RESUMO
The paper presents the immunogenicity of hepatitis vaccine (obtained by genetic engineering) in immunocompromised patients with preterminal renal insufficiency defined by depression of creatinine clearance of 10 to 25 ml/min. The study consisted of 28 randomized patients with impaired renal function. Sixteen patients received a single dose and, twelve a double dose of vaccine. Revaccination following 3 intramuscular doses of vaccine had been undertaken after 24 weeks if antibodies were not detected or their titer was 10 i. u. or less. All patients obtained a booster dose following 52 weeks. There was no statistically significant difference in titer values between immunocompromised patients regardless of whether they were vaccinated with a single or double dose. The antibody titer in patients with chronic renal insufficiency was significantly lower as compared with the results of vaccination in healthy population. It may be concluded that it is more beneficial and less expensive to use a single dose vaccine and revaccination if the titer is negative or insufficiently high.
Assuntos
Vacinas contra Hepatite B/administração & dosagem , Hepatite B/prevenção & controle , Hospedeiro Imunocomprometido , Falência Renal Crônica/imunologia , Vacinas Sintéticas/administração & dosagem , Hepatite B/imunologia , Anticorpos Anti-Hepatite B/biossíntese , Vacinas contra Hepatite B/imunologia , Humanos , Esquemas de Imunização , Vacinas Sintéticas/imunologiaRESUMO
We describe a severe multisystem Coxsackie virus type B3 infection in a previously healthy 14-year-old girl who presented with a mononucleosis-like syndrome (MS). Initial observations included a prominent cervical lymphadenopathy, exudative pharyngitis and leucocytosis with atypical lymphocytosis. At the end of the 2nd week of illness the patient developed meningoencephalomyelitis and haemolytic anaemia. Subclinical myocarditis was also recorded. Prolonged hepatitis recrudescing at the time of recovery coincided with serological evidence of a reactivated Epstein-Barr virus infection. The diagnosis was based on a significant rise in serum antibody titres against Coxsackie virus type B3, using the neutralization test. Intrathecal synthesis of antibodies to Coxsackie virus type B3 was also demonstrated. Generalized Coxsackie virus infections in adolescence are rare and an MS has not, to our knowledge, been associated with Coxsackie virus type B3 infection.