B型肝炎疫苗對台灣兒童至青少年免疫保護力衰退的探究

慢性肝病及肝硬化為台灣第10大死因，其發生與慢性病毒性肝病有密切的關聯。本研究主要探討兒童和青少年B型肝炎抗體免疫保護力與衰退率。此為回溯性研究，收集1990年後出生之1,585位年齡介於1至20歲的組群，其血清B型肝炎表面抗原（HBsAg）與B型肝炎表面抗體（anti-HBs）數據，並排除其中39位HBsAg陽性帶原者（2.46%），及50位於anti-HBs檢驗前已有疫苗追加接種者，最終共計1,496筆納入抗體效價統計。由研究結果發現，其中809位（54.08%）anti-HBs保護力不足。女性與男性之anti-HBs保護力陽性率分別為50.34%與41.74%，男性顯著較低（p=0.0008）；女性與男性其anti-HBs陽性率分別至18.5歲與17.9歲時，已衰退到6成，男性anti-HBs衰退較早。所以，當anti-HBs保護力隨年齡增加而下降時，成年後之高度危險群應主動接受追加疫苗接種，可降低B型肝炎病毒感染風險。

關鍵字

B型肝炎疫苗接種； B型肝炎表面抗體（anti-HBs）；保護效力；衰退率

並列摘要

Chronic liver disease and cirrhosis are the 10th death cause in Taiwan, and its occurrence is closely related to chronic viral liver disease. The aim of this study was to investigate the protective efficacy and decline rate of specific hepatitis B surface antibody (anti-HBs) in children and adolescents with hepatitis B vaccination. In this retrospective study, the hepatitis B surface antigen (HBs Ag) and anti-HBs data of 1585 children and juveniles, who were born after January 1, 1990, and aged between 1 and 20 years old, were analyzed to investigate the status and decline rate of anti-HBs protection. Thirty-nine of the 1585 young children were HBsAg positive carriers and 50 of them, who had hepatitis B vaccine boosted before the anti-HBs titer test, were also excluded. The anti-HBs titer of 1496 cases were statistics analyses and we found that 809 (54.08%) of them had insufficient anti-HBs protection. The efficacy of anti-HBs protection in female is 50.34%, and the efficacy of anti-HBs protection was significantly decreased in male (41.74%, p=0.0008). The efficacy of anti-HBs protection rate declined to 60% at the age of 18.5 in female, and the efficacy of anti-HBs protection rate declined to 60% in male at 17.9 years old, suggesting that the decline rate of serum anti-HBs was faster in male than female. When anti-HBs protection declines with age, high-risk groups of hepatitis B infection should take the initiative to receive anti-HBs titer test or additional booster vaccination to reduce the risk of hepatitis B virus infection.

並列關鍵字

hepatitis B vaccination ； hepatitis B antibody (anti-HBs) ； protective efficacy ； protection decline

參考文獻

陳美芸、林宜昀、宋壬夫、楊以屏：台灣青少年B型肝炎抗體與免疫記憶力。台灣醫學 2020;24:142 -9. https://doi.org/10.6320/FJM.202003_24(2).0002

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