Study On Failure Factor Of Hepatitis B Vaccine

BackgroundHepatitis B virus(HBV)infection is popular of all over the world.There are 2000 million people have ever affectted HBV in the world.And there are 350 million are clonic longtime carriers.About one million people die from failure of liver and cirrhosis of the liver and HCC from hepatitis B-related disease every year as reported by world helth organization.HBV infection is high prevalent,in China.and clonic liver flamation cost high health resource.There are not special medicine for cure HBV till now.Acknowledged by all over the world,Hepatitis B vaccination is the most effective measure to prevent HBV infection.But our anti-HBV engineering still face many difficulties and challenges:While the incidence for the vaccinated children had been descending,the rates of HBsAg and all the HBV markers for the total population didn't descend clearly.There are two reseaon,one is main only to the infant national immunization programme of hepatitis B in China.The other is about 5～10% vaccinees turned out to be non or hypo-responders,also they were susceptible to HBV.Many factor can lead to the non or hypo-responders.Including the vaccine pose,lack of pre-s gene of vaccine and personality.We explore the cause which leads to non or hypo-responders through poly-factor anlysising,which can provide sientistic proof for regulating anti-HBV engineering for the government.Which can servering for improving people's health.ObjectiveThe paper aims to observation about immunination effect of hepatitis B vaccination inoculating and investigation the cause which leads to non or hypo-responders and explore mechanism of hepatitis B vaccination in non-infant. Which can provide sientistic evidence for regulating anti-HBV engineering for the government.So that we can reduce that HBV does harm to people.This will be great republic health important.Materials and methodsWe adopt the random selection of poly-phase samples from people of both rural and urban sectors in Lucheng district in Wenzhou.Two neighborhood committees from the urban area and two villages from rural area were selected,from which we finally chose a certain part of people as the study populations.After an effort of spot inquiry and general body check,we finally chose the qualified people by means of examining the five HBV markers of serology,i.e HBsAg,Anti-HBs,HBeAg,HBeAb,HBcAb.For the people with negative five markers of HBV,we vaccinated in their lateral deltoid muscle of upper arms,totally 3 doses of 5μg vaccine for those under 19 years,and 3 doses of 10μg vaccine for those were 19 years old or above,one dose each time according to the procedure of the first month,one months later and 6 months later.The vaccine was applied in its expiration date.Each signal study person was in great observation for their reaction to the vaccine after 24 hours,48 hours and 72 hours,judged by the standards of observing human body reactions to biological product.One month after the entire inoculation of HBV vaccine,the study populations were examined for anti-HBs by the double antigen sandwich Time-Resoled Fluoroimmunoassay technique serologically,and classified the antibody titer≥10mIU/ml as anti-HBs positive,0≤the antibody titer＜110mIU/ml as non-and-hyporesponders and correspondingly in terms of the antibody titer≥100mIU/ml as high-responders.The Vaccine failures' people were examined for the DNA content in HBV by means of PCR.And the Human Leukocyte antigen genotype DR(HLA-DR)areas' detection were carried on in both failures and high-immune persons comparatively by microcytotoxicity test.Also investigations on the habits of failures and high-immune persons were carried out comparatively by a case-control study.The research data was recorded in EXCEL2003;and analysised with SPSS13.0, Statistical Package for the Social Sciences,Version13.0,was applied to implement ANOV and logistic regression.Results1.positive conversion rate of anti-HBsFor the totally 869 study persons,112 of which were examined as the titer of anti-HBs lower than 10mIU/mL.The positive conversion rate of anti-HBs was 87.11%. And the rate in female is higher than in male,which is significant(P=0.022＜0.05).There is a tendency that the positive rate of anti-HBs decreases while age increases,in different age groups,which comes a high negative correlation between the age and the positive conversion rate of anti-HBs using Spearman's rank correlation analysis(R=-0.123,P=0.000＜0.05).2.The titer of anti-bodyThere is significant difference between males and females,and the result showed that the titer of anti-body in females are higher than that in males(F=1.23,P=0.000). The titer of anti-body of different age groups were compared by means of analysis of three elements regression,which came the significant difference of single analysis(F=43.007,P=0.000),the titer of anti-body is negatively correlated with different ages groups,that is to say that the immune responding titer of anti-body increases while ages decreases.There was no interaction of age and gender on the titer of anti-body,after the interaction analysis.3.The relative factor Analysis of the Immunity FailureTrace virus infection:we examined the HBV DNA for 15 immunity failures, whose anti-HBV titer were smaller than10mIU/ml after primary immunization.One of them was found as the positive HBV DNA.HLA-DR gene phenotype:we selected 15 immunity failures and 15 high-responders,for testing the HLA-DR gene phenotype.The result came that there was no significant difference between them;the rate of DR2(15),DR5(12),DR7,DR9 detected were the same on the whole.Bahaviors factor research:For the 112 immunity failures,1 was found the positive HBV DNA,2 of which failed to be followed up.We took the remaining 109 immunity failures as our study object,while choosing 109 other higher-responders under 3 years as a comparison.All of them were made the relative factor investigation and field measurement,Which would be analyzed.In the single factor analysis,the result is that there was a correlation of immunity failure about 5 factors of gender, family history,alcohol drinking history,body height,and weight(P＜0.05).After the multiple conditional Stepward Logistic regression analysis,there were 3 of the 5 factors entered the regression equation,which is gender,family history and alcohol drinking history of the vaccinated objects.The regression equation was as follows: Ln(h_i/h₀)=1.606X₁+0.456X₂+0.575X₃;X₁,X₂ and X₃ respectively represents family history,alcohol history and gender.The Likelihood Regression rate -2 Log Likelihood=151.106,made the great difference of 132.342,which indicated that the regression equation had practical significance.For the study objects of the hepatitis B vaccination,the rate of immunity failure occurring in males is 1.788 times that of in females,the rate of those with family history was 4.983 times that of those without, the rate of those who drank the alcohol more than 100 grams a week was 1.578 times that of those rarely drank.Conclusions1.The people who is not infant inoculated HBVvaccinaion can aquire better immunity effect.2.The better as immunity effect,the younger as they are vaccined HBV vaccination.The man and old people who is weak responded when they are vaccined HBV vaccination.3.The person whose trace virus infection,yeays old,drinking the alcohol,family history is the factor that leads to their immunity failure.