| Objective: To understand the vaccine respond after the improving of the hepatitis B vaccine dose from 5μg to 10μg.To explore the effect of vaccination dose,infancy weight,occult hepatitis B infection(OBI)on hepatitis B vaccine response,and to reduce the response rate of hepatitis B vaccine in infants and young children.Methods: Continuous admission to 1-3 years children of routine physical examination in First Affiliated Hospital of Xinjiang Medical University.Children have completed full vaccination of hepatitis B vaccine.We confirmed the dose of hepatitis B vaccine by checking the vaccination after the consent of the guardian.Then face to questionnaire and collection of venous blood samples.HBV markers were detected by ELISA for all samples.Then amplified HBV S region by nested PCR and sequenced it.Molecular evolution characterization was performed using MEGA7.0.General statistical analysis was performed using SPSS 17.0.Logistic regression model was established using R software and the interaction index RERI,AP,S and Bootstrap were used to estimate the confidence interval.Results: A total of 1023 subjects,the average age of 1.26 ± 0.47 years,hepatitis B vaccine non-response rate was 15.44%(158/1023).1.There was significant difference in the response rate between different cumulative vaccination doses,P<0.001.OR of 20μg,25μg,30μg to 15μg were 0.463(0.293-0.732),0.259(0.126-0.530),0.217(0.132-0.356).2.There was significant difference in weight of age in 42-days,3-months,6-months between responders and non-responder,P <0.05.OR of right deviation compared with normal were 1.260(1.135-1.398),1.515(1.246-1.842),1.414(1.171-1.708).Covariance analysis was performed with birth weight as covariate.There was significant difference in 0-6months body weight gain between responders and non-responder,P <0.001,non-responders higer than responders.3.Logistic regression model was established using R software which showed: cumulative dose of hepatitis B and 0-6months body weight gain would affect hepatitis B vaccine response which with a negative multiplication of interaction.Then calculate the additive interaction indicator RERI=16.358(0.331~230.885)AP=0.673(0.123~0.846),S=3.231(1.219~6.553).4.OBI was 7.82%(80/1023)in 1-3years children,which was no significant difference between responders and non-responder.5.Most OBI were C genotype.Twenty-seven mutations occurred in the HBV S region,of which 10 occurred in the "a" determinant.6.One fifty-eight children who did not respond to hepatitis B vaccine were followed up.Reseeding rate was 87.34%(138/158),follow-up rate was 36.08%(57/158).7.To understand the reasons for refusal to follow up by calling or visiting to 64.92%(101/158)of children who refusal to followed up.Analyses by the fault tree found that subjective factors are the main ones including do not trust the researchers,do not recognize the professional quality of the researchers,do not understand the subject.Conclusion: Cumulative dose of hepatitis B and 0-6months body weight gain were influencing factors of hepatitis B vaccine non-response,and there is an additive interaction between the two factors.There is synergistic effect increased hepatitis B vaccine non-response risk when vaccine dose is low and 0-6months weight gain is fast at the same time.There was OBI in 1-3years children,which should be paid attention to the dangers of OBI. |
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