对移植患者使用不同产品与相同产品的乙型肝炎促进剂:贝叶斯推断的回顾性研究
Kentaro Iwata1, Shunkichi Ikegaki1, Yoji Hyodo2
1Division of Infectious Diseases, Kobe University Hospital, Kobe, Hyogo, Japan.
Clinical transplantation
|September 3, 2025
概括
在移植患者初始无反应后切换乙型肝炎疫苗产品并没有显著改善抗体水平. 需要进一步的策略,以确保在这个易受感染的群体中充分防范乙型肝炎感染.
科学领域:
- 免疫学
- 移植医学
- 疫苗学
背景情况:
- 对于接受移植 (KTR) 的人来说,B型肝炎疫苗接种对于预防感染至关重要.
- 对乙型肝炎疫苗的抗体反应不足,因此需要进一步研究增强剂策略.
- 在不反应的KTR中使用不同的疫苗产品的有效性尚未评估.
研究的目的:
- 评估使用不同产品与相同产品的乙型肝炎疫苗强化剂策略在抗体标位不足的移植患者中的有效性.
- 确定在强制疫苗接种后不反应的KTR中的血清转化率 (乙型肝炎表面抗体水平≥10 IU/ ml).
主要方法:
- 一项涉及移植患者的比较研究,在初级乙型肝炎疫苗接种后没有达到足够的抗体标位.
- 患者接受了相同的疫苗产品或不同的疫苗产品的强剂.
- 血清转化率被视为主要结果.
主要成果:
- 总体而言,只有19. 2%的不反应者在增剂后实现了血清转化.
- 交叉组 (不同产品) 的血清转化率为20%,而非交叉组 (相同产品) 的血清转化率为18. 2% (p=1. 0).
- 贝叶斯分析表明交叉组的后期概率为23%,而非交叉组的概率为14%,可信间隔重叠.
结论:
- 切换乙型肝炎疫苗作为强剂策略并没有显著提高移植患者的血清转化率.
- 目前的交叉策略没有明显优于使用相同的疫苗产品来增强免疫力.
- 需要采用替代方法来改善最初对疫苗接种无反应的KTR患者的乙型肝炎保护.
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