需要再接种疫苗的艾滋病毒感染者的乙型肝炎疫苗史
Minhee Kang1, Triin Umbleja1, Anchalee Avihingsanon2
1Center for Biostatistics in AIDS Research in the Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Journal of acquired immune deficiency syndromes (1999)
|December 26, 2025
概括
许多艾滋病毒感染者 (PWH) 无法通过疫苗获得乙型肝炎的保护. 检查抗体标位和重新接种PWH至关重要,特别是在新的长效抗逆转录病毒治疗中.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 过去对艾滋病毒感染者 (PWH) 的乙型肝炎疫苗的研究表明,对增加剂量或频率的反应不一致.
- 这导致PWH中乙肝疫苗接种的临床指导方针和实践变化.
- 需要评估缺乏保护性抗体水平的PWH患者的疫苗完成和再接种策略.
研究的目的:
- 检查缺乏血清保护反应的PWH中B型肝炎疫苗系列的完成和再接种疫苗.
- 分析PWH中抗体标位低于血清保护水平 (<10mIU/mL) 的疫苗接种史.
主要方法:
- 在A5379试验 (NCT04193189) 中对561名参与者的回顾性研究.
- 来自非洲,亚洲,南美和美国的41个地点的参与者.
- 评估过去的乙型肝炎疫苗接种史,重点关注接收的剂量数量.
主要成果:
- 在1098名试验候选人中,有561人 (51%) 由于非血清保护性标位 (<10mIU/mL) 而被录取.
- 平均年龄为46岁,区域差异较大.
- 24%的参与者接受了≥4剂 (高达12剂),但仍然缺乏保护性抗体标位.
结论:
- 不管过去的接种疫苗记录如何,在PWH中应检查抗体标位,以确定再接种疫苗的需要.
- 长效注射性抗逆转录病毒治疗 (ART) 不能保护人免受乙型肝炎病毒 (HBV) 的感染,这与基于tenofovir的ART不同.
- 建议重新评估血清学,并将CpG辅助剂的疫苗系列提供给没有血清保护的PWH,鉴于其有希望的响应耐久性.
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