小心“肝”，不是注射乙肝疫苗就可以“万事大吉”了

 

随着公众健康意识的增强，人们对乙肝疫苗的接受程度也越来越高，但是不是注射了乙肝疫苗就一定不会感染上乙肝呢？

With the increase of public health awareness, people's acceptance of hepatitis B vaccine is also getting higher and higher, but if you don’t get hepatitis B vaccine, you will not be infected with hepatitis B?

The answer is negative.

必须注意的是，注射疫苗后产生足够浓度的抗体才会对肝脏产生很好的保护性。所以注射了乙肝疫苗（三针后）一定要去化验确定产生抗体，如果没有产生抗体或乙肝抗体的滴度没有达到足够的水平，就需要再打乙肝疫苗加强针。下面谈谈可能出现的几个问题。

It must be noted that a sufficient concentration of antibodies produced after the injection of the vaccine will be very protective to the liver. Therefore, after the injection of the hepatitis B vaccine (after three injections), you must go to the laboratory to determine the production of antibodies. If the antibody is not produced or the titer of hepatitis B antibody does not reach a sufficient level, you need to get a booster shot of hepatitis B vaccine. Let's talk about a few problems that may arise.

Not all people develop antibodies after the vaccine

一般来说，乙肝疫苗注射第一针后大概有30%左右的人产生抗体，此时产生的抗体量很少，维持时间也短。第二针后有50%～70%的人产生抗体。第三针后90%左右的人产生抗体。

对不产生抗体的人则加大注射剂量，但仍然有5%～10%的人会出现无应答或弱应答，无法抵御乙肝病毒的侵袭。

Generally speaking, about 30% of people develop antibodies after the first injection of hepatitis B vaccine. At this time, the amount of antibodies produced is very small and the maintenance time is short. After the second injection, 50% to 70% of people develop antibodies. About 90% of people develop antibodies after the third injection. For people who do not produce antibodies, increase the injection dose, but 5% to 10% of people will still have no response or weak response, unable to resist the invasion of hepatitis B virus.

调查显示，接种时年龄大、嗜酒、吸烟、父母亲接种后无应答、肥胖等情况均为乙肝疫苗免疫无应答的危险因素。中老年人生理机能减退，机体免疫识别和应答能力降低，是造成高龄者无应答的原因。父母亲接种后无应答，其子女也存在无应答现象，提示免疫应答的发生可能与遗传有关系。吸烟嗜酒会降低机体的体液和细胞免疫功能，会导致免疫应答差。

The survey shows that old age at the time of vaccination, alcoholism, smoking, parental non-response after vaccination, obesity, etc. are all risk factors for non-response to hepatitis B vaccine. The decline in physiological functions of middle-aged and elderly people and the reduced ability of the body's immune recognition and response are the causes of non-response in the elderly. Parents did not respond after vaccination, and their children also did not respond, suggesting that the occurrence of immune response may be related to heredity. Smoking and drinking alcohol will reduce the body's humoral and cellular immune functions, which will lead to poor immune response.

因此在全程注射完该疫苗一个月后，应及时检测乙肝表面抗体。

Therefore, one month after the entire injection of the vaccine, the hepatitis B surface antibody should be detected in time.

抗体浓度越高，保护能力也就越强。随着时间的推移，乙肝抗体滴度会慢慢降低，当小于10mIU/ml时就应当加强接种乙肝疫苗。乙肝疫苗接种是预防乙肝的可靠方法，但也不是绝对的和一劳永逸的。

The higher the antibody concentration, the stronger the protective ability. As time goes by, the hepatitis B antibody titer will gradually decrease. When it is less than 10mIU/ml, the hepatitis B vaccine should be intensified. Hepatitis B vaccination is a reliable way to prevent hepatitis B, but it is not absolute and once and for all.

接种后一定要检验接种效果和抗-HBs滴度，并根据抗-HBs滴度情况适时复测，当滴度小于保护值时，要及时补种，使体内经常保持有效的抗-HBs滴度，这样才能有效地预防乙肝病毒感染，真正达到预防乙肝的目的。

After vaccination, the inoculation effect and anti-HBs titer must be checked, and the anti-HBs titer should be re-tested in time. When the titer is less than the protective value, timely replanting is required to keep the effective anti-HBs titer in the body. , So as to effectively prevent hepatitis B virus infection and truly achieve the goal of preventing hepatitis B.

很多人误认为乙肝疫苗是终身免疫疫苗，只要产生抗体就再也不会被感染乙肝病毒了，但事实并非如此。大量研究表明接种疫苗后三年，保护率在80%以上。就是说注射乙肝疫苗之后的3～5年，乙肝抗体滴度会逐渐下降，应及时检查补打乙肝疫苗加强针。

Many people mistakenly believe that hepatitis B vaccine is a lifelong immunization vaccine, as long as antibodies are produced, they will never be infected with hepatitis B virus again, but this is not the case. A large number of studies have shown that the protection rate is more than 80% three years after vaccination. That is to say, 3 to 5 years after the hepatitis B vaccine injection, the hepatitis B antibody titer will gradually decrease, and the hepatitis B vaccine booster injection should be checked in time.

对于滴度不太高或者滴度下降较快的人群建议每年到医院检查体内的乙肝抗体情况。另外注射疫苗尚未产生抗体的时间段也是感染的高风险期。

For people whose titer is not too high or the titer declines quickly, it is recommended to go to the hospital to check the hepatitis B antibody in the body every year. In addition, the time period during which the vaccine has not yet produced antibodies is also a high-risk period of infection.

有足够浓度的抗体，对于一般性的接触可以完全避免感染。但是如果大量的病毒进入体内那就无法保证安全，比如输血。

With sufficient concentration of antibody, infection can be completely avoided for general contact. However, safety cannot be guaranteed if a large amount of virus enters the body, such as blood transfusion.

随着医学的进步，此现象已经得到有效地控制，但是难以杜绝。常见的高危人群还有器官移植者、血液透析者等。

With the advancement of medicine, this phenomenon has been effectively controlled, but it is difficult to prevent it. Common high-risk groups include organ transplant recipients and hemodialysis patients.

Hepatitis B virus mutation

少数人接种乙肝疫苗后产生了高滴度的乙肝抗体，但仍患了乙肝，主要是因为乙肝病毒是一种高度变异的病毒，它发生变异后，可变成新结构、新属性的病毒变异体，原来体内的抗体对新的变异株没有免疫力，就失去了防护作用。所以说，注射乙肝疫苗产生抗体也不能完全杜绝乙肝的传播，只能是最大限度的进行保护。

A small number of people have developed high-titer hepatitis B antibodies after being vaccinated with hepatitis B vaccine, but they still suffer from hepatitis B, mainly because hepatitis B virus is a highly mutated virus. After it mutates, it can become a virus with new structure and new attributes. Body, the antibody in the original body does not have immunity to the new mutant strain, so it loses its protective effect. Therefore, the injection of hepatitis B vaccine to produce antibodies cannot completely prevent the spread of hepatitis B, but can only protect it to the utmost extent.

 

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