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目的比较艾滋病(AIDS)病人按标准方案和加强方案接种重组乙型肝炎(乙肝)疫苗后免疫应答的差异。方法 CD+4T淋巴细胞计数<200个/μL、抗乙肝病毒表面抗原抗体(抗-HBs)阴性的AIDS病人89例,其中55例(A组)按标准方案分别在0、1、6个月肌内注射重组乙肝疫苗20μg,34例(B组)按加强方案分别在0、1、2、6个月肌内注射重组乙肝疫苗40μg。两组在首剂注射后1个月及7个月时检测抗-HBs滴度,≥10mIU/mL即为阳性。结果 A组在首剂注射后1个月及7个月时,抗-HBs阳转率分别为40.00%(22/55)、50.91%(28/55),B组分别为35.29%(12/34)、67.65%(23/34)。两组在首剂注射后1个月时及7个月时,抗-HBs阳转率差异均无统计学意义(χ2=0.197、P=0.657;χ2=2.406、P=0.121)。首剂注射后7个月时,A组抗-HBs滴度的中位数为10.44mIU/mL,B组抗-HBs滴度的中位数为57.73mIU/mL,两组比较差异有统计学意义(Z=-2.018、P=0.044)。结论CD+4T淋巴细胞计数<200个/μL、抗-HBs阴性的AIDS病人,按加强方案接种重组乙肝疫苗后,血清抗-HBs阳转者抗-HBs滴度高于标准方案,但抗-HBs阳转率两种方案无差异。
Objective To compare the difference of immune response between AIDS patients receiving standard hepatitis B vaccine (HBsAg) and standard vaccination regimens. Methods Eighty-nine AIDS patients with CD + 4T lymphocyte counts <200 / μL and anti-HBs were negative, of which 55 (group A) were treated with standard protocols at 0, 1, and 6 months Intramuscular injection of recombinant hepatitis B vaccine 20μg, 34 cases (group B) were boosted at 0,1,2,6 months intramuscular injection of recombinant hepatitis B vaccine 40μg. Anti-HBs titers were detected in both groups at 1 and 7 months after the first dose of injection, with a positive rate of ≥10 mIU / mL. Results The positive rates of anti-HBs in group A were 40.00% (22/55) and 50.91% (28/55) respectively at 1 and 7 months after the first dose injection in group A, 35.29% (12 / 34), 67.65% (23/34). There was no significant difference in anti-HBs positive rates at 1 month and 7 months after the first dose injection in both groups (χ2 = 0.197, P = 0.657; χ2 = 2.406, P = 0.121). At 7 months after the first dose, the median titer of anti-HBs in group A was 10.44 mIU / mL, and the median titer of anti-HBs in group B was 57.73 mIU / mL. The difference between the two groups was statistically significant Significance (Z = -2.018, P = 0.044). Conclusion Anti-HBs titers in serum anti-HBs positive patients were higher than those in standard anti-HBs anti-HBs vaccine after AIDS patients with CD + 4T lymphocyte counts <200 / μL and anti-HBs negative AIDS patients receiving recombinant hepatitis B vaccine. HBs positive rate of the two programs no difference.