Response to single dose hepatitis B vaccine in Congolese non-HIV hemodialysis patients: a prospective observational study.

INTRODUCTION: Because of the cost, in the hemodialysis centers of Kinshasa, the double dose of hepatitis B (HBV) vaccine is administered only to HIV infected patients while other patients receive a single dose. This study aimed to evaluate the single-dose vaccination Protocol and identify determinants of seroconversion's lack of anti-HBs after vaccination schedule. METHODS: 56 non-HIV chronic hemodialysis patients serologically negative for HBs Ag, anti-HBs and anti-HBc were selected between January 2014 and December 2016. The recombinant DNA vaccine (Euvax B®20 µg) was administered intramuscularly in the deltoid muscle at days 0, 30, 60 and 180. Serum anti-HBs titer was assayed at day 240. The endpoint was seroconversion, defined as anti-HBs titer ≥ 10 IU/l (10-99 IU/l = low protective vaccine response; ≥ 100 IU/l = highly protective vaccine response). Anti-HBs titer < 10 IU/l defined a lack of seroconversion. A Logistic regression model was used to identify factors associated with the lack of seroconversion. RESULTS: In the study group (mean age 55.6± 15.1 years; 73 % men, 36% diabetic and 86% hypertensive), low and highly protective vaccine responses were seen in 32% and 50% respectively versus 18% of patient had a lack of seroconversion. CRP > 6 mg/L (aOR: 8.96), hypoalbuminemia (aOR: 6.50) and KT/V < 1.2 (aOR: 3.70) were associated with the lack of seroconversion. CONCLUSION: Half of the patients in the study had either a lack or low protective vaccine response. Patient-related factors and hemodialysis parameters were the main factors associated with the lack of anti-HbS seroconversion. These results highlight the need to maximize doses of vaccine in all patients.

Pulmonary localization of Mansonella perstans in a 16 months-old male patient in a tertiary care hospital in Bukavu, Democratic Republic of Congo.

INTRODUCTION: Mansonella perstans is a human filarial parasite transmitted by biting midges (Diptera: Ceratopogonidae) belonging to the genus Culicoides and it is widely spread in sub-Saharan Africa. While most cases are asymptomatic, mansonelliasis can be associated with angioedema, arthralgia, swellings, pain in the scrotum or in serous cavities such as the pleura, the peritoneum, the pericardium, etc. Mansonelliasis can be really hard to treat, but it has been shown that an intensive treatment using albendazole can clear the parasite. CASE REPORT: Here we describe a case of a 16 months-old malnourished child with pneumonia due to M. perstans in the east of the Democratic Republic of Congo. CONCLUSION: Although our investigations confirmed M. perstans infection, this case shows that it is very difficult to come to a conclusive diagnosis.

Occult HBV reactivation induced by ibrutinib treatment: a case report.

Ibrutinib is a small molecule that has been recently developped for the treatment of B cell malignancies. Common side effects are diarrhoea, nausea, fatigue, infections, neutropenia and thrombocytopenia. Here we report the first case of Hepatitis B virus reactivation in a 80 years old chronic lymphocytic leukaemia patient receiving ibrutinib, suggesting that such treatment must be associated with HBV screening.