Risk factors and individual immunologic intervention of non- or low-response status in infants of HBsAg positive mothers after hepatitis B vaccination

doi:10.3877/cma.j.issn.1674-1358.2017.05.017

Abstract

Abstract:

Objective

To identify the risk factors for non/low response to hepatitis B vaccinations in infants of hepatitis B surface antigen (HBsAg)-positive mothers and to evaluate the effects of subsequent individualized immune intervention in these infants.

Methods

Total of 144 infants of HBsAg-positive mothers enrolled in our hospital from August 2011 to January 2013, that had completed an immunization program of three-dose hepatitis B vaccines, were recruited. The risk factors for the non- or low-immune response to hepatitis B vaccinations were analyzed. Infants of the non-/low-immune response group were subsequently administered individualized immune interventions, following by reevaluation of immune responses to hepatitis B vaccinations at 18 months of age.

Results

Logistic regression showed that the risk of the non- or low-immune response to hepatitis B vaccinations in infants with preterm delivery, low birth weight of the infants, late administration of protein supplements, and failure to receive the second dose of hepatitis B immunoglobulin (HBIG) during neonatal days 15-30 increased 25.51, 20.54, 28.47 and 16.67 times than normal children, and the value of Wald χ² were 12.45, 14.59, 15.36 and 10.09, respectively (all P < 0.001). The risk increased 1.001 (Wald χ² = 3.97) and 1.16 times (Wald χ² = 4.45) when HBeAg and HBcAb in the mother during early pregnancy increased one unit (all P < 0.05). Moreover, 83.3% of low-immune response infants and 70.0% of non-immune response infants achieved normal-immune response at 18 months, and had no statistic significance with normal-immune response infants (χ² = 2.84, P = 0.12; χ² = 2.32, P = 0.15), and the HBsAb levels were significantly elevated after individualized immune interventions (t = 2.54, P = 0.02; t = 2.76, P = 0.01).

Conclusions

High HBeAg and HBcAb levels of the mothers during early pregnancy, preterm delivery, low birth weight of the infants, late administration of protein supplements, and failure to receive second HBIG injection in the infants were the risk factors for non- or low-immune response. Individualized immune intervention effectively enhanced the immune response and alleviated the risk of HBV infection in the infants.

Key words: Hepatitis B vaccination, Non-immune response, Low-immune response, Risk factors, Immune intervention

Lin Pang, Caiying Wang, Shuxin He, Hongling Yang, Yuhuan Liu, Yang Zhao. Risk factors and individual immunologic intervention of non- or low-response status in infants of HBsAg positive mothers after hepatitis B vaccination[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2017, 11(05): 508-512.

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References 25

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变量	b值	stb值	Wald χ²值	P值	OR值	95%CI
常数项	-0.93	1.40	0.44	0.509
早产（是vs.否）	3.24	0.92	12.45	< 0.001	25.51	4.22～154.16
低出生体重（是vs.否）	3.02	0.79	14.59	< 0.001	20.54	4.36～96.87
辅食添加情况（否vs.是）	3.35	0.85	15.36	< 0.001	28.47	5.34～151.94
第2次Ig（接种vs.未接种）	-2.80	0.64	19.09	< 0.001	0.06	0.02～0.21

变量	b值	stb值	Wald χ²值	P值	OR值	95%CI
常数项	-0.93	1.40	0.44	0.509
早产（是vs.否）	3.24	0.92	12.45	< 0.001	25.51	4.22～154.16
低出生体重（是vs.否）	3.02	0.79	14.59	< 0.001	20.54	4.36～96.87
辅食添加情况（否vs.是）	3.35	0.85	15.36	< 0.001	28.47	5.34～151.94
第2次Ig（接种vs.未接种）	-2.80	0.64	19.09	< 0.001	0.06	0.02～0.21

变量	b值	stb值	Wald χ²值	P值	OR值	95%CI
e抗原	0.00	0.00	3.97	0.046	1.00	1.000～1.001
核心抗体	0.15	0.07	4.45	0.035	1.16	1.01～1.34

变量	b值	stb值	Wald χ²值	P值	OR值	95%CI
e抗原	0.00	0.00	3.97	0.046	1.00	1.000～1.001
核心抗体	0.15	0.07	4.45	0.035	1.16	1.01～1.34

组别	例数	18月正常应答	18月低应答	18月无应答
正常应答组	50	38（76.01）	12（24.03）	0（0.00）
低应答组	30	25（83.28）^a	5（16.72）	0（0.00）
无应答组	20	14（70.02）^b	6（30.01）	0（0.00）

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