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1.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(9): 1537-1545, 2021 Sep 10.
Artículo en Chino | MEDLINE | ID: mdl-34814581

RESUMEN

Objective: To make a cost-benefit analysis of the hepatitis B vaccination (HepB) to prevent mother-to-child transmission (PMTCT) strategies in China, 1992-2019. Methods: We built a decision analytic-Markov model to estimate the birth cohorts of 1992-2019. The parameters in our model were referred from literature, published yearbooks, and data from Chinese Center for Disease Control and Prevention. We conducted a univariate sensitivity analysis to test the robustness of the model. Results: For the 28 birth cohorts, the Chinese government has invested 37.43 billion RMB Yuan in direct costs and 47.61 billion RMB Yuan in societal costs on HepB vaccination and HBV prevention of mother to child transmission (PMTCT). And we estimated that about 50 million chronic HBV infections and 12.5 million premature deaths due to HBV-related diseases would be averted. China would save 2.89 trillion RMB Yuan and 6.92 trillion RMB Yuan for the direct and societal medical burden on HBV-related conditions. The direct and societal net benefit was 2.85 trillion RMB yuan 6.87 trillion RMB yuan, respectively. The direct and societal benefit-cost ratios (BCRs) were 77.21 and 145.29, respectively. Conclusion: The strategies of HepB vaccination for HBV PMTCT prevention were cost-effective in China during 1992-2019.


Asunto(s)
Hepatitis B , Transmisión Vertical de Enfermedad Infecciosa , China/epidemiología , Análisis Costo-Beneficio , Femenino , Hepatitis B/prevención & control , Vacunas contra Hepatitis B , Humanos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Vacunación
2.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(9): 1546-1552, 2021 Sep 10.
Artículo en Chino | MEDLINE | ID: mdl-34814582

RESUMEN

Objective: To evaluate the persistence of HBsAg-specific antibodies eight years after revaccination with hepatitis B vaccine (HepB) among adults who were non-responsive to primary immunization. Methods: From August to September 2009, rural communities in Zhangqiu district of Ji'nan city were selected as the study site. The subject's inclusion criteria were 18 to 49 years old, local resident population, without HBV infection history and HepB vaccination history, and good health status. Antibodies against hepatitis B surface antigen (anti-HBs) were detected in adults following the standard primary vaccination. Those who were non-responders (anti-HBs titer <10 mIU/ml) were revaccinated with three doses of HepB and included in the study. Blood samples were collected from all of them at one month (T1), two years, four years, and eight years after revaccination. The three indexes of anti-HBs, hepatitis B surface antigen (HBsAg), together with antibody against hepatitis B core antigen (anti-HBc), were measured by chemiluminescence microparticle immunoassay (CMIA). Results: The proportion of subjects with anti-HBs titers ≥10 mIU/ml was 85.12% (549/645) at T1, 60.60% (283/467) at two years, 55.90% (199/356) at four years and 55.09% (222/403) at eight years after revaccination. The first two years' annual decline rates, three to four years and five to eight years, were 15.62%, 3.96%, and 0.36%. The GMC of anti-HBs was 153.92 mIU/ml at T1, 21.43 mIU/ml at two years, 15.02 mIU/ml at four years, and 13.68 mIU/ml at eight years. In the first two years, three to four years and five to eight years, the annual decline rate of GMC was 62.69%,16.28%, and 2.31%, respectively. Multivariable analysis showed that the titer of anti-HBs at T1 was independently associated with the persistence of anti-HBs at eight years after revaccination. Compared with anti-HBs titer <100 mIU/ml , those whose anti-HBs titers were 100-mIU/ml and ≥1 000 mIU/ml at T1 had a higher positive rate of anti-HBs (OR=14.13, P<0.001; OR= 62.91, P<0.001) and a higher probability of anti-HBs titer (ß=1.88, P<0.001; ß=3.24, P<0.001) at 8 years after revaccination. Nobody was found seroconversion of HBsAg, and the anti-HBc positive rate was 14.14% (57/403). Conclusions: Following revaccination with three doses of HepB in adults who were non-responsive to primary immunization, anti-HBs titers declined rapidly within the first four years. They then maintained a stable level after the fifth year. More than half still kept anti-HBs protective titer at eight years after revaccination. The immunity persistence was associated with anti-HBs titer at one month after revaccination.


Asunto(s)
Vacunas contra Hepatitis B , Hepatitis B , Adolescente , Adulto , Estudios de Seguimiento , Hepatitis B/prevención & control , Anticuerpos contra la Hepatitis B , Humanos , Inmunización Secundaria , Persona de Mediana Edad , Adulto Joven
3.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(9): 1559-1565, 2021 Sep 10.
Artículo en Chino | MEDLINE | ID: mdl-34814584

RESUMEN

Objective: To explore the immunogenicity and persistence of hepatitis B vaccine in HIV-infected patients with different CD4+T cell (CD4) levels, and analyze the influence effect of CD4 levels on immunization response. Methods: A total of 182 HIV-infected patients who participated in a randomized controlled trial of 20 µg and 60 µg hepatitis B vaccination at month 0, 1, and 6 in 2014 by Guangxi Zhuang Atonomous Region CDC and Ningming county CDC were surveyed. Six months later after the first dose and 1 month, 6 months, 1 year, and 3 years later after the full course of the vaccination, 5 ml of the venous blood of the patients was collected, and the anti-HBs was detected by Chemiluminescent Microparticle Immunoassay (CMIA). On the basis of previous studies, this study focused on analyzing the immunogenicity and persistence of hepatitis B vaccine under different CD4 levels. Results: One month later after the whole course of hepatitis B vaccination, the anti-HBs geometric mean concentration (GMC), anti-HBs positive rate (≥10 mIU/ml) and strong positive rate (≥100 mIU/ml) in HIV patients with CD4 <350 cells/µl were 442.50 mIU/ml, 71.05% (27/38) and 44.74% (17/38), respectively, which were significantly lower than those HIV-infected patients with CD4 ≥350 cells/µl [583.90 mIU/ml, 92.13% (117/127) and 77.95% (99/127)] (P<0.05). After controlling the confounding factors, the probability of being anti-HBs positive induced by hepatitis B vaccine in patients with CD4 <350 cells/µl was 0.14 times higher than in those with CD4≥350 cells/µl (95%CI: 0.03-0.62), and patients with CD4 <350 cells/µl had higher risk of no response. From 6 months to 3 years after the whole course of the vaccination, the anti-HBs GMC (195.00-27.55 mIU/ml vs. 300.10-45.81 mIU/ml), the positive rate (56.67%-36.67% vs. 78.57%- 51.58%) and the strong positive rate (33.33%-6.67% vs.44.64%-15.79%) in patients with CD4 <350 cells/µl gradually declined, lower than the levels in those with CD4 ≥350 cells/µl. Conclusions: HIV-infected patients with CD4 <350 cells/µl have high risk of no response to hepatitis B vaccination and poor immune persistence. It is necessary to strengthen the anti-HBs monitoring in HIV-infected patients, with special attention to those with CD4 <350 cells/µl. When anti-HBs is negative, hepatitis B vaccine should be injected as early as possible.


Asunto(s)
Infecciones por VIH , Hepatitis B , Animales , Células CHO , China , Cricetinae , Cricetulus , Estudios de Seguimiento , Hepatitis B/prevención & control , Antígenos de Superficie de la Hepatitis B , Vacunas contra Hepatitis B , Humanos , Inmunización Secundaria , Encuestas y Cuestionarios , Linfocitos T , Vacunación
4.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(9): 1566-1572, 2021 Sep 10.
Artículo en Chino | MEDLINE | ID: mdl-34814585

RESUMEN

Objective: To compare the anti-HBs level in maintained hemodialysis patients one year after receiving 20 µg and 60 µg hepatitis B vaccination at 0, 1 and 6 months, and explore the influence factors for the immunity persistence and their interactions. Methods: Based on a randomized controlled trial of 20 µg and 60 µg hepatitis B vaccine immunization in maintained hemodialysis patients at 0, 1, and 6 months, follow up was conducted for the patients for one year after the completion of the vaccination for the quantitative detection of anti-HBs, and χ2 test, t test, unconditional logistic regression and interaction analyses were used for statistical analysis. Results: One year after the vaccination, 125 and 124 patients in the 20 µg and 60 µg groups were tested for anti-HBs, respectively. The positive rate of anti-HBs in the 60 µg group (77.42%, 96/124) was significantly higher than that in the 20 µg group (65.60%, 82/125) (P<0.05). After adjusting for the confounding factors, the positive probability of anti-HBs in the 60 µg group was 1.925 times higher than that in the 20 µg group (95%CI: 1.068-3.468). Patients with hemodialysis duration ≥5 years (OR=0.523, 95%CI: 0.293-0.935) and diabetes mellitus (OR=0.376, 95%CI: 0.173-0.818) had lower positive probability of anti-HBs. Moreover, there were additive and multiplicative interactions between hemodialysis duration ≥5 years and diabetes mellitus. Conclusions: The immunity persistence after one year in 60 µg hepatitis B vaccination group was longer than that in 20 µg hepatitis B vaccination group in maintained hemodialysis patients, vaccine dose, hemodialysis duration and diabetes mellitus were the influencing factors for the immunity persistence, there were additive and multiplicative interactions between hemodialysis duration ≥5 years and diabetes mellitus.


Asunto(s)
Vacunas contra Hepatitis B , Hepatitis B , Estudios de Seguimiento , Hepatitis B/prevención & control , Anticuerpos contra la Hepatitis B , Antígenos de Superficie de la Hepatitis B , Humanos , Diálisis Renal , Factores de Riesgo , Vacunación
5.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(11): 2066-2070, 2021 Nov 10.
Artículo en Chino | MEDLINE | ID: mdl-34818856

RESUMEN

Hepatitis B virus (HBV) can cause a variety of hepatitis B-related diseases in infected people, and there is no specific drug for treatment. China, with a large population base, is the country with the heaviest burden of HBV infection in the world. Therefore, hepatitis B vaccination is particularly important in the prevention and control of this disease. However, some vaccinees did not produce effective protective immune response after vaccination according to the recommended hepatitis B vaccine immunization schedule. The purpose of this review is to analyze the influential factors of non/low immune response after hepatitis B vaccination from the aspects of organism and vaccine, and explore the mechanism of non/low immune response, so as to provide scientific basis for the prevention and treatment of hepatitis B in China.


Asunto(s)
Vacunas contra Hepatitis B , Hepatitis B , Hepatitis B/prevención & control , Anticuerpos contra la Hepatitis B , Virus de la Hepatitis B , Humanos , Inmunidad , Vacunación
6.
Clin Liver Dis ; 25(4): 859-874, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34593158

RESUMEN

Owing to standard precautions and initiatives for universal hepatitis B virus (HBV) vaccination in the general population and health care workers, risk of transmission of HBV infection from the patient to a health care worker (and vice versa) is very low. The need for mandatory HBV screening and vaccination in health care workers is less clear than in the past. Health care workers with chronic HBV infection neither require restrictions on professional practice nor disclosure of infection status to a patient. Further study is required to develop effective revaccination strategies to manage health care workers who are vaccine nonresponders.


Asunto(s)
Hepatitis B , Personal de Salud , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Anticuerpos contra la Hepatitis B , Vacunas contra Hepatitis B , Virus de la Hepatitis B , Humanos
7.
Vaccine ; 39(44): 6529-6534, 2021 10 22.
Artículo en Inglés | MEDLINE | ID: mdl-34600748

RESUMEN

BACKGROUND: As people living with HIV (PLWH) are at risk for contracting Hepatitis B Virus (HBV), they should be screened for HBV and vaccinated if not immune. Seroconversion rates in PLWH receiving traditional recombinant HBV vaccines (Engerix-B® and Recombivax-HB®) have historically been low with at most 70% achieving immunity. In 2017, a recombinant, adjuvanted HBV vaccine (Heplisav-B®) was approved for use in HIV-negative patients. Heplisav-B® has shown superior seroprotection in this population compared to Engerix-B® and Recombivax-HB®, as well as interim analysis showing higher seropositivity rates in patients undergoing dialysis. However, its efficacy in PLWH is currently unknown. This study evaluates the rate of seroconversion following Heplisav-B® administration in PLWH with previous HBV vaccination failure. METHODS: Retrospective, cross-sectional study at The Brooklyn Hospital Center's HIV primary care clinic in Brooklyn, NY. HIV-positive adults who received at least two doses of Heplisav-B® and had previously failed to seroconvert after vaccination with Engerix-B® or Recombivax-HB® were included. The primary outcome is the percentage of PLWH who became seropositive following Heplisav-B®. RESULTS: A total of 67 patients met the inclusion criteria. Twenty-five (37.3%) PLWH had failed at least 2 courses of recombinant vaccines. Fifty-eight (86.6%) PLWH became seropositive (Anti-HBs > 10 mIU/mL) at least two months after completing Heplisav-B®. For the 9 (13.4%) patients that did not develop immunity, 3 (33%) had a detectable HIV RNA and 3 (33%) had a CD4 count < 200 cells/uL3. CONCLUSIONS: Heplisav-B® was highly effective in achieving immunity to HBV in PLWH who failed non-adjuvanted recombinant vaccines.


Asunto(s)
Infecciones por VIH , Hepatitis B , Estudios Transversales , Hepatitis B/prevención & control , Vacunas contra Hepatitis B/uso terapéutico , Humanos , Estudios Retrospectivos
8.
Vaccine ; 39(44): 6477-6484, 2021 10 22.
Artículo en Inglés | MEDLINE | ID: mdl-34607747

RESUMEN

BACKGROUND: Expanded programs on immunization (EPIs) are country-specific vaccine programs designed and implemented to prevent childhood diseases globally, including in Thailand. Hill tribe children in Thailand live in remote areas with underdeveloped education systems and low economic status. This study aimed to assess serocoverage under the EPI and access to vaccination clinics. METHODS: A cross-sectional study was performed to assess serocoverage after childhood vaccination among hill tribe children who lived in 34 selected villages in Chiang Rai Province, Thailand. A validated questionnaire was administered, and 3-mL blood specimens were collected. Antibodies against hepatitis B surface antigen (anti-HBs), hepatitis B core antigen (anti-HBc), measles, Japanese encephalitis virus (JEV), and tetanus were detected. Chi-square tests were performed to detect the different proportion of patients with antibodies with different characteristics. RESULTS: Half of the hill tribe children aged 1-18 years did not have medical evidence (logbook) of immunization. More than 98.0% of the children who had medical evidence received the recommended immunizations. Only half of the children had anti-HBs (51.1%), and 22.3% had antibodies against JEV. The majority were found to be positive for antibodies against measles (83.3%) and tetanus (91.4%). Sex (p-value = 0.028), tribe (p-value < 0.001), age (p-value < 0.001), and parents' monthly income (p-value = 0.008) were associated with a lack of medical evidence. CONCLUSIONS: Existing immunization programs for hill tribe children in Thailand should be urgently evaluated and monitored for effectiveness.


Asunto(s)
Vacunas contra Hepatitis B , Hepatitis B , Niño , Estudios Transversales , Humanos , Inmunización , Programas de Inmunización , Tailandia
9.
BMJ Open Qual ; 10(4)2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34607903

RESUMEN

Administration of the birth dose of hepatitis B vaccine is an important step in reducing perinatally acquired hepatitis B infection, yet the USA is below the Healthy People 2020 goal for rate of administration.In response to updated Advisory Committee on Immunisation Practices recommendations to administer the dose within 24 hours of birth, we used quality improvement methodology to implement changes that would increase the vaccination rates of healthy newborns in our nurseries. The goal was to improve the proportion of infants who receive the hepatitis B vaccine within 24 hours of birth to >90% within a 2-year period, with a secondary goal of increasing vaccination rates prior to discharge from the nursery to >95%.Multiple Plan-Do-Study-Act (PDSA) cycles were performed. Initial cycles focused on increasing nurse and provider awareness of the updated timing recommendations. Later cycles targeted nursing workflow to facilitate timely administration of the vaccine. We implemented changes at our university medical centre and community hospital newborn nurseries.At the university medical centre nursery, both primary and secondary goals were met; the rate of hepatitis B vaccine administration within 24 hours increased from 81.7% to 96.2%, with vaccine administration prior to discharge increasing from 93.4% to 97.9%. In the community hospital nursery, the baseline rate of hepatitis B vaccine administration within 24 hours was 78.1%, and this increased to 85.8% with the interventions, falling short of the target of >90%. Vaccine administration prior to discharge increased from 87.2% to 92.0%, also not meeting the secondary target of 95%.Interventions that facilitated workflow had additional benefit beyond education alone to improve timing and rates of hepatitis B vaccine administration in both a university medical centre and community hospital nursery.


Asunto(s)
Hepatitis B , Casas Cuna , Hepatitis B/prevención & control , Vacunas contra Hepatitis B , Humanos , Lactante , Recién Nacido , Salas Cuna en Hospital , Vacunación
10.
BMC Public Health ; 21(1): 1831, 2021 10 09.
Artículo en Inglés | MEDLINE | ID: mdl-34627173

RESUMEN

BACKGROUND: In July 1984, Taiwan officially began a nationwide hepatitis B virus (HBV) vaccination program where only infants born to HBsAg-positive mothers were vaccinated free of charge until June 1986. However, from July 1986, all infants were vaccinated against HBV. The impact of the July 1986 HBV vaccination program on first-time blood donors has not been exhaustively studied. We, therefore, determined the risk of HBV among male and female first-time blood donors born before and after the July 1986 HBV vaccination program in Taiwan. METHODS: Initially, we recruited 857,310 first-time blood donors whose data were collected between 2013 and 2018 from 5 blood donation centers in Taiwan. However, we excluded donors with incomplete and outlying data (n = 12,213) and those born between July 1984 and June 1986 (n = 21,054). The final study participants comprised 9118 HBV positive and 814,925 HBV negative individuals. We divided the participants into two birth cohorts (born before and after July 1986) and assumed that those born before July 1986 were not vaccinated at birth while those born after July 1986 were vaccinated. RESULTS: The prevalence of HBV among those born before and after July 1986 was 4.53 and 0.25%, respectively. Individuals born after July 1986 had a lower risk of HBV than those born before July 1986. The adjusted odds ratio (OR), 95% confidence interval (CI) was 0.16, 0.13-0.19. Men had a higher risk of HBV than women (OR = 1.40, 95% CI = 1.34-1.47). The interaction between sex and birth date was significant (p-value = 0.0067). Stratification of participants by birth date revealed a higher risk of HBV in men compared to women in both birth cohorts. The OR, 95% CI was 1.47, 1.40-1.55 for those born before July 1986 but declined to 1.15, 1.02-1.29 for those born after July 1986. CONCLUSIONS: The risk of HBV was lower among those born after than those born before the July 1986 vaccination program. In both cohorts, the risk was high in men relative to women. The seemingly protective effect among those born after July 1986 was higher in women than men.


Asunto(s)
Virus de la Hepatitis B , Hepatitis B , Donantes de Sangre , Femenino , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Antígenos de Superficie de la Hepatitis B , Vacunas contra Hepatitis B , Humanos , Lactante , Recién Nacido , Masculino , Taiwán/epidemiología , Vacunación
11.
Rev Chilena Infectol ; 38(3): 401-409, 2021 Jun.
Artículo en Español | MEDLINE | ID: mdl-34479298

RESUMEN

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.


Asunto(s)
Hepatitis B , Complicaciones Infecciosas del Embarazo , Antivirales/uso terapéutico , Chile , Femenino , Hepatitis B/diagnóstico , Hepatitis B/prevención & control , Antígenos de Superficie de la Hepatitis B , Vacunas contra Hepatitis B , Virus de la Hepatitis B , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Complicaciones Infecciosas del Embarazo/prevención & control
12.
Zhonghua Gan Zang Bing Za Zhi ; 29(8): 725-731, 2021 Aug 20.
Artículo en Chino | MEDLINE | ID: mdl-34517450

RESUMEN

China has the highest disease burden of viral hepatitis. After understanding the epidemic characteristics of viral hepatitis in China and putting forward scientific prevention and control strategies, the Chinese government has been effectively practicing the policy of "prevention first with combination of prevention and control". Over the past 40 years, China has taken effective measures to promote vaccination, strengthen blood screening, standardize diagnosis and treatment services and strengthen supervision, and achieved remarkable success. The incidence of hepatitis A decreased from 52.6 per 100,000 in 1990 to 1.38 per 100,000 in 2019, the HBsAg prevalence among children under 5 years of age decreased from 9.67% in 1992 to 0.32% in 2014, and the cure rate of chronic hepatitis C patients has reached more than 95%. The incidence of hepatitis E is also on the decline. However, in 2019, the estimated diagnosis rate for hepatitis B patients is 25% and treatment rate is 17%; hepatitis C diagnosed rate is 30% and only 9% of the diagnosed were treated. This still falls far from the target of 90% diagnosis rate and 80% treatment rate by 2030. Relevant policies should be implemented as soon as possible, health promotion should be carried out, and screening and diagnosis and treatment services should be strengthened to promote timely treatment for more chronically infected people.


Asunto(s)
Hepatitis B , Hepatitis C , Hepatitis Viral Humana , Niño , Preescolar , China/epidemiología , Antígenos de Superficie de la Hepatitis B , Vacunas contra Hepatitis B , Hepatitis Viral Humana/diagnóstico , Hepatitis Viral Humana/epidemiología , Hepatitis Viral Humana/prevención & control , Humanos
14.
Value Health Reg Issues ; 26: 150-159, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34474265

RESUMEN

OBJECTIVES: To evaluate cost implications of a hexavalent vaccine (diphtheria, tetanus, and acellular pertussis [DTaP]-inactivated polio vaccine [IPV]-hepatitis B [HB]-Haemophilus influenzae type B [Hib] polysaccharide conjugated to T protein [PRP∼T]) as an alternative to DT-whole-cell pertussis (wP)-HB//Hib, DTwP, IPV, and oral polio vaccines in the Expanded Program on Immunization schedule in Colombia. METHODS: Primary vaccination (DTaP-IPV-HB-PRP∼T or DTwP-HB-Hib + IPV [2, 4, 6 months]) and booster (DTaP-IPV-HB-PRP∼T or DTwP + oral polio vaccine [18 months]) (scenario 1) and primary vaccination only (DTaP-IPV-HB-PRP∼T or DTwP-HB-Hib + IPV) (scenario 2) were evaluated. An estimated cost-minimization analysis was based on a micro costing technique for vaccination-associated activities. Adverse event (AE)-associated costs, out-of-pocket costs, and productivity losses for caregivers were included. A budget impact (12-month temporal horizon) was estimated according to the distribution of full-term and premature infants. A 5% annual discount rate was used. A 2-way univariate (tornado) analysis evaluated which variables had the greatest impact on the overall cost. RESULTS: DTaP-IPV-HB-PRP∼T resulted in a cost increase of 29.38% (scenario 1) and 22.19% (scenario 2) for full-term infants and a decrease of 0.99% (scenario 1) and 18.88% (scenario 2) for premature infants, probably because of the higher incidence of wP-related AEs and associated costs in premature infants. With a 100% replacement rate, the budget impact for full-term infants and full-term plus premature infants was 23.73% and 21.80% (scenario 1), respectively, and 13.02% and 11.14% (scenario 2), respectively, of the national immunization program budget. The variables with most impact were the hexavalent vaccine price and costs associated with the pentavalent safety profile. CONCLUSIONS: Incorporation of the hexavalent vaccine in the Expanded Program on Immunization schedule would lead to an increase in spending largely mitigated by reduced AE incidence and reduced logistic and social costs.


Asunto(s)
Programas de Inmunización , Colombia , Vacuna contra Difteria, Tétanos y Tos Ferina , Vacunas contra Haemophilus , Vacunas contra Hepatitis B , Humanos , Inmunización Secundaria , Lactante , Vacuna Antipolio de Virus Inactivados , Vacunas Combinadas
15.
Vaccine ; 39(43): 6385-6390, 2021 10 15.
Artículo en Inglés | MEDLINE | ID: mdl-34561142

RESUMEN

Worldwide Hepatitis B is known as one of the imperative causes of mortality and morbidity as well as occupational health hazard among health workers. Bangladesh is intermediate endemic country for Hepatitis B infection for which the government has introduced hepatitis B vaccination into the Expanded Programme on Immunization (EPI) nationwide since 2009 for new born children. However, the people who were born before 2009, was dependent on imported hepatitis B vaccine as there was no locally manufactured hepatitis B vaccine in Bangladesh. Hence, we conducted a randomized observer blinded non-inferiority clinical trial to assess the immunogenicity and safety of the locally manufactured Hepa-B vaccine in comparison with World Health Organization prequalified Engerix-B vaccine. Total 158 eligible adult participants were enrolled in this study with mean age of 30 and 29 years old in Hepa-B and Engerix-B groups, respectively. Both the vaccines were administered intramuscularly at 0, 1 and 6 months schedule. Baseline and post vaccination anti-HBs titers were measure at different time points. Seroconversion rate post three doses of Hepa-B vaccine was 98.67% similar to the comparator Engerix-B vaccine which was 100%. The geometric mean test ratios of both vaccines at all analysis time points were found > 0.5 predefined non-inferiority margin. Soreness at the injection site was the most common symptom for both the vaccines which resolved without any complication. No serious adverse event was reported throughout the study period. These results suggest that locally manufactured hepatitis B vaccine 'Hepa-B' vaccine is non-inferior to the well-known licensed 'Engerix-B' vaccine. ClinicalTrials.gov NCT03627507.


Asunto(s)
Vacunas contra Hepatitis B , Hepatitis B , Adulto , Bangladesh , Hepatitis B/prevención & control , Anticuerpos contra la Hepatitis B/sangre , Humanos , Vacunas Sintéticas
16.
Microb Pathog ; 160: 105184, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34508828

RESUMEN

Hepatitis B virus (HBV) infection is limited through vaccination against HBsAg formulated in the Alum adjuvant. However, this alum-formulated vaccine fails to be preventive in some cases, also known as non-responders. Recent studies have shown the immunomodulatory effect of α-tocopherol in various models. Here, we developed a new formulation for HBsAg using α-tocopherol, followed by assessment of immune responses. Experimental BALB/c mice were immunized with a commercial alum-based vaccine or the one formulated in α-tocopherol at different doses. Mice were immunized subcutaneously with 5 µg of HBsAg with different formulations three times with 2-week intervals. Specific total IgG, IgG1, and IgG2a isotypes of antibodies were measured by ELISA. Immunologic cytokines, such as IFN-γ, IL-4, IL-2, and TNF-α, were also evaluated through commercial ELISA kits. Our results showed that the new α-tocopherol-formulated vaccine had the ability to reinforce specific total IgG responses. Moreover, α-tocopherol in the HBsAg vaccine increased IFN-γ, IL-2, and TNF-α cytokines at higher concentrations; however, the vaccine suppressed IL-4 cytokine release. At a lower concentration of α-tocopherol, the IL-4 cytokine response increased without a positive effect on IFN-γ and TNF-α cytokine response. It seems that α-tocopherol can change the immune responses against HBsAg; however, the type of response depends on the dose of α-tocopherol used in the vaccine formulation.


Asunto(s)
Citocinas , Vacunas contra Hepatitis B , Interferón gamma/inmunología , Adyuvantes Inmunológicos , Animales , Citocinas/inmunología , Anticuerpos contra la Hepatitis B , Vacunas contra Hepatitis B/inmunología , Ratones , Ratones Endogámicos BALB C
17.
PLoS One ; 16(9): e0257621, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34547021

RESUMEN

BACKGROUND: Hepatitis B virus (HBV) infection is a significant global public health problem. Health care providers and medical students in developing countries including Ethiopia are at an increased risk of contracting HBV due to the high burden of this infection. The most effective way of prevention against HBV infection is vaccination of health care providers. However, there is a paucity of data on the HBV vaccination coverage among students of health science in Ethiopia. Therefore, this study aimed to determine HBV vaccination coverage and associated factors, level of knowledge, attitudes, and practices (KAP) towards HBV among students of medicine and health science at Wolkite University. MATERIALS AND METHODS: A cross-sectional study was conducted at Wolkite University among 417 study participants from November to December 2020. The study participants were recruited by using a simple random sampling technique. Data were collected using a self-administered structured questionnaire and analyzed using SPSS version 21. A binary logistic regression model was used to determine the factors associated with full-dose vaccination status. Statistical significance was set at P-value <0.05. RESULTS: Out of the 417 study participants, 5.8% (95%CI: 3.8-7.9) received a full-dose of the HBV vaccine in this study. Unavailability and high cost of the vaccine were frequently mentioned reasons for not being vaccinated against HBV. About 73.6%, 36.2%, and 47% of participants had good knowledge, positive attitudes, and good practices towards HBV, respectively. Being male gender (AOR: 8.8; 95%CI: 2.9-27), rural residence (AOR: 3.6; 95%CI:1.2-10.6), positive attitude (AOR: 0.44; 95%CI: 0.1-1.1), good practice (AOR: 0.17; 95%CI: 0.05-0.5), medicine department (AOR: 5.9; 95%CI: 1.2-29), being second-year student (AOR: 11.7; 95%CI: 2.7-50.9), third-year student (AOR: 19; 95%CI: 4.25-45), and fourth-year student (AOR: 27; 95%CI: 5.8-56) were significantly associated factors with full-dose vaccination status. CONCLUSION: Our study revealed that only small proportions (5.8%) of study participants received full-dose HBV vaccination. Vaccinations of students before starting clinical attachments, provisions of training for students on infection prevention mechanism and universal precautions particularly on HBV, increasing the uptake of the HBV vaccine, creating awareness on attitude and practice of students towards HBV to enhance uptake of the vaccine are recommended.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Estudiantes/psicología , Vacunación/estadística & datos numéricos , Adulto , Estudios Transversales , Etiopía , Femenino , Hepatitis B/prevención & control , Vacunas contra Hepatitis B/administración & dosificación , Humanos , Modelos Logísticos , Masculino , Oportunidad Relativa , Población Rural , Factores Sexuales , Encuestas y Cuestionarios , Universidades , Adulto Joven
19.
Artículo en Inglés | MEDLINE | ID: mdl-34360071

RESUMEN

Before the introduction of universal vaccination, hepatitis B caused high morbidity and mortality, especially among healthcare workers. In the present study, the immune status against hepatitis B was assessed in a cohort of 11,188 students of the degree courses of the School of Medicine of the University of Padua (Italy) who had been subjected to mandatory vaccination in childhood or adolescence and who will be future healthcare workers. The variables that influence the antibody response to vaccination are mainly the age at which the vaccine was administered and sex. If vaccination was administered before one year of age, there is a high probability (around 50%) of having an antibody titer lower than 10 IU/L compared to those vaccinated after one year of age (12.8%). The time between vaccine and analysis is not decisive. Furthermore, female sex, but only if vaccination was administered after one year of age, shows a significant (p = 0.0008) lower percentage of anti-HBs below 10 IU/L and a greater antibody titer (p < 0.0001). In conclusion, the differences related to the age of vaccination induce more doubts than answers. The only plausible hypothesis, in addition to the different immune responses (innate and adaptive), is the type of vaccine. This is not easy to verify because vaccination certificates rarely report it.


Asunto(s)
Vacunas contra Hepatitis B , Hepatitis B , Adolescente , Femenino , Personal de Salud , Hepatitis B/prevención & control , Anticuerpos contra la Hepatitis B , Humanos , Vacunación
20.
Zhonghua Gan Zang Bing Za Zhi ; 29(7): 631-635, 2021 Jul 20.
Artículo en Chino | MEDLINE | ID: mdl-34371533

RESUMEN

Chronic hepatitis B (CHB) causes approximately 30% cirrhosis and 53% liver cancer in the world, and is still a serious threat to human health. Treatment CHB through therapeutic vaccination has long been a urgent goal of the medical community. In the past two decades, various therapeutic vaccines have been developed and studied in clinical trials, however, few has achieved satisfactory results. Recently, a nanoparticle therapeutic vaccine for CHB, εPA-44, has entered pahse III clinical trial. Results of phase II trial for εPA-44 showed that the vaccine had good safety profile and achieved profound clinical benefits in patients with CHB. Here, we first introduce the rational of therapeutic vaccine for CHB and summarize the progress of clinical trials. Finally, we t review the phase II clinical trial data of εPA-44 and discuss the posssible impact to the development of next generation therapeutic vaccine for CHB.


Asunto(s)
Hepatitis B Crónica , Vacunas contra Hepatitis B , Virus de la Hepatitis B , Hepatitis B Crónica/terapia , Humanos , Vacunación
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