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3.
East Mediterr Health J ; 28(10): 768-775, 2022 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-36382732

RESUMEN

Background: The detection of hepatitis B surface antigen positivity in pregnant women before delivery is crucial to preventing mother-to-child transmission of hepatitis B virus. Aims: This study aimed to evaluate the status and rate of testing for hepatitis B surface antigen, rate of hepatitis B surface antigen positivity, hepatitis B surface antigen positivity distribution rate by age, and changes in hepatitis B surface antigen positivity rate in pregnant women over the study period. Methods: We conducted a multicentre, cross-sectional, descriptive study covering the period January 2005 to June 2019 for 2 145 668 pregnant women from 27 provinces in all 7 regions of Turkey, collected using Microsoft Excel before statistical analysis. Results: We found that 1 012 593 (47.1%) pregnant women were tested for hepatitis B surface antigen over the 15-year period, out of which 11 471 (1.1%) were hepatitis B surface antigen-positive. Overall, 97% of the hepatitis B surface antigen positive women were born before 1998, the year that national HBV vaccination was launched in Turkey. The rate of hepatitis B surface antigen positivity in that group was 1.1%, compared with 0.3% among women born after 1998. Conclusion: There was a downward trend in the hepatitis B surface antigen positivity rate among pregnant women in the younger age groups, especially among those born after universal hepatitis B vaccination was inaugurated, and low rate of HBsAg testing during pregnancy.


Asunto(s)
Hepatitis B , Complicaciones Infecciosas del Embarazo , Femenino , Embarazo , Humanos , Antígenos de Superficie de la Hepatitis B , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Hepatitis B/diagnóstico , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , Mujeres Embarazadas , Estudios Transversales , Turquia/epidemiología , Virus de la Hepatitis B , Vacunación , Vacunas contra Hepatitis B
4.
PLoS One ; 17(11): e0277473, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36355809

RESUMEN

The effect of vitamin D levels on the response to the hepatitis B vaccine in childhood and the induced levels of antibodies against the hepatitis B surface antigen (anti-HBs) is not yet well understood. The study aimed to investigate the relationship between age, serum 25-hydroxyvitamin D (25(OH)D) concentration and anti-HBs titer among children under 12 years old. Serum 25(OH)D concentration and anti-HBs titer were determined in 352 healthy Caucasian children with the average age of 4.2 (2.5; 6.3) years. All children were vaccinated with 3 doses of hepatitis B vaccine (Engerix-B, GlaxoSmithKline Pharmaceuticals Limited) in infancy according to the Centers for Disease Control and Prevention recommendations. Only 14.5% of children had an optimal concentration of 25(OH)D ≥ 30 ng/mL and 71.9% children had a seroprotective anti-HBs titer ≥ 10 mIU/mL. Significant negative correlations were found between 25(OH)D, anti-HBs titer and age (r = -0.420, p = 0.000; r = -0.425, p = 0.000, respectively), and a weak positive correlation between 25(OH)D concentration and anti-HBs titer (r = 0.243, p = 0.000). Analysis of six clusters of children demonstrated that age is the main factor affecting anti-HBs titer. One third of children under 12 years of age had nonprotective anti-HBs titer < 10 mIU/mL and around 40% had vitamin D deficiency. We conclude that vitamin D status has no impact on anti-HBs titer in children vaccinated against hepatitis B virus in infancy. Age, so time since the receipt of the last dose of hepatitis B vaccine, is the main factor influencing a decline in anti-HBs titer.


Asunto(s)
Vacunas contra Hepatitis B , Hepatitis B , Niño , Humanos , Preescolar , Antígenos de Superficie de la Hepatitis B , Inmunización Secundaria , Vacunación , Anticuerpos contra la Hepatitis B , Vitaminas , Vitamina D
5.
BMC Infect Dis ; 22(1): 863, 2022 Nov 18.
Artículo en Inglés | MEDLINE | ID: mdl-36401190

RESUMEN

BACKGROUND: The long-term protective effect of hepatitis B vaccine (HepB), the incidence of hepatitis B virus (HBV) vaccine breakthrough infections (VBIs), and whether a booster HepB is necessary remain to be clarified in children born to mothers with chronic HBV infection. METHODS: Based on a long-term follow-up prospective cohort of 1177 hepatitis B surface antigen (HBsAg)-positive mothers and their paired infants which was established from 2009 to 2011, total 454 children with immunoprophylaxis success as determined by postvaccination serologic testing (PVST) at 7 months old were included in this study. Among the 454 children, 246 never had a booster HepB, and 208 children received a booster HepB from 1 to 5 years of age. Multivariate logistic regression analysis was used to analyse the risk factors for HBV VBIs. RESULTS: The hepatitis B surface antibody (anti-HBs) levels declined sharply from 7 months to 2 years old, and the anti-HBs seronegative rate in the children increased significantly from 2 years old. A total of 31 (6.83%) of the 454 children experienced VBIs, of which 7 had overt and 7 had occult HBV infections. Notably, 14 (45.16%) of the 31 children with VBIs were diagnosed at 2 years old, and all of them had anti-HBs positivity (> 10 mIU/mL) at 1 year old. Maternal hepatitis B e antigen (HBeAg) positivity, higher HBV DNA and HBsAg levels, lower initial infant anti-HBs levels and not receiving a booster HepB were independent risk factors for VBIs. The incidence of VBIs was significantly lower in children with a booster HepB than in nonboosted children (0.50 vs. 11.90%, P < 0.001), and none of the boosted children developed overt or occult HBV infection. The anti-HBs levels of 76.67% for the children with VBIs in the nonboosted group indicated positivity before VBIs was detected. CONCLUSIONS: After the primary full immunization with HepB, children born to mothers with chronic HBV infection, especially the children with maternal HBeAg positivity, high HBV DNA levels, high HBsAg levels and/or low initial infant anti-HBs levels, were at a high risk of VBIs, and a booster HepB for these children before 2 years old, instead of when their anti-HBs level is < 10 mIU/mL, could reduce the incidence of VBIs.


Asunto(s)
Vacunas contra Hepatitis B , Hepatitis B Crónica , Humanos , Niño , Lactante , Preescolar , Antígenos de Superficie de la Hepatitis B , Antígenos e de la Hepatitis B , ADN Viral , Estudios Prospectivos , Anticuerpos contra la Hepatitis B , Hepatitis B Crónica/epidemiología , Hepatitis B Crónica/prevención & control , Hepatitis B Crónica/tratamiento farmacológico , Complicaciones Posoperatorias/tratamiento farmacológico
6.
BMJ Open ; 12(11): e063482, 2022 11 08.
Artículo en Inglés | MEDLINE | ID: mdl-36351715

RESUMEN

OBJECTIVES: Eliminating mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is central to WHO's target of reducing hepatitis B infection in children to <0.1% by 2030. While Nigeria accounts for 8.3% of the global burden, interventional studies on prevention of MTCT of HBV are hardly available. This study aimed to assess the impact of prevention of MTCT interventions on vertical transmission of HBV among pregnant women in Nigeria. DESIGN: A prospective cohort study. SETTING: A University Teaching Hospitals Complex in Nigeria between 2015 and 2021. PARTICIPANTS: 10 866 pregnant women and their pre-existing children. INTERVENTIONS: Eligible pregnant women were screened for HBsAg using chromatographic immunoassay (Micropoint, USA). HbsAg-positive women had HBV serological assay done and their pre-existing children were screened. Women with HBV DNA ≥2 00 000 IU/mL and those positive for hepatitis B e-antigen (HBeAg) had 300 mg/day of Tenofovir Disoproxil Fumarate (TDF) in the third trimester. The newborns had hepatitis B vaccines and HB immunoglobulin (HBIG) administered, followed by testing for HBsAg at 9 months postnatally. PRIMARY OUTCOME MEASURES: Prevalence of chronic hepatitis B infection in pregnancy, and the incidence of MTCT of HBV. RESULTS: Overall, 395 women had chronic HBV infection, giving a prevalence of 3.64%. Their mean age was 31.51±5.71 years, with a median parity of 1.2. Thirteen women (5.2%) were positive for HBeAg, seven (3.1%) of the 225 pre-existing hepatitis B-exposed children were HbsAg positive and 17 women had prenatal TDF. Overall, 376 women completed the study, with mean birth weight of 3.21±1.86 kg and perinatal mortality rate of 29.2/1000 births. Hepatitis Bvaccine-HBIG combination was administered to 260 newborns, while the others had hepatitis B vaccine alone. All the children tested negative to the HbsAg at 9 months. CONCLUSION: Eliminating MTCT of HBV infection through validated protocols in low and middle income countries with the highest burden of chronic HBV infections is feasible. National scale-up of such protocols is recommended.


Asunto(s)
Hepatitis B Crónica , Hepatitis B , Complicaciones Infecciosas del Embarazo , Lactante , Femenino , Recién Nacido , Embarazo , Humanos , Adulto , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Antígenos e de la Hepatitis B , Antígenos de Superficie de la Hepatitis B , Estudios Prospectivos , Estudios de Seguimiento , Nigeria/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , ADN Viral , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Virus de la Hepatitis B , Vacunas contra Hepatitis B/uso terapéutico , Hepatitis B Crónica/epidemiología , Hepatitis B Crónica/prevención & control , Tenofovir/uso terapéutico , Inmunoglobulinas/uso terapéutico
9.
Front Immunol ; 13: 1043375, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36426360

RESUMEN

A single birth-dose of Hepatitis B vaccine (HepB) can protect newborns from acquiring Hepatitis B infection through vertical transmission, though several follow-up doses are required to induce long-lived protection. In addition to stimulating antibodies, a birth-dose of HepB might also induce polyfunctional CD4+ T-cells, which may contribute to initial protection. We investigated whether vaccination with HepB in the first week of life induced detectable antigen-specific CD4+ T-cells after only a single dose and following completion of the entire HepB vaccine schedule (3 doses). Using HBsAg- stimulated peripheral blood mononuclear cells from 344 infants, we detected increased populations of antigen-specific polyfunctional CD154+IL-2+TNFα+ CD4+ T-cells following a single birth-dose of HepB in a proportion of infants. Frequencies of polyfunctional T-cells increased following the completion of the HepB schedule but increases in the proportion of responders as compared to following only one dose was marginal. Polyfunctional T-cells correlated positively with serum antibody titres following the birth dose (day30) and completion of the 3-dose primary HepB vaccine series (day 128). These data indicate that a single birth dose of HepB provides immune priming for both antigen-specific B- and T cells.


Asunto(s)
Vacunas contra Hepatitis B , Leucocitos Mononucleares , Lactante , Recién Nacido , Humanos , Linfocitos T Colaboradores-Inductores , Linfocitos T CD4-Positivos
10.
PLoS One ; 17(11): e0277186, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36331946

RESUMEN

This study aimed to assess the knowledge, practices, and beliefs among the Jordanian population regarding hepatitis B virus (HBV) infection. A cross-sectional questionnaire was designed and used to recruit participants from October 5th through December 12th. Statistical analysis was conducted using SPSS. Descriptive statistical analysis was used to analyse the sociodemographic data, the Shapiro-Wilk test was used to assess the normality, Cronbach's α was used to evaluate the reliability of the questionnaire and Point-biserial correlation was used to figure out whether there is an association between Score of knowledge and the dichotomous variables. A random sample of 432 participated in the study. The majority were females (n = 310, 71.8%), the mean age was 21 (42.0%) years,416 (96.3%) were urban inhabitants and most of them (n = 351, 81.3%) had bachelor's degree. School/university (n = 280, 64.8%) were reported as a major source of information followed by TV/internet/social media 276 (63.9%). The total mean (± SD) of knowledge score regarding HBV infection symptoms, transmission modes and treatment was found 12.28 ± 3.2. Participants' knowledge regarding symptoms including nausea, vomiting and loss of appetite was 73 (16.9%). More than 80% had good knowledge regarding the complications of HBV infection. Only 100 participant reported vaccination (23.1%) against the virus. Poor knowledge and low vaccination rate against HBV were found thus implementing comprehensive educational program for people highlighting the importance of vaccination against the virus is crucial.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Hepatitis B , Femenino , Humanos , Adulto Joven , Adulto , Masculino , Estudios Transversales , Jordania , Reproducibilidad de los Resultados , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Virus de la Hepatitis B , Vacunación , Encuestas y Cuestionarios , Vacunas contra Hepatitis B
12.
J Viral Hepat ; 29(12): 1115-1126, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36200313

RESUMEN

Adults at increased risk for hepatitis B virus (HBV) infection are recommended to receive vaccination. We conducted a cost utility analysis to evaluate approaches for implementing that recommendation in selected high-risk settings: community outreach events with a large proportion of immigrants, syringe service programs, substance use treatment centres, sexually transmitted infection (STI) clinics, tuberculosis (TB) clinics and jails. We utilized a decision tree framework with a Markov disease progression model to compare quality adjusted life-years and cost in 2021 United States dollars from four strategies: a 3-dose vaccination regimen with prevaccination screening and testing (PVST; baseline comparison); PVST at the initial encounter followed by a 2-dose series (Intervention 1); PVST with the first dose of a 2-dose vaccination series at the initial encounter (Intervention 2); and a 2-dose vaccination series without PVST (Intervention 3). In all settings, Intervention 1 resulted in worse health outcomes compared with the baseline strategy. Intervention 2 averted incident chronic HBV infections in all settings (range -9.4% in TB clinics, -14.8% in syringe service programs) and was a cost-saving approach in settings with higher risk of infection (i.e. jails, -$266 per person; syringe service programs, -$597; substance use treatment centres, -$130). Providing a 2-dose vaccination series without any screening (Intervention 3) averted incident HBV infections and was cost-saving in all settings but resulted in more HBV-related deaths in settings with higher HBV prevalence. These results demonstrate a 2-dose vaccine series is a cost-effective approach in these high-impact settings, even if prevaccination testing is not possible.


Asunto(s)
Vacunas contra Hepatitis B , Hepatitis B , Adulto , Humanos , Análisis Costo-Beneficio , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Hepatitis B/tratamiento farmacológico , Vacunación , Virus de la Hepatitis B
13.
Biomed Environ Sci ; 35(9): 792-803, 2022 Sep 20.
Artículo en Inglés | MEDLINE | ID: mdl-36189994

RESUMEN

Objective: This study aimed to investigate the effects of Montanide ISA-720 and Naloxone (NLX) in Hepatitis B surface antigen (HBsAg) vaccine formulation on cytokine and long-lasting antibody responses. Methods: First, the HBsAg was formulated in Montanide ISA-720 adjuvant and Naloxone at 5 and 10 mg/kg. The experimental mice were immunized three times at a 2-week interval, and then IL-4, IL-2, TNF-α, and IFN-γ cytokines; long-lasting IgG antibody responses 220 days after the last shot; and IgG1/IgG2a isotypes were assessed by ELISA. Results: The HBsAg-Alum group exhibited the highest IL-4 cytokine response among the experimental groups, whereas NLX in HBsAg-MON720 vaccine formulation did not affect cytokine responses. In addition, NLX in Alum-based vaccine suppressed IL-4 cytokine response and increased the IL-2/IL-4 cytokine ratio. Moreover, HBsAg-MON720 was more potent than HBsAg-Alum in the induction of antibody responses, and NLX in Alum- and MON720-based vaccines induced long-lasting antibody responses. Conclusion: NLX in Alum-based vaccine decreased IL-4 cytokine response, increased IL-2/IL-4 cytokine ratio, and improved long-lasting humoral immune responses in both vaccine formulations. Therefore, the adjuvant activity of NLX in the vaccine formulation depends on the type of adjuvant and the nature of the antigen in the vaccine formulation.


Asunto(s)
Antígenos de Superficie de la Hepatitis B , Inmunidad Humoral , Adyuvantes Inmunológicos/farmacología , Compuestos de Alumbre , Animales , Citocinas , Vacunas contra Hepatitis B , Inmunoglobulina G , Interleucina-2 , Interleucina-4 , Ratones , Ratones Endogámicos BALB C , Aceite Mineral , Naloxona/farmacología , Factor de Necrosis Tumoral alfa
14.
Infect Dis Poverty ; 11(1): 106, 2022 Oct 11.
Artículo en Inglés | MEDLINE | ID: mdl-36221140

RESUMEN

BACKGROUND: Elimination of hepatitis B virus (HBV) is a striking challenge for countries with high or moderate disease burden. Therefore, using China as a practical case to share experiences for similar countries may accelerate the achievement of the WHO 2030 target of 90% reduction in HBV-related incidence. We aim to evaluate the impact of national HBV immunization strategies in China; and the feasibility to achieve WHO 2030 targets under different scenarios. METHODS: We constructed an expanded Susceptible-Exposed-Infectious-Recovered (SEIR) model and decision tree-Markov model to estimate the epidemic of HBV in China, assess the feasibility of 2030 Elimination Goals through the projections and conduct the economic analysis. Least square method was used to calibrate the expanded SEIR model by yearly data of laboratory-confirmed HBV cases from 1990 to 2018. Two models were separately used to evaluate the impact and cost-effectiveness of HBV vaccine by comparing prevalence of chronic HBV infections, quality-adjusted life-years (QALYs), incremental cost effectiveness ratio and benefit-cost ratio (BCR) under various intervention options, providing a basis for exploring new containment strategies. RESULTS: Between 1990 and 2020, the number of chronic HBV infections decreased by 33.9%. The current status quo would lead to 55.73 million infections (3.95% prevalence) in 2030, compared to 90.63 million (6.42% prevalence) of the "Without the NIP" scenario (NIP: National Immunization Program), 114.78 million (8.13% prevalence) without any interventions. The prevention of mother to child transmission (PMTCT) strategy showed a net benefit as 12,283.50 dollars per person, with BCR as 12.66, which is higher than that of universal vaccination at 9.49. Compared with no screening and no vaccination, the PMTCT strategy could save 7726.03 dollars for each QALY increase. CONCLUSIONS: Our findings proved the HBV vaccination has demonstrated a substantial positive impact on controlling the epidemic of HBV in terms of effectiveness and economy after about 30 years of implementation of the national hepatitis B immunization program which also provided containment experience for high or medium burden countries. As for China, the next step should focus on exploring strategies to improve diagnosis and treatment coverage to reduce the burden of HBV-related deaths and ultimately eliminate HBV.


Asunto(s)
Vacunas contra Hepatitis B , Hepatitis B , Programas de Inmunización , China/epidemiología , Análisis Costo-Beneficio , Femenino , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Hepatitis B/transmisión , Vacunas contra Hepatitis B/administración & dosificación , Hepatitis B Crónica/epidemiología , Hepatitis B Crónica/prevención & control , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Embarazo , Evaluación de Programas y Proyectos de Salud
15.
Przegl Epidemiol ; 76(2): 243-254, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36218179

RESUMEN

OBJECTIVE: Aim of the study was the assessment of hepatitis B epidemiological situation in Poland in 2019 compared to previous years, taking into consideration the impact of the COVID-19 pandemic during that time. MATERIAL AND METHODS: Data for 2020 included in individual reports on hepatitis B and HBV infections recorded by sanitary and epidemiological stations at EpiBaza, i.e. in the electronic epidemiological surveillance system on infectious diseases, were analyzed. In the assessment of the epidemiological situation, data published in the annual bulletins: "Infectious diseases and poisonings in Poland in 2020" and "Vaccinations in Poland in 2020" were also used. Data on deaths were obtained from the Statistics Poland (GUS). RESULTS: In 2020, 2,854 cases of hepatitis B were reported, which corresponds to the incidence of 2.59 per 100,000 population, lower by 65.1% than in 2019. 14 cases of acute hepatitis B were reported, constituting 1.4% of all registered cases. The incidence of acute hepatitis B was 0.04 per 100,000 population and was lower by 67% compared to 2019 and lower by 71% compared to the median for the years 2014-2018. There were no cases of acute disease in the age group 0-29 years. A total of 978 chronic and unknown hepatitis B cases (UNK) were registered and the diagnosis rate was 2.56 per 100,000 population, lower by 64.2% than in 2019. Compared to the median diagnosis rate of chronic hepatitis B in 2014-2018, a decrease of 70.4% was observed. In the age group 0-19 years, there was no case reported. In 2020, 24 people died due to hepatitis B, including 22 from chronic hepatitis B. CONCLUSIONS: The COVID-19 pandemic resulted in a significant reduction in the number of HBV tests performed and, consequently, a reduction in the number of diagnosed infections. A decrease in the number of detected infections was observed from the second quarter of 2020, i.e. from the beginning of the COVID-19 pandemic, although already in the first quarter of 2020 the number of registered hepatitis B cases was lower than in the same period in 2019. No acute cases were reported among people who were vaccinated against hepatitis B during childhood. Vaccination with three doses of hepatitis B vaccine in children in the second year of life was only slightly lower than in 2019, which proves the stability of the implementation of the preventive vaccination program, despite the limited access to primary health care during the pandemic.


Asunto(s)
COVID-19 , Enfermedades Transmisibles , Hepatitis B Crónica , Hepatitis B , Adolescente , Distribución por Edad , COVID-19/epidemiología , Niño , Preescolar , Enfermedades Transmisibles/epidemiología , Brotes de Enfermedades , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Vacunas contra Hepatitis B/uso terapéutico , Hepatitis B Crónica/epidemiología , Hepatitis B Crónica/prevención & control , Humanos , Incidencia , Lactante , Recién Nacido , Pandemias , Polonia/epidemiología , Sistema de Registros , Población Rural , Población Urbana , Adulto Joven
16.
Zhonghua Gan Zang Bing Za Zhi ; 30(8): 873-878, 2022 Aug 20.
Artículo en Chino | MEDLINE | ID: mdl-36207944

RESUMEN

Aim: To identify the key risk factors of intrauterine hepatitis B virus transmission (HBV) and its effect on the placenta and fetus. Methods: 425 infants born to hepatitis B surface antigen (HBsAg)-positive pregnant women who received combined immunization with hepatitis B immunoglobulin and hepatitis B vaccine between 2009 to 2015 were prospectively enrolled in this study. The intrauterine transmission situation was assessed by dynamic monitoring of infants HBV DNA load and quantitative HBsAg. Univariate and multivariate regression analysis was used to determine the high risk factors for intrauterine transmission. Stratified analysis was used to determine the relationship between maternal HBV DNA load and fetal distress. Transmission electron microscopy was used to observe HBV Effects on placental tissue. Results: HBV intrauterine infection rate was 2.6% (11/425). Multivariate analysis result showed that the maternal HBV DNA load was an independent risk factor for intrauterine infection among infants (P=0.011). Intrauterine infection and distress rate was significantly higher in infants with with maternal HBV DNA>106 IU/ml than those with HBV DNA <106 IU/ml (12.2% vs. 1.8%; χ2=11.275, P=0.006), and (24.4% vs. 16.0%, χ2=3.993, P=0.046). Transmission electron microscopy showed that mitochondrial edema, endoplasmic reticulum expansion and thicker basement membrane were apparent when the maternal HBV DNA>106 IU/ml than that of maternal HBV DNA<106 IU/ml (960 nm vs. 214 nm, Z=-2.782, P=0.005) in the placental tissue. Conclusion: Maternal HBV DNA>106 IU/ml is associated not only with intrauterine infection, but also with increased incidence of intrauterine distress and placental sub-microstructural changes, providing strong clinical and histological evidence for pregnancy avoidance and treatment in this population.


Asunto(s)
Hepatitis B , Complicaciones Infecciosas del Embarazo , ADN Viral , Femenino , Sufrimiento Fetal/tratamiento farmacológico , Hepatitis B/prevención & control , Antígenos de Superficie de la Hepatitis B , Vacunas contra Hepatitis B/uso terapéutico , Virus de la Hepatitis B/genética , Humanos , Inmunoglobulinas/uso terapéutico , Lactante , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Placenta , Embarazo
17.
Front Immunol ; 13: 956473, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36248783

RESUMEN

Background: Hepatitis B vaccine (HepB) has been routinely recommended as part of the immunization program in China and has had a satisfactory safety and effectiveness profile in protecting infants from hepatitis B virus infection. We evaluated the surveillance sensitivity and changes over time of AEFI reports related to HepB among infants based on the consistent national data before and after the introduction of vaccine administration law (LAW) from 2013 to 2020 in China. Methods: AEFI records were extracted from the Chinese National AEFI Surveillance System from 2013 to 2020. According to the proportion of different kinds of HepB vaccines distributed, the annual administration data of the most distributed HepB produced by Bio-Kangtai and its corresponding adverse reaction reports were collected and analyzed. We categorized the time interval into the pre-LAW period (2013 to 2017), transition period (2018 to 2019), and LAW period (2020) to demonstrate the impact of LAW on the surveillance patterns of AEFIs. Results: The annual AEFI rates increased from 3.1/100,000 to 14.8/100,000 over this period in total. The rate ratio for the post-LAW period and pre-LAW period was 2.19 (95%CI: 2.10, 2.29). Common reactions occupied 87.6% of the total reported AEFIs whose rate was recorded as 7.9/100,000. Rare reactions occupied 9.1% of the total AEFIs showing an average rate of 0.8/100,000, of which anaphylaxis accounted for over 80%, with the rate ratio of the transition period and LAW period as 1.36 (95%CI:1.22, 1.52) and 1.14 (95%CI:0.95, 1.35), respectively. Children receiving more than one vaccine showed a higher proportion of fever, anaphylaxis, and febrile convulsions, which were suggested to be a result of vaccine co-administration vaccines, such as the DPT and Polio vaccine. Conclusion: Most reactions were mild and self-limited and the rates of rare more serious events remained stable. The LAW has largely increased the surveillance capability and sensitivity on AEFIs of HepB and also contributes to enhancing public confidence in HepB immunization. Hepatitis B vaccination is a safe and effective means of preventing the complications of hepatitis B disease and continuous standardized AEFI investigation and assessment of causal association should be maintained.


Asunto(s)
Anafilaxia , Hepatitis B , Sistemas de Registro de Reacción Adversa a Medicamentos , Anafilaxia/inducido químicamente , Anafilaxia/etiología , Niño , China/epidemiología , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Vacunas contra Hepatitis B , Humanos , Inmunización/efectos adversos , Lactante , Fenilbutiratos , Vacunación/efectos adversos
18.
J Physiol Pharmacol ; 73(2)2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36193970

RESUMEN

Vaccination against COVID-19 is a highly debated subject that brings confusion due to contradictory information coming from the scientific community and the media. Our aim was to focus on a homogeneous group of students in the healthcare field to assess their intention to vaccinate and the drivers behind this decision. A cross-sectional study was performed in the spring of 2021 in a Medical University in Romania. 725 of the undergraduates that completed an online questionnaire regarding their intention to vaccinate against COVID-19 were included in the study. Univariable analysis and logistic regression were performed on several variables to analyze factors affecting the willingness to vaccinate against COVID-19. In our study sample, 93.1% of students presented a strong intention to vaccinate, out of which the highest proportion belonged to subjects studying general medicine (96%). On logistic regression, we identified the following predictor factors: previous infection with coronavirus, prior vaccination refusal, VAX score, scientifically oriented sources of information and preference for RNA-based technology. Medical students have an increased willingness towards vaccination. Even for them, a highly educated and informed group of subjects, the general attitude towards vaccinations has a strong impact on the choice of COVID-19 vaccination.


Asunto(s)
Vacunas contra el SIDA , COVID-19 , Vacunas contra Haemophilus , Vacunas contra la Influenza , Vacunas contra Papillomavirus , Vacunas contra Virus Sincitial Respiratorio , Vacunas contra el SIDAS , Estudiantes de Medicina , Vacunas Tifoides-Paratifoides , Vacuna BCG , COVID-19/prevención & control , Vacunas contra la COVID-19/uso terapéutico , Estudios Transversales , Vacuna contra Difteria y Tétanos , Vacuna contra Difteria, Tétanos y Tos Ferina , Vacunas contra la Hepatitis A , Vacunas contra Hepatitis B , Humanos , Vacuna contra el Sarampión-Parotiditis-Rubéola , ARN , Rumanía , Vacunas de Productos Inactivados , Vacunas Sintéticas
19.
Hepatol Int ; 16(6): 1273-1281, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36258066

RESUMEN

BACKGROUND: We conducted an evaluation on the potential data resources for the elimination of hepatitis B virus (HBV) mother-to-child transmission in China, so as to provide reference for WHO and other countries in the validation of HBV elimination of mother-to-child transmission (EMTCT) in a real-world large country setting. METHODS: We used the indicators set out in WHO Interim guidance for country validation of viral hepatitis elimination as the benchmark to evaluate the availability of data and progress against indicators for the elimination validation in China. We used descriptive analysis to illustrate the status of all indicators and parameters. RESULTS: According to the indicators which are recommended by WHO for HBV EMTCT validation, the national data in China are attainable, though not for HBV DNA testing for the HBsAg-positive mothers and their subsequent management. The remaining challenges for China are to consider how the national serosurvey might be conducted in future in the context of low HBV prevalence among children under 5 years; to collect systematically the programmatic impact data; to strengthen multi-sectoral collaboration among immunization, maternal and child health, hospital services, as well as other stakeholders. CONCLUSION: The available data on HBV EMTCT are sufficient to support the validation of the elimination of HBV mother-to-child transmission in China.


Asunto(s)
Hepatitis B , Complicaciones Infecciosas del Embarazo , Embarazo , Femenino , Humanos , Lactante , Preescolar , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Virus de la Hepatitis B/genética , Antígenos de Superficie de la Hepatitis B , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , China/epidemiología , Vacunas contra Hepatitis B
20.
Vaccine ; 40(48): 6939-6946, 2022 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-36280563

RESUMEN

OBJECTIVES: This study examined healthcare resource use (HCRU) for selected vaccine-preventable diseases (VPD) in secondary care in England. METHODS: The hospital episode statistics (HES) dataset covering all secondary care interactions within the English National Health Service (NHS) from 2015 to 2021 was used to identify and track HCRU for patients with a primary or secondary diagnosis for pertussis and Haemophilus influenzae type b (Hib), or a primary diagnosis only for hepatitis B, diphtheria, poliomyelitis, or tetanus. The first documented diagnosis during the study period (01/04/2015-31/03/2021) was the index event. RESULTS: 7,274 patients with a total of 5,554,343 patient-days (mean follow up 1,491 days) were included. The total number of hospital admissions was 27,092 and total inpatient cost was £4,987,770, with hepatitis B making up ∼80 % of this. Mean outpatient hospital appointments per patient were highest for tetanus (4.00), but total outpatient A&E cost burden was highest for Hib (£643,343 [mean per attendance £144.57]). For patients 0-9 years of age (n = 1,917), pertussis (n = 1,547) and Hib (n = 313) were by far the most commonly coded diseases. Hepatitis B was the most common disease in adults of working age and Hib was most prevalent in adults of retirement age. Surprisingly, poliomyelitis was observed in the database potentially due to historic diagnoses and/or coding inaccuracy. Other discrepancies with surveillance data were noted. CONCLUSIONS: VPDs impose a large burden on the NHS, but there is potential to reduce this and improve public health by optimising vaccination schedules, improving access and ensuring high coverage rates.


Asunto(s)
Infecciones por Haemophilus , Vacunas contra Haemophilus , Haemophilus influenzae tipo b , Hepatitis B , Poliomielitis , Tétanos , Enfermedades Prevenibles por Vacunación , Tos Ferina , Adulto , Humanos , Lactante , Tos Ferina/epidemiología , Tos Ferina/prevención & control , Vacunas contra Hepatitis B , Vacunas Combinadas , Atención Secundaria de Salud , Medicina Estatal , Infecciones por Haemophilus/epidemiología , Vacuna contra Difteria, Tétanos y Tos Ferina
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