Vertical Transmission of Hepatitis B Virus-An Update.

Hepatitis B virus (HBV) infection is a major public health problem in the world. Approximately 296 million people are chronically infected. In endemic areas, vertical transmission is a common route of transmission. There are several strategies for the prevention of HBV vertical transmission, such as antiviral treatment during the third trimester of pregnancy and immunoprophylaxis to newborns that includes the administration of hepatitis B immune globulin (HBIG) and an HBV vaccine. Despite this, immunoprophylaxis failure can occur in up to 30% of infants born to HBeAg-positive mothers and/or with high viral load. Therefore, management and prevention of HBV vertical transmission is of paramount significance. In this article, we provided a review of the epidemiology, mechanisms of pathogenesis and risk factors of vertical transmission, as well as the strategies implemented to prevent the infection.

Vertical transmission of hepatitis B virus from father to child: what can be concluded about this possibility?

Vertical hepatitis B virus (HBV) transmission is defined as transmission that occurs during pregnancy or postpartum from an HBV-infected mother to her fetus or child. It is an efficient route for the spread of HBV and is responsible for most of the cases of chronic HBV infection in adults. During pregnancy, vertical transmission can occur in the intrauterine phase, by placental infection via peripheral blood mononuclear cells, by placental leakage, or through female germ cells.The detection of HBV DNA in semen and spermatids from HBV-infected men has provided strong evidence that the male genital tract may act as a reservoir of the virus in HBV-infected men, supporting the possibility that vertical HBV transmission from an HBV-infected father to his child may also occur via the germ line at the time of fertilization, as occurs in HBV transmission from mother to child. Furthermore, it has been shown that integration of the HBV genome into the sperm cell genome can compromise sperm morphology and function and even cause hereditary or congenital biological effects in the offspring when an HBV-infected sperm fuses with an ovum.Since vertical HBV transmission from father to child can be a topic of interest and of global importance for controlling the spread of HBV, this article addresses the evidence supporting its occurrence via germ cells, the biological impact of integration of the HBV genome into the male germ cell genome, and the role of maternal immunoprophylaxis in vertical HBV transmission from father to child.

Primeros pasos en la inmunoprofilaxis contra la leptospirosis en Cuba

RESUMEN Introducción: La leptospirosis es una zoonosis de distribución mundial. En la década de los años 70 del pasado siglo xx aumentó la incidencia en Cuba, principalmente en trabajadores agrícolas. En Camagüey se produjo un brote que llevó a establecer el Programa Nacional de Control de la Leptospirosis Humana, puesto en vigor por los Ministerios de Salud Pública y la Agricultura. En 1982 investigadores de la Dirección Nacional de Zoonosis realizaron un ensayo clínico para evaluar inmunogenicidad y reactogenicidad de una vacuna antileptospirósica humana del Instituto de Sueros y Vacunas de Stávropol. Objetivo: Reconstruir los primeros pasos en la inmunoprofilaxis contra la leptospirosis en Cuba. Métodos: Se utilizó el método historiográfico. Los datos se obtuvieron en las bases de datos: Infomed, Dialnet, Medigraphic, Medline y Scielo. Análisis y síntesis de la información: Las recomendaciones de la investigación plantearon aplicar la vacuna a grupos de riesgo y producir una vacuna con cepas autóctonas de leptospiras. El análisis de la bibliografía consultada de las últimas cuatro décadas corrobora el cumplimiento de las recomendaciones. Conclusiones: Hace cuarenta años científicos cubanos realizaron los estudios iniciales sobre inmunogenicidad y reactogenicidad de una vacuna procedente de la pretérita Unión Soviética. Las recomendaciones de la investigación se cumplieron. Se realizó la vacunación a grupos de riesgo en la población, principalmente trabajadores agrícolas y se logró una vacuna con cepas autóctonas de leptospiras. Los datos expuestos sobre los primeros pasos en la inmunoprofilaxis contra la leptospirosis en Cuba tienen relevancia para la historiografía médica por los aportes a la salud pública, prioridad del Estado cubano.

ABSTRACT Introduction: Leptospirosis is a zoonosis of worldwide distribution. In the 1970s, there was an increase in the incidence of this disease in Cuba, mainly among agricultural workers. An outbreak in Camagüey led to the establishment of the National Program for the Control of Human Leptospirosis adopted by the Ministries of Public Health and Agricultures. In 1982, a clinical trial was conducted to evaluate the immunogenicity and the reactogenicity of a vaccine against human leptospirosis from the Institute of Vaccines and Sera of Stavropol. Objective: To retrace the first steps towards immunoprophylaxis against leptospirosis in Cuba. Methods: The historiographic method was used. Data were retrieved from the following databases: Infomed, Dialnet, Medigraphic, Medline and SciELO. Analysis and synthesis of the information: Recommendations from the research suggested administering the vaccine to risk groups, and producing a vaccine from autochthonous Leptospira strains. The analysis of the consulted bibliography from the last four decades corroborates the fulfillment of these recommendations. Conclusions: Forty years ago, Cuban scientists conducted the first studies on immunogenicity and reactogenicity of a vaccine from the former Soviet Union. The recommendations derived from the research were fulfilled. Population groups at risk, mainly agricultural workers, were vaccinated, and a vaccine from autochthonous Leptospira strains was obtained. Given the contributions to public health, which is a priority of the Cuban government, data presented on the first steps towards immunoprophylaxis against leptospirosis in Cuba are of paramount importance for the medical historiography.

Guía de manejo obstétrico y del recién nacido en madre aloinmunizada / Guidelines for the obstetric management of an alloimmune mother and her newborn / Guia de manejo obstétrico e neonatal em mães aloimunizadas

Resumen: La aloinmunización es una respuesta biológica frente a la exposición de antígenos no propios. La gestación, las transfusiones de hemocomponentes, los trasplantes de órganos sólidos y células hematopoyéticas, así como el consumo de drogas intravenosas exponen a las pacientes al desarrollo de aloanticuerpos antieritrocitarios. El hallazgo de los mismos debe cumplir con las instancias diagnósticas para identificar la probabilidad de estar asociados a enfermedad hemolítica feto neonatal (EHFN) y su oportuna derivación a policlínica de alto riesgo obstétrico (ARO) para su correcto seguimiento. Es fundamental que sean los laboratorios de inmunohematología de los servicios de hemoterapia y medicina transfusional los encargados de los estudios diagnósticos de aloinmunización eritrocitaria(1). En este sentido hemos elaborado esta guía con el objetivo de protocolizar de manera multidisciplinaria el manejo de las embarazadas aloinmunizadas y sus recién nacidos.

Abstract: Alloimmunization is the biological response to exposure to non-HLA antigens. Pregnancy, transfusion of blood components, solid organ and hematopoietic cell transplantation, as well as intravenous drug use expose patients to the development of anti-erythrocyte antibodies. When the latter are found, they must match diagnostic criteria to identify the potential association to hemolytic disease of the fetus and newborn (HDFN) and its timely referral to the high-risk obstetric risk polyclinic for due follow-up. It is of the essence for erythrocyte alloimmunization diagnostic tests to be carried out by the immunohematology laboratories of the Hemotherapy and Transfusional Medicine services. To that end, we have prepared these guidelines with the purpose of providing a multidisciplinary protocol for the handling of maternal alloimmunization and alloimmunization of the newborn.

Resumo: A aloimunização é uma resposta biológica à exposição a antígenos não próprios. A gravidez, as transfusões de hemocomponentes, os transplantes de órgãos sólidos e células hematopoiéticas, bem como o uso de drogas intravenosas expõem os pacientes ao desenvolvimento de anticorpos antieritrocitários. O achado destes deve obedecer a critérios diagnósticos para identificar a doença e a probabilidade de estarem associados a doença hemolítica feto neonatal (DHPN) e seu encaminhamento oportuno para uma unidade de alto risco obstétrico para acompanhamento adequado. É fundamental que os laboratórios de imuno-hematologia dos serviços de Hemoterapia e Medicina Transfusional se encarreguem dos estudos diagnósticos da aloimunização eritrocitária. Elaboramos este guia com o objetivo de estabelecer um protocolo multidisciplinar para o manejo de gestantes aloimunizadas e seus recém-nascidos.

Transmisión vertical de hepatitis B: importancia de incorporar el cribado en el control prenatal en Chile / Vertical transmission of hepatitis B: the importance of incorporating screening during pregnancy in Chile

Resumen La transmisión vertical de hepatitis B es responsable de 50% de las infecciones en el mundo e implica 90% de riesgo de evolucionar a hepatitis crónica y sus complicaciones. La inmunoprofilaxis postparto (inmunoglobulina más vacuna) es la medida de prevención más efectiva. Sin embargo, puede existir fracaso a pesar de dicha intervención, debido a factores como alta carga viral o la presencia de HBeAg en la madre, los que sólo pueden evitarse si se hace el diagnóstico y tratamiento durante la gestación. En Chile, en el año 2019 se incorporó la vacunación en los recién nacidos, pero no existe aún cribado durante el embarazo, a diferencia de los países desarrollados. En los últimos años se ha experimentado un aumento acelerado de inmigración proveniente principalmente de América latina y el Caribe, con prevalencias altas en algunos de ellos. Chile debiese avanzar prontamente hacia el cribado de hepatitis B en embarazo.

Abstract Half of cases of hepatitis B around the world are produced from vertical transmission; and 90% of them can evolve to chronic hepatitis and their long term complications. Postpartum immunoprophylaxis (immunoglobulin and vaccine) is the most effective preventive measure. However, despite this prophylaxis, vertical transmission is possible if the mother presents a high viral load or e-antigen. This risk can be reduced only if screening during pregnancy and treatment if needed, are incorporated. In 2019, vaccination for hepatitis B in newborn was incorporated in Chile, but not yet prenatal screening, unlike developed countries. Chile has experienced a growth in immigration from Latin America and Caribbean, some countries with high endemicity included. Prenatal screening in Chile should be promptly incorporated.

Vaccines for caseous lymphadenitis: up-to-date and forward-looking strategies.

Caseous lymphadenitis (CLA) is an infectious chronic disease responsible for economic losses in sheep and goat breeding worldwide. CLA has no effective treatment, evidencing the vaccination schedule as the best control strategy. Although some commercial vaccines have been available, none of them provides total protection, which is sometimes insufficient and does not reach the same efficiency when compared in sheep and goats. They also have questionable safety levels and side effects. In light of this, several experimental vaccines are in development in order to improve safety, reproducibility, and protective immune response against the etiologic agent of CLA, Corynebacterium pseudotuberculosis. In this review, we discussed aspects as antigen, adjuvant, routes of administration, protection level, and animal models used in CLA vaccine development, as well the challenges and future perspectives. KEY POINTS: Caseous lymphadenitis (CLA) does not have an appropriate commercial vaccine. Different experimental vaccines are in development aiming to protect against Corynebacterium pseudotuberculosis. An ideal vaccine for CLA is necessary for the disease control.

Toxocariasis and Toxocara vaccine: a review / Toxocariasis y vacunación para Toxocara: una revisión sistemática / Toxocaríase e vacina para controle de Toxocara: uma revisão

Abstract Based on prevalence and impact on public health, toxocariasis is an underestimated zoonosis in developing and developed countries. The transmission of Toxocara spp. involves pets, stray dogs and cats (Canis familiaris and Felis catus, respectively), which spread the parasite's eggs in their feces to the environment. One of the main risk factors for the infection and development of human toxocariasis, is to cohabit with puppies and kittens. For a long time, the preventive strategy for this parasitic infection has been the regular use of antiparasitic drugs to reduce parasite burden in the short term. A long lasting immunological protection can be achieved with vaccination, however, a vaccine is not yet available. Therefore, it is fundamental to know and to understand the state of the art of vaccine development for effective control of this zoonosis. This paper reviews the experimental studies focused on vaccine development for toxocariasis control, and special attention is given to relevant epidemiological studies on the importance of dogs in human toxocariasis.

Resumen Según la prevalencia y el impacto en la salud pública, la toxocariasis es una zoonosis subestimada en los países en desarrollo y desarrollados. La transmisión de Toxocara spp. involucra animales de compañía caninos y felinos, como también perros y gatos sin hogar (Canis familiaris y Felis catus, respectivamente), que diseminan los huevos del parásito en sus heces al medio ambiente. Uno de los principales factores de riesgo para la infección y el desarrollo de la toxocariasis humana es convivir con cachorros felinos y caninos. Durante mucho tiempo, la estrategia preventiva para esta infección parasitaria ha sido el uso regular de medicamentos antiparasitarios para reducir la carga parasitaria a corto plazo. Se puede lograr una protección inmunológica duradera con la vacunación, sin embargo, todavía no se dispone de una vacuna. Por lo tanto, es fundamental conocer y comprender el estado del arte del desarrollo de vacunas para el control efectivo de esta zoonosis. Este artículo revisa los estudios experimentales centrados en el desarrollo de vacunas para el control de la toxocariasis, y se presta especial atención a los estudios epidemiológicos relevantes sobre la importancia de los caninos domésticos en la toxocariasis humana.

Resumo Com base na prevalência e no impacto na saúde pública, a toxocaríase é uma zoonose subestimada nos países em desenvolvimento e desenvolvidos. A transmissão de Toxocara spp. envolve animais cães e gatos de estimação e vadios (Canis familiaris e Felis catus, respectivamente), que espalham os ovos do parasita nas fezes para o meio ambiente. Um dos principais fatores de risco para a infecção e desenvolvimento da toxocaríase humana é coabitar com filhotes de cachorros e gatos. Por um longo tempo, a estratégia preventiva para essa infecção parasitária tem sido o uso regular de medicamentos antiparasitários para reduzir a carga parasitária a curto prazo. Uma proteção imunológica duradoura pode ser alcançada com a vacinação, no entanto, uma vacina ainda não está disponível. Portanto, é fundamental conhecer e entender o estado da arte do desenvolvimento de vacinas para o controle efetivo dessa zoonose. Este artigo revisa os estudos experimentais focados no desenvolvimento de vacinas para o controle da toxocaríase, e atenção especial é dada a estudos epidemiológicos relevantes sobre a importância dos cães na toxocaríase humana.

Immunoprophylactic Potential of a New Recombinant Leishmania infantum Antigen for Canine Visceral Leishmaniasis: An In Vitro Finding.

The development and application of safe and effective immunoprophylactic/immunotherapeutic agents against canine visceral leishmaniasis (CanL) have been pointed out as the only means for the real control of the disease. Thus, this study aimed to evaluate the in vitro cellular immune response of dogs, elicited by the new recombinant proteins of Leishmania infantum, Lci10 and Lci13, in order to investigate their potential for vaccinology. Twenty-four dogs were submitted to clinical, parasitological, serological and molecular tests, and then separated into two study groups: 12 infected (InD) and 12 non-infected dogs (NInD), and six of each group were directed for Lci10 and Lci13 evaluation. Peripheral blood mononuclear cells (PBMC) were cultured and stimulated with Lci10 (10 µg/ml) or Lci13 (5 µg/ml), and with L. infantum soluble antigen (LSA) (25 µg/ml) or no stimulus (NS) as controls. Afterwards, the mRNA levels of different cytokines were quantified through qPCR, and Nitric Oxide (NO) production was assessed in the culture supernatants. Significant differences were considered when p ≤ 0.05. The comparative analysis revealed that, in the NInD group, Lci13 promoted a significant increase in the expression of IFN-γ in relation to LSA (p = 0.0362), and the expression of this cytokine in NInD was significantly higher than that presented in the InD (p = 0.0028). A negative expression for TGF-ß was obtained in both groups. Lci13 also induced a greater production of NO in relation to the NS sample in the NInD group. No significant differences were observed after stimulation with Lci10. In conclusion, the results suggest a protective role of Lci13 for uninfected animals, thus with a potential for immunoprophylaxis. The results will help to direct the antigen Lci13 for further studies (pre-clinical trials), in order to determine its immunogenicity and reactogenicity effects, as a way to consolidate its real applicability for vaccinology against CanL.

Cribado de virus de hepatitis B en mujeres embarazadas: inmigrantes, y chilenas con conductas de riesgo. Manejo del binomio madre-hijo: Plan piloto / Screening of hepatitis B in high risk Chilean and immigrant pregnant women: management of mother to child transmission

Resumen Introducción: Chile es un país de baja endemia de virus de hepatitis B (VHB), pero los países de mayor flujo migratorio hacia Chile tienen una endemia intermediaalta. La inmunoprofilaxis (IP) en el recién nacido (RN) es fundamental para evitar la transmisión vertical de VHB. Objetivos: Determinar la prevalencia de HBsAg en mujeres embarazadas: inmigrantes, y chilenas con conductas de riesgo (CR), y evaluar el cumplimiento de la indicación de IP a los RN de madre con HBsAg reactivo. Material y Métodos: Cohorte prospectiva de cribado de HBsAg a mujeres embarazadas inmigrantes, y chilenas con CR, entre julio 2017 y junio 2018 en CABL. Los RN de madre con HBsAg reactivo se les administró IP adecuada (antes de 12 h de vida). Resultados: Se realizó un total de 1.415 HBsAg: 1.265 a inmigrantes y 150 a chilenas con CR. Se obtuvieron 37 pacientes con HBsAg reactivos. Dos falsos positivos. La prevalencia HBsAg en inmigrantes fue 2,7% y 0,66% en chilenas con CR (p < 0,05). El 91,1% provenía de Haití, con una prevalencia de 3,5% en nuestra área. Todos los RN (36) recibieron IP. La mediana de administración de IP fue 3:02 h. Conclusiones: La prevalencia de VHB en mujeres gestantes inmigrantes fue superior a lo reportado en la población general y en mujeres chilenas con CR. Planteamos la necesidad de implementar el cribado universal en el embarazo, y en especial, en mujeres embarazadas provenientes de países con endemia intermedia-alta.

Background: Chile is a low-endemic HBV country, but countries with the highest migratory flow to Chile have an intermediate-high endemicity. In order to avoid vertical transmission of HBV, immunoprophylaxis (IP) in the newborn (NB) is a key factor. Aim: To identify HBsAg prevalence in pregnant immigrants and Chilean pregnant women with risk behaviors (RB) and to asses IP use in the NB. Material and Methods: Prospective HBsAg screening cohort of immigrant and Chilean pregnant women with RB, between July 1, 2017 and June 30, 2018 in CABL. IP of all NB of reactive HBsAg mothers was assessed. Results: 1,415 HBsAg samples, 1,265 immigrants and 150 Chileans with RB. 37 reactive HBsAg. Two false positive. HBsAg prevalence in immigrant pregnant women was 2.7% and 0.66% in Chileans with RB (p < 0.05). 91.1% came from Haiti, with a prevalence of 3.5% in our region. All NB (36) received IP with a median of administration of 3:02 h. Conclusions: The prevalence in immigrant pregnant women was higher than that reported in the general population and in Chilean women with RB. We proposed the need for universal screening in pregnancy, especially in pregnant women from countries with intermediate-high endemicity.

Effectiveness of Palivizumab against Respiratory Syncytial Virus: Cohort and Case Series Analysis.

OBJECTIVE: To measure the real-world effectiveness of palivizumab immunoprophylaxis against respiratory syncytial virus (RSV)-confirmed infection before age 2 years in a population-cohort of high-risk infants. STUDY DESIGN: Palivizumab is funded for high-risk infants in Western Australia. We used probabilistically linked administrative data encompassing RSV laboratory-confirmed infections, hospital admissions, and palivizumab dispensing records for a cohort of 24 329 high-risk infants admitted to neonatal intensive care units, born 2002-2013 with follow-up to 2015. We used a traditional cohort method with Cox proportional hazards regression and a self-controlled case series analysis to assess effectiveness of palivizumab in reducing RSV-confirmed infection by number of doses. RESULTS: From the cohort of 24 329 infants, 271 (1.1%) received at least 1 dose of palivizumab and 1506 (6.2%) had at least 1 RSV-confirmed infection before age 2 years. Using the traditional cohort approach, we found no protective association of palivizumab receipt with RSV detection (adjusted hazard ratio = 0.99 [95% CI 0.5, 1.9] for 1 dose). However, using a self-controlled case series to eliminate confounding by indication, a protective association was seen with a 74% lower RSV incidence (relative incidence = 0.26; 95% CI 0.11, 0.67) following any dose of palivizumab compared with control (nonexposed) periods. CONCLUSIONS: After accounting for confounding by indication through a self-controlled analysis, palivizumab appeared effective for reducing virologically confirmed RSV in this high-risk cohort.

Hospitalization for Respiratory Syncytial Virus in Children with Down Syndrome Less than 2 Years of Age: A Systematic Review and Meta-Analysis.

OBJECTIVES: To compare the respiratory syncytial virus (RSV)-related hospitalization rate, hospital length of stay (LOS), and need for assisted ventilation in children aged <2 years with Down syndrome and those without Down syndrome. STUDY DESIGN: MEDLINE, Embase, and CINAHL databases were searched from inception up to December 2017. Studies that provided data on RSV-related hospitalization in children aged <2 years with Down syndrome and those without Down syndrome were included. Data were independently extracted in pairs by 2 reviewers and synthesized with random-effects meta-analysis. RESULTS: In 10 studies including a total of 1 748 209 children, 12.6% of the children with Down syndrome (491 of 3882) were hospitalized with RSV infection. The presence of Down syndrome was associated with a significantly higher risk of RSV-related hospitalization (relative risk [RR], 6.06; 95% CI, 4.93-7.45; I2 = 65%; Grading of Recommendations, Assessment, Development and Evaluation [GRADE], moderate). RSV-related LOS (mean difference, 2.11 days; 95% CI, 1.47-2.75 days; I2 = 0%; GRADE, low), and the need for assisted ventilation (RR, 5.82; 95% CI, 1.81-18.69; I2 = 84%; GRADE, low). Children with Down syndrome without congenital heart disease (RR, 6.31; 95% CI, 4.83-8.23; GRADE, moderate) also had a significantly higher risk of RSV-related hospitalization. The risk of RSV-related hospitalization remained significant in the subgroup of children aged <1 year (RR, 6.25; 95% CI, 4.71-8.28; GRADE, high). CONCLUSION: RSV-related hospitalization, hospital LOS, and the need for assisted ventilation are significantly higher in children with Down syndrome aged <2 years compared with those without Down syndrome. The results should prompt reconsideration of the need for routine RSV prophylaxis in children with Down syndrome up to 2 years of age.

Usefulness of Non-Invasive Fetal RHD Genotyping towards Immunoprophylaxis Optimization.

Introduction: Since anti-D immunoprophylaxis given to D-negative pregnant women is a blood product, blood donations have an impact on the availability of prophylactic doses. The Pan American Health Organization reported, in June 2017, that less than half of blood donors are volunteers in Latin America and the Caribbean. In these countries, guidelines for use of anti-D prophylaxis are still controversial. The aim of this study was to demonstrate the convenience of a simple and cost-effectivene non-invasive prenatal diagnostic assay for anti-D prophylaxis optimization in multiethnic populations. Methods: Cell-free fetal DNA from plasma samples of D-negative pregnant women were analyzed by real-time PCR for simultaneous amplification of sequences of exons 5 and 10 of the RHD gene. Fetal RHD genotype was determined in 111 pregnant women. Neonates' phenotype was determined 72 h after birth. Results: Genotyping predicted fetal phenotype with 100% accuracy. Prenatal diagnosis showed 78% RHD-positive and 22% RHD-negative neonates. Conclusion: We demonstrated that, beyond the large genetic variation of the Rh system and the numerous D variants present in multiethnic groups, non-invasive fetal RHD genotyping using two sequences of the gene can be enough for clinical application in an admixed population. This robust technique of simple implementation allows to determine fetal RHD in maternal blood with high sensitivity, specificity, and accuracy. The introduction of fetal RhD genotyping as part of an antenatal screening program constitutes a reliable manner to optimize anti-D prophylaxis; however, it has not been implemented so far in most American countries.

¿Es necesario inyectar inmunoglobulina (Ig anti-HB) como profilaxis en los contactos sexuales de pacientes con Hepatitis B?: síntesis rápida de evidencia / Is it necessary to inject immune globulin (Anti-HBc igg) as prophylaxis in sexual contacts of patients with Hepatitis B?: rapid evidence synthesis

ANTECEDENTES Y OBJETIVO Aproximadamente 240 millones de personas a nivel mundial están infectadas con Hepatitis B, mientras que más de 780 mil mueren cada año a causa de alguna complicación producto de esta enfermedad. En términos de vigilancia epidemiológica, al ser ésta una Enfermedad de Notificación Obligatoria (ENO), cada vez que se reporta un caso, se deben considerar medidas de profilaxis para los contactos que puedan contraer la enfermedad. De esta forma, recién nacidos de madres con Hepatitis B son vacunados, además de recibir Inmunoglobulina anti-Hepatitis B (Ig anti-HB), para prevenir la transmisión vertical de esta enfermedad, lo cual está incorporado en la guía clínica actual de tratamiento En este contexto en Departamento de Epidemiología solicita esta síntesis con el objetivo de conocer el efecto de aplicar Inmunoglobulina anti-Hepatitis B (Ig anti-HB) a contactos sexuales, de manera de evaluar su incorporación en la actualización de la circular de vigilancia epidemiológica para esta condición. METODOLOGÍA Se formuló una estrategia de búsqueda para ser utilizada en 10 bases de datos con el objetivo de identificar revisiones sistemáticas del tema. Al no encontrarse, se procedió a buscar estudios primarios que abordaran la pregunta estudiada. Se excluyeron los casos que consideraban exposiciones del personal de salud, transmisión vertical e inmunosupresión. Consultando al solicitante, se decidió excluir cualquier tipo de transmisión no sexual. RESULTADOS -La evidencia encontrada muestra que la Ig anti-HB no genera diferencia sobre el número de casos con HBsAg+, en comparación a Ig no específica. -La evidencia encontrada muestra que la Ig anti-HB no genera diferencia sobre el número de casos con anti-HBc+, en comparación a Ig no específica. -La evidencia encontrada muestra que la Ig anti-HB, en comparación a Ig no específica, reduce levemente el número de casos clínicos de Hepatitis B. -La calidad de la evidencia es incierta, puesto que este resumen no realiza una evaluación de ésta. -Se han notificado más de 5 000 casos de Hepatitis B entre 2001 y 2012, más del 80% en población masculina.

Estudo da soroprevalência do AgHBs em gestantes da 15ª Regional de Saúde e da imunoprofilaxia para os recém-nascidos das gestantes AgHBs positivo / Study into the HBsAg seroprevalence in pregnant women from the 15th Health Regional and the immunoprophylaxia on the newborns of these HBsAg-positive women

Determinar a prevalência do AgHBs nas gestantes da 15ª Regional de Saúde (15ª R.S.) atendidas no Laboratório de Ensino e Pesquisa em Análises Clínicas (Lepac), Universidade Estadual de Maringá, e verificar se foi solicitada a imunoprofilaxia para hepatite B aos recém-natos das gestantes AgHBs positivo, no período de janeiro de 1998 a dezembro de 2002. A pesquisa do AgHBs foi realizada pela técnica imunoenzimática IMxHBsAg e Axsym HBsAg (Laboratório Abbott). As solicitações de imunobiológicos especiais para a imunoprofilaxia da hepatite B ao CRIE foram obtidas na Seção de Epidemiologia da 15ª R.S. Foram analisadas 12.274 gestantes e a prevalência do AgHBs foi de 1,0%. Dentre as 125 gestantes AgHBs positivo, foram solicitadas imunoprofilaxia para 32 (25,6%) recém-nascidos. Ainda que a prevalência encontrada indique ser esta uma área de baixa endemicidade, os resultados reafirmam a importância da realização do diagnóstico da hepatite B no atendimento pré-natal, para adoção da imunoprofilaxia no recém-nascido.

To determine HBsAg prevalence among pregnant women from the 15th Health Regional assisted in the Laboratório de Ensino e Pesquisa em Análises Clínicas (Lepac), Universidade Estadual de Maringá, and verify whether immunoprophylaxis with vaccine and immunoglobulin was requested for the newborns of HBsAg-positive women during the period from January 1998 to December 2002. The research about HBsAg was conducted using the immunoenzymatic IMxHBsAg (Abbot Lab) and Axsym HBsAg (Abbot Lab) techniques. The requests to the CRIE for special immunobiologic agents for Hepatitis B immunoprophylaxis were obtained in the Department of Epidemiology from the 15th Health Regional. The analysis includes 12,274 pregnant women, and the HBsAg prevalence was 1.0%. Among 125 HBsAg positive pregnant women, immunoprophylaxis was requested for 32 (25.6%) newborns. Although the prevalence detected demonstrates this to be a low endemic area, the results evidence the importance of conducting the hepatitis B diagnostic during prenatal assistance, in order to perform immunoprophylaxis on the newborns.