这一高危人群。