[Study on antibody response to revaccination of hepatitis B vaccine among firstly low-response adults].

Objective: To evaluate and compare the antibody to hepatitis B virus (HBV) surface antigen (anti-HBs) response and the influent factors of revaccination of 4 kinds of hepatitis B vaccine (HepB) among firstly low-response adults.

Methods: A total of 11 590 adults who were 18 - 49 years old, never received HepB vaccination, without HBV infection history, HBs-Ag negative, and had been living at 3 towns of Zhangqiu county in Shandong province Ji'nan city for more than half a year, were selected in the study in July, 2009. Self-designed questionnaire was used to select the basic information of the subjects. The subjects were divided into 4 groups by cluster sampling, and were vaccinated according to the "0-1-6" immune procedure with 10 µg HepB made by recombinant deoxyribonucleic acid techniques in Saccharomyces Cerevisiae (HepB-SC), 10 µg HepB made by recombinant deoxyribonucleic acid techniques in Hansenula Polymorpha (HepB-HP), 20 µg HepB-SC and 20 µg HepB made by recombinant deoxyribonucleic acid techniques in Chinese hamster ovary cell (HepB-CHO), 3 doses respectively. The adults who were low-response to the primary hepatitis B vaccination (10 mU/ml ≤ anti-HBs < 100 mU/ml) were divided into four groups by cluster sampling. These groups were revaccinated with one-dose of above-mentioned four kinds of HepB respectively. Blood samples were drawn from each person one month after the revaccination. Anti-HBs was detected by chemiluminescence microparticle immunoassay and compared by the vaccine type. The influence factors about antibody response were also analyzed.

Results: Out of the 11 590 subjects, 8592 adults had accepted the primary vaccination of hepatitis B and been collected the blood samples; among whom, 1306 subjects showed low-response, at the rate of 15.20%. A total of 1034 low-response subjects accepted secondary strengthened vaccination and were collected blood samples; 55.13% of them showed anti-HBs seroconversion (anti-HBs ≥ 100 mU/ml); while the seroconversion rate in each group was 44.54% (106/238) in 10 µg HepB-SC group, 57.14% (156/273) in 10 µg HepB-HP group, 56.08% (143/255) in 20 µg HepB-SC group and 61.57% (165/268) in 20 µg HepB-CHO group, respectively. There was significant difference among the groups (χ² = 17.14, P < 0.01). The rates of anti-HBs seroconversion were significantly higher in 10 µg HepB-HP and 20 µg HepB-CHO groups than it in 10 µg HepB-SC group (χ² were 8.09 and 14.70 respectively, P < 0.01). The geometric mean concentration (GMC) of anti-HBs was 178.24 mU/ml among the low-responders after one dose of revaccination. The GMC was 109.77, 243.50, 144.98 and 242.83 mU/ml in 10 µg HepB-SC group, 10 µg HepB-HP group, 20 µg HepB-SC group and 20 µg HepB-CHO group, respectively. There was significant difference among groups (F = 9.52, P < 0.01).

Conclusion: Anti-HBs response could be strengthened effectively after one-dose of HepB revaccination among the low-response adults. Many factors like the vaccine types could effect the immune effects to HepB. A better response could be achieved if the 20 µg HepB-CHO or 10 µg HepB-HP was used for revaccination.