Multivariate analysis of immune effect of hepatitis B vaccination in post-liver transplantation children aged under 5 years old / 国际外科学杂志

ABSTRACT

Objective To investigate the effect of hepatitis B vaccine immune response after liver transplantation in children under 5 years old and assess the necessity of multiple vaccination.Methods A retrospective collection of children who had liver transplantation from February 2014 to December 2018 in the same liver transplantation group in the Department of General Surgery,Beijing Friendship Hospital,Capital Medical University were analyzed.In accordance with the requirements of the doctor,170 children under 5 years old injected with over 4 doses were enrolled,including 75 males and 95 females,aged from 4 months to 5 years old.After every dose of vaccination,the blood were collected to detect hepatitis B following regular review in liver transplantation clinic,observe the effect of HBsAb (hepatitis B surface antibody) after postoperative hepatitis B vaccination.Count data were represented by cases and percentage (％),and comparison between groups were analyzed by chi-square test.Results After the first course of treatment,in total children under 5 years old who completed the first course of treatment,121 cases got successful immune responses (HBsAb ≥ 100 IU/L) and 49 cases got the responses failure (HBsAb ＜ 100 IU/L).After the second course of treatment,29 cases got successful immune responses,and only 20 cases finally failed to response (HBsAb ＜ 10 IU/L) to 8 injections namely two courses.The factors affecting the immune effect of hepatitis B vaccination were not related to gender,primary disease,liver feeding mode,and postoperative vaccination time,and were related to age,place of residence,and preoperative level of HBsAb titer (100 IU/L).The immune responses rate of children averagly aged over 2 years old was significantly higher than that of children under 1 year old after the first course of postoperative vaccination.Children with preoperative hepatitis B vaccination and ＞ 100 IU/L anti-HBs titer had a higher immune response rate after the first course of postoperative vaccination (84.72％),and the immune response rate of children with anti-HBs titers ＜ 100 IU/L after the first course of hepatitis B vaccine was slightly lower(60.71％).Conclusions Most post-liver transplantation children can obtain protective antibodies to prevent re-infection of hepatitis B virus by inoculation with hepatitis B vaccine.Multiple inoculation can effectively induce hepatitis B antibody production and improve immune response level economically.The hepatitis B vaccination proved to be indispensable and is one of the current methods promoted and applied to post-liver transplantation.