Immunological Effects Of60ug/Dose Hepatitis B Vaccine In Adults And Effects Of General Practitioners On The Prevention And Control Of Hepatitis B

Objectives:To evaluate the immunological effects of one or two doses of60μg/dose hepatitis B vaccines (HepB) in adults and to investigate the effects of revaccination of one dose of60ug HepB vaccine among non-responders after the primary course of HepB vaccination.Methods:Subjects who tested negative for HBsAg, anti-HBs, and anti-HBc were selected in our study and then divided into four groups.Group Ⅰ:primary vaccination Group I,2000subjects were selected for one dose of60μg/dose HepB vaccine. Anti-HBs levels were assessed using a chemiluminescence immunoassay one month after the vaccination.Group Ⅱ:primary vaccination Group Ⅱ,1000subjects were selected for two doses of60μg/dose HepB vaccines with the first dose administered immediately and subsequent doses1month later. Anti-HBs levels were assessed one month after the second vaccinationGroup Ⅲ:primary vaccination control Group,1400subjects were selected and received3doses of lOug/dose hepatitis B vaccines with the first dose administered immediately and subsequent doses1and6months later. Anti-HBs levels were assessed one month after the third vaccination.Group Ⅳ:people who failed to respond after a course of3vaccinations in2010.1000non-responders with an anti-HBs titer level being less than lOmlU/ml were selected. They were given one dose of60ug/dose HepB vaccine and the Anti-HBs levels were assessed one month after the vaccination.Results:1、Group I:The seroconversion rate of anti-HBs after the primary vaccination course was19.73%, and the geometric mean titer (GMT) of anti-HBs was1.53mIU/ml (95%CI1.35-1.74). But the seroconversion rate of anti-HBs among those aged between14-24years old was80%, and the GMT was147.64mIU/ml (95%CI56.10-388.60).2、Group Ⅱ:The seroconversion rate of anti-HBs was78.97%, and the GMT was51.61mIU/ml (95%CI43.96-60.56).3、Group Ⅲ:The seroconversion rate of anti-HBs was89.50%, and the GMT was197.24mlU/ml (95%CI176.47-220.46).4、The seroconversion rate of anti-HBs and GMT of anti-HBs in Group Ⅱ were significantly higher than those in Group Ⅰ (χ2=707.243, P<0.001; t=33.777, P<0.001).5、The seroconversion rate of anti-HBs and GMT of anti-HBs in control Group were significantly higher than those in Group Ⅰ (χ2=1751.78, P<0.001; t=56.633, P<0.001).6、The seroconversion rate of anti-HBs and GMT of control Group were significantly higher than those of Group Ⅱ(χ2=46.182, P<0.001; t=13.498, P<0.001).7. The seroconversion rate of anti-HBs in non-responder Group was86.91%after receiving one dose of60ug/dose HepB vaccine,and the GMT was213.80mIU/ml (95%CI177.83-263.03)Conclusions:1、Except for those aged between15-24years, the immunological effects of one dose of60μg/dose hepatitis B vaccines were not very good.2、The immunological effects of two doses of60μg/dose hepatitis B vaccines can elicit high seroconversion rate of anti-HBs, but the level of GMT was low, which needs further study.3、Among those non-responders,60μg/dose hepatitis B vaccines can exert good immunological effects.4、Among the different schedules of hepatitis B vaccination, the three-dose course was better than one or two-dose series and two doses were better than one. Simply increasing the dose and reduce the doses course of hepatitis B vaccine could not achieve good immunological effects. Objectives1. To find out the current status of prevention and control of Hepatitis B.2. To explore the effects of general practitioners (GPs) on the prevention and control of Hepatitis B through comparing the differences in awareness among residents of Hepatitis B control and rate of complete immunization schedule of Hepatitis B vaccine between residents in study group who were educated and managed by the general practitioners shortly trained in expertise in control of Hepatitis B and those in control group. Methodology1. A literature review has been done on the current status of prevention and control of Hepatitis B and interviews about GPs’knowledge of prevention and control of Hepatitis B2. Self-complete questionnaires were administered to GPs in study group before and after a short training course3. GPs in study group carried out their work according to the training requirements for half a year, meanwhile the control group managed their residents in the old way. Comparisons of awareness rate of control of Hepatitis B and rate of complete immunization schedule of Hepatitis B between study group and control group have been done after the plan.Research outcomes1. Qualitative study results(1) Interviews with primary health service staff1) GPs played a key role in the detection, treatment and prevention of Hepatitis B, but the prevention and control of Hepatitis B was mainly done by public health workers now.2) It was highly necessary for GPs to take part in the prevention and control of Hepatitis B; however how they participate need further research.3) Major difficulties GPs experienced in the prevention and control of Hepatitis B were heavy workload, staff shortage and lack of expertise in control of Hepatitis B.(2) After the short training course, GPs’knowledge of control of Hepatitis B significantly improved.(3) GPs thought that factors influencing the rate of complete immunization schedule were vaccination time, vaccination sites, vaccination frequency, flow of population and health education.2. Quantitative study results(1) Awareness among residents of Hepatitis B control after the intervention in study group was higher than that before intervention and there was significant difference between the two groups.(2) Rate of complete immunization schedule of Hepatitis B in study group was significantly higher than that in control group (74.62%and26.99%respectively).χ2=512.2, P<0.05, there was significant difference between the two groups.Conclusions1. There is a real lack of knowledge in control of Hepatitis B among general practitioners; meanwhile, the current system exerts a negative impact on the GPs’ role in Hepatitis B control.2. Short training course can remarkably enhance the knowledge of control of Hepatitis B among GPs.3. The model of Hepatitis B control involving GPs can raise resident awareness of Hepatitis B control and rate of complete immunization schedule of Hepatitis B to some extent.