ABSTRACT
Objective To analyze the correlation between response to hepatitis B virus (HBV) vaccine and cellular immunity and clinical characteristics in children with respiratory infection.Methods Nine hundred and sixty children in Department of Respiratory in Children's Hospital of of Soochow University,who were over 7 months old and had full course of HBV vaccination between January and December 2015 were enrolled in this study.Peripheral blood (1-2 mL) was collected,and antigen-antibody of HBV was detected by using enzyme-linked immunosorbent assay and PCR included HBV surface antigen,hepatitis B antibody,HBV e antigen,HBV e antibody,HBV core antibody,and HBV nucleic acid.According to the results,these children were divided into 4 groups:non response group,low response group,normal response group and high response group according to their responses to HBV vaccine.Cellular immunity was detected by using flow cytometry and patients' clinical data was collected.Results There was no statistical differences of CD3 + CD4 +,which were (3.43 ± 0.28) ％,(3.42 ± 0.30) ％,(3.43 ± 0.36) ％ and (3.52 ± 0.29) ％,among the four groups (F =0.520,P =0.669).CD3 + CD8 + in non response group was (3.18 ±0.28)％,which was significantly higher than that in low response group,normal response group and high response group [(3.08 ± 0.36)％,(3.05 ±0.34)％,(2.93 ±0.30)％],the differences were significant (all P＜0.05);CD4/CD8 in non response group (0.26 ± 0.43) were significantly lower than that in normal response group (0.40 ± 0.50),the differences were significant (P =0.001).There was no significant difference of CD3 +,CD3 + CD8 + and CD4/CD8 among low response group,normal response group and high response group (all P ＞ 0.05).CD3-CD19 + and CD19 + CD23 + level were lowest in non response group [(3.00 ± 0.57) ％,(2.25 ± 0.67) ％] and highest in high response group [(3.33 ± 0.45) ％,(2.57 ± 0.38) ％],the differences were significant (all P ＜ 0.05).Among the 4 groups,children in normal response group had the shortest average hospitalization days [(1.88 ±-0.31) d],which was significantly shorter than that in non response group,low response group and high response group [(1.96 ± 0.39) d,(1.95 ± 0.38) d,(1.96 ±0.15) d],the differences were significant (all P ＜0.05),there was no significantly difference of average hospitalization days among other 3 groups (all P ＞ 0.05).Proportion of severe pneumonia was significantly higher in non response group [6.1％ (22/363cases)] and high response group [13.3％ (2/15 cases)] compared to those in normal response group [2.6％ (7/274cases)],the differences were statistically significant (x2 =4.417,P =0.036;x2 =5.476,P =0.019).The total white blood cell number was lowest in non response group (F =4.695,P =0.003).Platelet number was increased with higher degree of response to HBV (F =6.598,P ＜ 0.001).Conclusions Cellular immunity is lower in respiratory infection children with non response or low response to HBV vaccine.After they have respiratory infection,children with non response to HBV vaccine may have a longer course of disease and worse condition.
ABSTRACT
Objective To analyze the failure ratio and the causes of the inoculation failure of hepatitis B virus(HBV)-vaccine in children and relevant the remedial measures. Methods One thousand three hundred and sixty cases treated in Suzhou Wuzhong people′s hospital during Jan.2007 to Jul.2008 were chosen,of whom 286 children from 1-5 years old to be anti-HBs negative or anti-HBs titre to be 0-10 IU/L were screened,and specific failure reasons for the vaccination were analyzed,also the timely treatment measures were taken.Then 286 children were divided into 5 groups randomly.Apart from one group was set up as blank control,the other 4 groups were arranged to accept different immunization methods with 0,1,2 month schedule,group A simply got revaccinated with HB vaccine(10 ?g) 3 times;group B revaccinated with double dosage of HB vaccine(20 ?g) 3 times;group C besides being revaccinated 3 times,the immune regulatory agent was jointly used;group D revaccinated 3 times with genetically engineered CHO hepatitis B vaccine. Results The ratio of failure of HBV-vaccine was 21.03%,what caused failure of hepatitis B vaccine included immunologic inadequacy 218(76.22%),repeated respiratory infection 192 cases(67.13%),abuse hormone 140 cases(48.95%),zinc deficiency 129 cases(45.10%),anaemia 108 cases(37.76%),passive smoking 80 cases(27.97%),the mother being chronic parenchymatous nephritis or HBV carrier 63 cases(22.03%),premature 54 cases(18.88%),adiposity 38 cases(13.29%),dystrophy 29 cases(10.14%).There were 4 methods of revaccination,the positive rate for group A,B,C,D were 90.00%,96.47%,99.08%,95.83%,respectively.Group C had the highest positive rate,compared with the other 3 groups,which were statistically significant(P a