主题：关于乙肝疫苗、抗体以及其他 -- 紫色月亮

这个问题还真值得好好讨论一下.

看看下面这个研究: 对接受过免疫接种但血清标志物全部阴性的大学新生,重新进行3次免疫接种,同时进行血清学检测.结果显示:在第一次接种7-10天后(我们可以把它当作一次病毒暴露来看待),80%的人还没产生保护性抗体,只有20.5%的人重新出现了抗体(其实这些人的抗体出现时间也存疑,是否有保护作用还是未知数,我对乙肝病毒复制周期记不清了).

所以,我支持抗体滴度下降后进行补种.

另一句题外话: 我认为接种的目的不是要完全避免病毒感染和肝炎,而是避免发生大病毒量导致的严重感染,对于肝脏基础不好的人来说,严重感染可能意味着重症肝炎,意味着丧命.因此,抗体滴度非常要紧,过低的话就丧失了保护的作用.

Hepatology. 2010 May;51(5):1547-54.

Determination of immune memory to hepatitis B vaccination through early booster response in college students.

Jan CF, Huang KC, Chien YC, Greydanus DE, Davies HD, Chiu TY, Huang LM, Chen CJ, Chen DS.

Department of Family Medicine, National Taiwan University Hospital, National Taiwan University, Taiwan.

Abstract

The long-term protection of hepatitis B (HB) vaccination has been debated for years. The purpose here was to evaluate the kinetic changes of antibody to HB surface antigen (anti-HBs) and define immune memory of the HB vaccine among college students who had previously received full neonatal immunization against HB. In all, 127 college students aged 18-23 years born after July 1984 who had completed HB vaccination and were seronegative for all three HB viral markers, including HB surface antigen (HBsAg), antibody to HB core protein (anti-HBc), and anti-HBs, were recruited. They received three doses of HB vaccine at enrollment, 1 month and 6 months after enrollment. Their anti-HBs titers were assayed at enrollment, 7-10 days, 1 month, 6 months, and 7 months following the first dose of HB vaccine. The anti-HBs seroprotective rates for subjects 7-10 days, 1 month, 6 months, and 7 months postvaccination were 20.5%, 75.6%, 94.5%, and 99.2%, respectively. Those who were seroprotective at 7 to 10 days after one dose of HB vaccine booster developed significantly higher levels of anti-HBs at 1 and 6 months than those not developing seroprotective anti-HBs response at an earlier timepoint. CONCLUSION: At least one-quarter of HB vaccinees have lost their immune memory to the HB vaccine when entering college. Immune memory to HB vaccine was identified by early seroconversion, which was present in only 20% of vaccinees in the present study. To ensure higher than 90% anti-HBs seroconversion rates, at least 2 doses of HB booster vaccines are recommended for at-risk youths who received complete HB vaccinations in neonatal or infant periods but are seronegative for HBsAg, anti-HBs, and anti-HBc in adolescence.