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1.
Zhonghua Gan Zang Bing Za Zhi ; 27(4): 241-243, 2019 Apr 20.
Artigo em Chinês | MEDLINE | ID: mdl-31082332

RESUMO

The mechanism of innate and adaptive immune responses to chronic infections with hepatotropic viruses (HBV, HCV) was studied in 2018. Its mechanism elucidated the dysregulation of natural killer (NK) cells, monocytes, B cells and T cells. In addition, a new target for immune regulation of HBV infection (TLR3/OX40L) was introduced. The discovery of new NK cell immune checkpoints, the involvement of mononuclear macrophages in liver failure and inflammation, sex hormone affecting intrahepatic-resistant bacterial infection through the regulation of humoral immunity, and the communication mechanism between liver and other immune organs have enriched people's understanding of liver immunology and its clinical significance.


Assuntos
Hepatite A/imunologia , Hepatovirus/imunologia , Células Matadoras Naturais , Fígado/imunologia , Humanos , Linfócitos T
2.
BMC Infect Dis ; 19(1): 443, 2019 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-31113369

RESUMO

BACKGROUND: Hepatitis A Virus (HAV) is one of the most common food and water borne infectious disease prevailing globally. The objective of the study was to determine sero-prevalence of HAV infection in a district of Sri Lanka. METHODS: This was a descriptive cross sectional study conducted on 1403 participants aged 1 year and above selected by multistage stratified (for age group and area of residence) cluster sampling from September 2015 to December, 2016. An interviewer-administered questionnaire was used to collect data and Anti-IgG testing was done to determine sero-positivity. The overall, the age and sex specific sero-prevalence of HAV were calculated with 95% confidence intervals (CI). RESULTS: Of the 1403 participants 1132 were anti HAV IgG positive. Therefore the overall sero-prevalence of HAV infection was 80.7% (95%CI: 78.64-82.76). There were 283 (20.2%) individuals below the age group of 14 years and below and out of them, 204 had anti HAV IgG, therefore sero-prevalence was 72.1% for that age group. The age group 15 years and aboe comprised of 1120 (79.8%) participants and of them 928 had anti HAV IgG, making sero-prevalence 82.9%. The lowest sero-prevalence (66.9%, n = 232) was observed in the age group of 11-20 years followed by 21-30 age group. From age 31 years onwards, the sero-prevalence exceeded 90%, reaching 100% after 71 years. The urban population showed a sero-prevalence of 83% (n = 195) and 80.2% (n = 937) for the rural sector while females had a sero-prevalence of 82.2% (n = 766) and it was 77.7% (n = 366) for males. Thirty-four (3.0%) participants who had sero-positive results (n = 1132) claimed that they have had HAV in the past. CONCLUSIONS: Overall, four fifth of the population was immune to HAV infection in the district of Gampaha.


Assuntos
Vírus da Hepatite A/isolamento & purificação , Hepatite A/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Feminino , Hepatite A/sangue , Hepatite A/imunologia , Hepatite A/virologia , Anticorpos Anti-Hepatite A/sangue , Anticorpos Anti-Hepatite A/imunologia , Vírus da Hepatite A/genética , Vírus da Hepatite A/imunologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural/estatística & dados numéricos , Estudos Soroepidemiológicos , Sri Lanka/epidemiologia , População Urbana/estatística & dados numéricos , Adulto Jovem
3.
Bull Hosp Jt Dis (2013) ; 77(2): 146-152, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31128586

RESUMO

INTRODUCTION: Autoimmune hepatitis (AIH) is a cause of chronic liver disease. It is usually suspected based on clinical presentation and laboratory findings, but the diagnosis relies on the presence of specific autoantibodies and characteristic histology. Other unexplained findings should always prompt investigation for coexisting syndromes. CASE PRESENTATION: The patient is a 60-year-old Hispanic female with a history of mild asthma presented with exertional and pleuritic chest pain with weight loss, arthralgia, subjective fever, and night sweats for the last 3 months. Given the nonspecific nature of the presentation, further workup was pursued. Laboratory results indicated pancytopenia, elevated INR, and positive autoimmune panel including ANA, anti-chromatin, anti-histone, and rheumatoid factor as well as abnormal C3 and C4. Subsequent liver biopsy with interface hepatitis lead to a diagnosis of AIH with concurrent systemic lupus erythematosus suspected. CONCLUSION: The diagnostic work up for AIH is multimodal and aims to differentiate other etiologies such as congestive hepatopathy, iron overload, viral hepatitis, and other autoimmune liver diseases. In this particular case, unusual clinical and laboratory findings led to diagnosis of the overlap syndrome. Treatment for both was necessary to prevent further progression of disease.


Assuntos
Autoanticorpos , Hepatite A , Hepatite Autoimune , Hidroxicloroquina/administração & dosagem , Fígado/patologia , Lúpus Eritematoso Sistêmico , Prednisona/administração & dosagem , Fator Reumatoide/sangue , Antirreumáticos/administração & dosagem , Artralgia/diagnóstico , Artralgia/etiologia , Autoanticorpos/sangue , Autoanticorpos/classificação , Biópsia/métodos , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Diagnóstico Diferencial , Feminino , Hepatite A/diagnóstico , Hepatite A/imunologia , Hepatite A/fisiopatologia , Hepatite A/terapia , Hepatite Autoimune/diagnóstico , Hepatite Autoimune/imunologia , Hepatite Autoimune/fisiopatologia , Hepatite Autoimune/terapia , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/fisiopatologia , Lúpus Eritematoso Sistêmico/terapia , Pessoa de Meia-Idade , Administração dos Cuidados ao Paciente/métodos , Resultado do Tratamento
4.
Viruses ; 11(3)2019 03 20.
Artigo em Inglês | MEDLINE | ID: mdl-30897727

RESUMO

Hepatitis A virus (HAV) outbreaks among men who have sex with men (MSM) have been reported worldwide and associated primarily with sexual transmission through oral-anal sex. Here, we provide the molecular and evolutionary description of a European strain, linked to HAV outbreaks among MSM, detected in a Brazilian homosexual couple. Bayesian analysis provided evidence that the viral isolates were introduced in Brazil from Spain between the end of 2016 and the beginning of 2017.


Assuntos
Surtos de Doenças , Vírus da Hepatite A/genética , Hepatite A/transmissão , Homossexualidade Masculina , Adulto , Anticorpos Antivirais/sangue , Teorema de Bayes , Brasil , Evolução Molecular , Hepatite A/diagnóstico , Hepatite A/imunologia , Vírus da Hepatite A/imunologia , Humanos , Masculino , Fatores de Risco , Espanha/epidemiologia
5.
Future Microbiol ; 14: 247-258, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30663895

RESUMO

AIM: We evaluated the accuracy of a commercial rapid immunochromatographic test (rapid test [RT]) for hepatitis A (HA) diagnosis and epidemiological studies. MATERIALS & METHODS: The accuracy of a RT was evaluated in laboratory and in field conditions. Predictive modeling estimated the test performance in a hypothetical population. RESULTS: The RT showed sensitivities of 66-86%, and specificities of 21-100%, depending on the antibody isotype (IgM or IgG) analyzed and prevalence of infection. CONCLUSION: The RT is a good alternative for diagnostic in HA outbreaks. The predictive model indicates that it should not be used alone for HA diagnosis in low prevalence populations. These data can be used in the future to strengthen decision-making during the implementation of rapid diagnostic methods in health services.


Assuntos
Anticorpos Antivirais/sangue , Cromatografia de Afinidade/métodos , Testes Diagnósticos de Rotina/métodos , Hepatite A/diagnóstico , Hepatite A/imunologia , Adolescente , Adulto , Idoso , Brasil , Tomada de Decisão Clínica , Reações Cruzadas , Surtos de Doenças , Reações Falso-Negativas , Reações Falso-Positivas , Feminino , Serviços de Saúde , Hepatite A/epidemiologia , Vacinas contra Hepatite A , Humanos , Imunoglobulina G/sangue , Isotipos de Imunoglobulinas , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Prevalência , Sensibilidade e Especificidade , Estudos Soroepidemiológicos , Adulto Jovem
6.
EBioMedicine ; 39: 348-357, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30472089

RESUMO

BACKGROUND: A huge outbreak in the men-having-sex-with-men (MSM) has hit Europe during the years 2016-2018. Outbreak control has been hampered by vaccine shortages in many countries, and to minimize their impact, reduction of antigen doses has been implemented. However, these measures may have consequences on the evolution of hepatitis A virus (HAV), leading to the emergence of antigenic variants. Cases in vaccinated MSM patients have been detected in Barcelona, opening the possibility to study HAV evolution under immune pressure. METHODS: We performed deep-sequencing analysis of ten overlapping fragments covering the complete capsid coding region of HAV. A total of 14578255 reads were obtained and used for the analysis of virus evolution in vaccinated versus non-vaccinated patients. We estimated maximum and minimum mutation frequencies, and Shannon entropy in the quasispecies of each patient. Non-synonymous (NSyn) mutations affecting residues exposed in the capsid surface were located, with respect to epitopes, using the recently described crystal structure of HAV, as an indication of its potential role in escaping to the effect of vaccines. FINDINGS: HAV evolution at the quasispecies level, in non-vaccinated and vaccinated patients, revealed higher diversity in epitope-coding regions of the vaccinated group. Although amino acid replacements occurring in and around the epitopes were observed in both groups, their abundance was significantly higher in the quasispecies of vaccinated patients, indicating ongoing processes of fixation. INTERPRETATION: Our data suggest positive selection of antigenic variants in some vaccinated patients, raising concerns for new vaccination polices directed to the MSM group.


Assuntos
Proteínas do Capsídeo/genética , Vírus da Hepatite A/imunologia , Hepatite A/epidemiologia , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Mutação , Adulto , Proteínas do Capsídeo/imunologia , Surtos de Doenças , Europa (Continente)/epidemiologia , Evolução Molecular , Hepatite A/imunologia , Hepatite A/virologia , Antígenos da Hepatite A/genética , Antígenos da Hepatite A/metabolismo , Vírus da Hepatite A/genética , Homossexualidade Masculina , Humanos , Masculino , Pessoa de Meia-Idade , Quase-Espécies , Análise de Sequência de RNA/métodos , Vacinação
7.
Saudi J Gastroenterol ; 25(1): 67-70, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30117491

RESUMO

Acute hepatitis A viral (HAV) infection is rare in the liver transplant population due to recommended pre-transplant vaccinations. We report a case of acute hepatitis A infection in a liver transplant recipient. This individual had immunity to hepatitis A with protective IgG antibodies and presented with abnormal liver biochemistry in the post-transplant in-patient setting. Hepatitis A infection was confirmed by positive HAV IgM whereas other etiologies, including acute cellular rejection, were ruled out by laboratory tests and liver biopsies. He was treated conservatively with supportive care and liver enzymes recovered to normal baseline. Despite adequate pre-transplant immunity, in the post-transplant setting there may be loss of protective immunity due to profound immunosuppression and hence hepatitis A should remain an important differential diagnosis in the setting of acute hepatitis.


Assuntos
Vírus da Hepatite A Humana/imunologia , Hepatite A/imunologia , Transplante de Fígado/efeitos adversos , Fígado/virologia , Doença Aguda , Diagnóstico Diferencial , Hepatite A/epidemiologia , Humanos , Imunoglobulina G/imunologia , Imunoglobulina M/imunologia , Imunossupressão/efeitos adversos , Fígado/química , Fígado/enzimologia , Transplante de Fígado/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos/métodos , Resultado do Tratamento , Vacinação/normas , Cobertura Vacinal/normas
9.
World J Gastroenterol ; 24(43): 4870-4879, 2018 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-30487697

RESUMO

Acute acalculous cholecystitis (AAC) is the inflammatory disease of the gallbladder in the absence of gallstones. AAC is estimated to represent at least 50% to 70% of all cases of acute cholecystitis during childhood. Although this pathology was originally described in critically ill or post-surgical patients, most pediatric cases have been observed during several infectious diseases. In addition to cases caused by bacterial and parasitic infections, most pediatric reports after 2000 described children developing AAC during viral illnesses (such as Epstein-Barr virus and hepatitis A virus infections). Moreover, some pediatric cases have been associated with several underlying chronic diseases and, in particular, with immune-mediated disorders. Here, we review the epidemiological aspects of pediatric AAC, and we discuss etiology, pathophysiology and clinical management, according to the cases reported in the medical literature.


Assuntos
Colecistite Acalculosa/epidemiologia , Colecistite Aguda/epidemiologia , Infecções por Vírus Epstein-Barr/complicações , Hepatite A/complicações , Colecistite Acalculosa/diagnóstico , Colecistite Acalculosa/etiologia , Colecistite Acalculosa/terapia , Antibacterianos/uso terapêutico , Criança , Colecistectomia , Colecistite Aguda/terapia , Colecistite Aguda/virologia , Infecções por Vírus Epstein-Barr/imunologia , Infecções por Vírus Epstein-Barr/virologia , Vesícula Biliar/imunologia , Vesícula Biliar/cirurgia , Vesícula Biliar/virologia , Hepatite A/imunologia , Hepatite A/virologia , Vírus da Hepatite A Humana/isolamento & purificação , Herpesvirus Humano 4/isolamento & purificação , Humanos , Incidência , Fatores de Risco , Resultado do Tratamento
10.
Aten Primaria ; 50 Suppl 2: 80-85, 2018 11.
Artigo em Espanhol | MEDLINE | ID: mdl-30274864

RESUMO

Vaccines constitute one of the main foundations of the public health system, improving the quality and life expectancy of people. The vaccination calendar must be extended to the whole life of a person and in recent years the vaccination of the adult has become more complex and requires a greater knowledge of it. The role of primary care health is essential in order to improve vaccination coverage given the patient's closeness and trust. It is important to know the recommendations on vaccination for reasons of age, underlying pathology, work circumstances or any other factor that may endanger health and be preventable by vaccination and at the same time have clear criteria of what should not be done in this countryside. An excess in vaccination can pose a risk to the health of the patient and a waste of resources.


Assuntos
Vacinação/normas , Vacinas/administração & dosagem , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Armazenamento de Medicamentos/métodos , Emigrantes e Imigrantes , Feminino , Hepatite A/imunologia , Hepatite B/imunologia , Humanos , Esquemas de Imunização , Masculino , Sobremedicalização , Pessoa de Meia-Idade , Espanha , Tétano/prevenção & controle , Confiança , Trabalho
11.
PLoS One ; 13(10): e0204867, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30325924

RESUMO

BACKGROUND: Relevant seroprevalence data for endemic pathogens in a given region provide insight not only into a population's susceptibility to acute infection or risk for reactivation disease but also into the potential need for policy initiatives aimed at reducing these risks. Data from sub-Saharan Africa are sparse and since Aga Khan University Hospital Nairobi is an internationally accredited hospital equipped with a laboratory electronic medical record system, analysis of pertinent local seroprevalence data has been made possible. METHODS: We have analyzed serology data from laboratory electronic records at a 300 bed tertiary private teaching hospital in Kenya for the dates, 2008 to 2017 for Toxoplasma gondii, cytomegalovirus, and rubella, which were used primarily for antenatal screening. We also analyzed the data from hepatitis A and amebiasis serologies, which were used primarily for diagnostic purposes. RESULTS: For T. gondii, cytomegalovirus, and rubella, we used IgG serology to determine seroprevalence, finding rates of 32%, 86%, and 89%, respectively. There was no significant age-related difference in the 20 to 49 year old age range for any of these three pathogens. Of the Hepatitis A IgM tests that were ordered, 33% were positive with a peak positive rate of 70% in the five to nine year old age range. The seroprevalence of amebiasis was 4% and all cases of seropositivity were accompanied by compatible clinical illness (hepatic abscess). CONCLUSIONS: These data provide insight into seroprevalence rates of selected pathogens that can be used to guide screening and diagnostic laboratory testing as well as private and public immunization practices.


Assuntos
Citomegalovirus/imunologia , Entamoeba histolytica/imunologia , Hepatite A/imunologia , Complicações Infecciosas na Gravidez/epidemiologia , Rubéola (Sarampo Alemão)/imunologia , Toxoplasma/imunologia , Adolescente , Adulto , Anticorpos Antiprotozoários/sangue , Anticorpos Antivirais/sangue , Criança , Pré-Escolar , Registros Eletrônicos de Saúde , Feminino , Hospitais Privados/normas , Hospitais de Ensino/estatística & dados numéricos , Humanos , Lactente , Quênia/epidemiologia , Pessoa de Meia-Idade , Gravidez , Complicações Infecciosas na Gravidez/imunologia , Diagnóstico Pré-Natal , Estudos Soroepidemiológicos , Adulto Jovem
12.
Int J Clin Pract ; 72(12): e13268, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30259605

RESUMO

AIM: When screening newly arrived refugees, physicians must decide whether to vaccinate against hepatitis A and B at first encounter, thereby minimising missed opportunity, or to test for immunity and vaccinate only the susceptible, minimising unnecessary intervention. Better knowledge of hepatitis A and B immunity in refugee populations from different parts of the world is needed. METHOD: Overseas and domestic medical records of refugees from Africa, Asia, and the Middle East who entered Marion County (Indiana) between 1 September 2016 and 31 December 2017 were reviewed. RESULTS: Of 1191 refugees, 1163 and 1153 were tested for immunity to hepatitis A and B respectively. Among <19 year-olds, immunity to hepatitis A ranged from 52.1% to 79.6%, and immunity to hepatitis B ranged from 75.5% to 87.6%. Among ≥19 year-olds, immunity to hepatitis A was greater than 90% for each of the three regions, whereas immunity to hepatitis B ranged from 19.3% to 94.4%. 96% of refugees in the subset of Burmese ≥19 years old were immune to hepatitis B. Of individuals immune to hepatitis B, immunity was due to vaccination in 94.1% of <19 year-olds and 57.4% of ≥19 year-olds. 10% of refugees with at least three documented doses of hepatitis B vaccine were negative for hepatitis B surface antibody. 34.1% of uninfected refugees with no documented doses of hepatitis B vaccination were positive for hepatitis B surface antibody. CONCLUSION: It is reasonable to begin hepatitis A vaccination of <19 year-olds in this refugee population at first encounter but to test first for hepatitis A susceptibility before vaccinating those ≥19 years old. Similarly delaying hepatitis B vaccination might be appropriate only for a subset of Burmese adults.


Assuntos
Anticorpos Anti-Hepatite A/sangue , Hepatite A/imunologia , Anticorpos Anti-Hepatite B/sangue , Hepatite B/imunologia , Adolescente , Adulto , África/etnologia , Feminino , Hepatite A/diagnóstico , Hepatite B/diagnóstico , Hepatite B/prevenção & controle , Antígenos de Superfície da Hepatite B/imunologia , Vacinas contra Hepatite B/imunologia , Humanos , Masculino , Programas de Rastreamento , Oriente Médio/etnologia , Mianmar/etnologia , Refugiados , Estados Unidos , Vacinação , Adulto Jovem
13.
Ann Agric Environ Med ; 25(3): 572-575, 2018 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-30260171

RESUMO

INTRODUCTION: Hepatitis A (HA) is caused by infection with the hepatitis A virus (HAV). The differential etiological diagnosis of acute hepatitis is based on a positive result of the serological test detecting IgM class anti-HAV. For epidemiological studies on past infection and seroprevalence of HAV in populations, the tests measuring IgG class anti-HAV or total anti-HAV are used. Since the 1990s, specific prophylaxis is possible by vaccination against HA. In Poland, vaccination is recommended and in majority is performed at own cost. MATERIAL AND METHODS: Database was obtained from electronic medical records of the 2 major private health care providers networks (Luxmed and Medicover) operating in Poland. During a 3-year period (2013-2015), 1,124 persons with unknown status of anti-HA vaccination were tested for the presence of total anti-HAV. Objective. The aim of the study was to evaluate the seroprevalence of anti-HAV among working professionals in Poland. RESULTS: Anti-HAV were detected in 603 (53.6%) persons, while 521 (46.3%) tested negative. The study group was divided into 2 subgroups: 25-44 and 45-64-years-old. For detailed statistical analysis, the presence of anti-HAV was considered as a dependent variable, and its predictors were gender, age and the year of the test performance. The presence of anti-HAV was significantly more prevalent in older age group. The lack of specific antibodies was more prevalent in younger age group. CONCLUSIONS: Results of the study show increasing susceptibility to HAV infection in the younger age group, compared with the older age group of corporate professional employees in large cities in Poland. Since the epidemiological situation of HA is currently changing with increasing number of symptomatic cases of HA, it is suggested that employers might consider including an additional procedure of vaccination against HA into their private health insurance portfolio.


Assuntos
Anticorpos Antivirais/sangue , Hepatite A/imunologia , Imunoglobulina G/sangue , Adulto , Fatores Etários , Feminino , Hepatite A/sangue , Hepatite A/epidemiologia , Hepatite A/virologia , Vírus da Hepatite A/genética , Vírus da Hepatite A/imunologia , Vírus da Hepatite A/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Fatores de Risco , Estudos Soroepidemiológicos , Fatores Sexuais , Inquéritos e Questionários , Adulto Jovem
14.
Am J Trop Med Hyg ; 99(4): 1058-1061, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30182922

RESUMO

Hepatitis A and hepatitis E viruses (HAV and HEV) are the most common etiologies of viral hepatitis in India. To better understand the epidemiology of these infections, laboratory surveillance data generated during 2014-2017, by a network of 51 virology laboratories, were analyzed. Among 24,000 patients tested for both HAV and HEV, 3,017 (12.6%) tested positive for HAV, 3,865 (16.1%) for HEV, and 320 (1.3%) for both HAV and HEV. Most (74.6%) HAV patients were aged ≤ 19 years, whereas 76.9% of HEV patients were aged ≥ 20 years. These laboratories diagnosed 12 HAV and 31 HEV clusters, highlighting the need for provision of safe drinking water and improvements in sanitation. Further expansion of the laboratory network and continued surveillance will provide data necessary for informed decision-making regarding introduction of hepatitis-A vaccine into the immunization program.


Assuntos
Vírus da Hepatite A/imunologia , Hepatite A/epidemiologia , Anticorpos Anti-Hepatite/sangue , Vírus da Hepatite E/imunologia , Hepatite E/epidemiologia , Imunoglobulina M/sangue , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Coinfecção , Água Potável/virologia , Ensaio de Imunoadsorção Enzimática , Monitoramento Epidemiológico , Feminino , Hepatite A/imunologia , Hepatite A/virologia , Vírus da Hepatite A/isolamento & purificação , Hepatite E/imunologia , Hepatite E/virologia , Vírus da Hepatite E/isolamento & purificação , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Saneamento
16.
Vaccine ; 36(35): 5333-5339, 2018 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-29909136

RESUMO

INTRODUCTION: Adult vaccination coverage rates in the US are well below national targets, leaving many adults at increased risk. Additionally, typical vaccination coverage calculations do not adequately approximate population immunity as they do not consider whether multidose vaccines were administered within the recommended schedules. As timely administration of each dose optimizes overall vaccine effectiveness, we sought to document adherence to and completion of the hepatitis A (HepA), hepatitis B (HepB), and combined hepatitis A and hepatitis B (HepA-HepB) multidose vaccine schedule in an insured adult population in the US. METHODS: We conducted a retrospective database study of administrative claims from 2008 to 2015 (analyzed in 2017). Completion of 2 (HepA) and 3 doses (HepB and HepA-HepB), and adherence to the 2- and 3-dose recommended schedules were measured among individuals aged 19 years and older at first dose. The proportion of patients who completed 2 and 3 doses and were adherent to the recommended schedule were estimated using Kaplan-Meier methods. RESULTS: For HepA, 27.14% of initiating adults were adherent to the recommended schedule, and 32.05% had received a second dose by 42 months. Approximately one-third of adults who initiated the HepB or HepA-HepB series completed all 3 doses within 2 years of the minimum spacing (31.17% and 32.27%, respectively). Generally, completion and adherence were highest in individuals aged 60-64 years at the time of initiation. CONCLUSIONS: Hepatitis vaccine adherence and completion in adults is suboptimal. As a result, the majority of adults initiating each series may not be receiving the full protective benefit of these multidose vaccines.


Assuntos
Hepatite A/prevenção & controle , Vacinas contra Hepatite B/uso terapêutico , Hepatite B/prevenção & controle , Adulto , Feminino , Hepatite A/imunologia , Hepatite B/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estados Unidos , Vacinação/métodos
18.
J Infect Chemother ; 24(9): 766-768, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29490881

RESUMO

We describe a rare case of hepatitis A virus (HAV) replication in feces despite presence of hepatitis A antibodies in an acute myeloid leukemia (AML) patient after transfusion with HAV contaminated platelets. The patient has been vaccinated against HAV years before the AML diagnosis. Transient infection and reshedding should thus be considered in antibody-positive hematological patients. Transfusion associated HAV transmission is rare, and little evidence exists on the clinical consequences and possible effect of treatment with immunoglobulin. Further reporting on fecal shedding despite antibodies are needed, as HAV antibody levels are used as course of action for post-exposure prophylaxis and infection control.


Assuntos
Fezes/virologia , Vírus da Hepatite A/isolamento & purificação , Hepatite A/transmissão , Reação Transfusional/virologia , Adulto , Transfusão de Sangue/métodos , Feminino , Hepatite A/imunologia , Hepatite A/virologia , Anticorpos Anti-Hepatite A/imunologia , Vacinas contra Hepatite A/imunologia , Vírus da Hepatite A/imunologia , Humanos , Leucemia Mieloide Aguda/imunologia , Leucemia Mieloide Aguda/virologia , Profilaxia Pós-Exposição/métodos , Vacinação/métodos
19.
Virol J ; 15(1): 47, 2018 03 20.
Artigo em Inglês | MEDLINE | ID: mdl-29558945

RESUMO

BACKGROUND: Recent GWAS-associated studies reported that single nucleotide polymorphisms (SNPs) in ABCB1, TGFß1, XRCC1 genes were associated with hepatitis A virus (HAV) infection, and variants of APOA4 and APOE genes were associated with and hepatitis E virus (HEV) infection in US population. However, the associations of these loci with HAV or HEV infection in Chinese Han population remain unclear. METHODS: A total of 3082 Chinese Han persons were included in this study. Anti-HAV IgG and anti-HEV IgG were detected by enzyme-linked immunosorbent assay (ELISA). Genotypes in ABCB1, TGFß1, XRCC1, APOA4 and APOE SNPs were determined by TaqMan MGB technology. RESULTS: In Chinese Han population, rs1045642 C to T variation in ABCB1 was significantly associated with the decreased risk of HAV infection (P < 0.05). However, the effect direction was different with the previous US study. Rs1001581 A to G variation in XRCC1, which was not identified in US population, was significantly associated with the protection against HAV infection in our samples (P < 0.05). In addition, our results suggested that rs7412 C to T variation in APOE was significantly associated with lower risk of HEV infection in males (adjusted OR < 1.0, P < 0.05) but not in females. CONCLUSIONS: ABCB1 and XRCC1 genes variants are significantly associated with the protection against HAV infection. Additionally, Chinese Han males with rs7412 C to T variation in APOE gene are less prone to be infected by HEV.


Assuntos
Predisposição Genética para Doença , Vírus da Hepatite A , Hepatite A/epidemiologia , Hepatite A/genética , Vírus da Hepatite E , Hepatite E/epidemiologia , Hepatite E/genética , Adulto , Idoso , China/epidemiologia , Feminino , Regulação da Expressão Gênica , Estudo de Associação Genômica Ampla , Genótipo , Hepatite A/imunologia , Vírus da Hepatite A/imunologia , Hepatite E/imunologia , Vírus da Hepatite E/imunologia , Humanos , Imunoglobulina G/imunologia , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Vigilância da População , Estudos Soroepidemiológicos
20.
Med. clín (Ed. impr.) ; 150(6): 233-239, mar. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-171547

RESUMO

El número de viajeros internacionales bajo inmunodepresión farmacológica (IDF) ha aumentado debido a la mejor expectativa y calidad de vida que proporcionan estas terapias. La complejidad de la asesoría previaje en estos pacientes radica en su mayor susceptibilidad y gravedad ante determinadas infecciones relacionadas con el viaje, así como en las contraindicaciones e interacciones de determinadas vacunas y/o profilaxis con sus terapias de base. El consejo al viajero representa un reto para el clínico, que tiene que adaptar las vacunas y otras medidas preventivas a los pacientes inmunodeprimidos. Por ello, la valoración previa al viaje en pacientes con IDF debe realizarse en una unidad de medicina del viajero, de forma coordinada con el médico especialista que maneja su enfermedad de base. El objetivo de este artículo es revisar la evidencia disponible sobre las recomendaciones sanitarias indicadas en viajeros bajo tratamiento inmunosupresor en relación con la aplicación de vacunas, quimioprofilaxis antimalárica y otras medidas de prevención de enfermedades transmisibles (AU)


There is an increasing number of international travelers receiving immunosuppressive therapy due to the better life expectation and quality offered by this kind of treatment. The complexity of pre-travel counseling in these patients lies in their greater susceptibility to certain travel-related infections and the potential severity of these, as well as in the contraindications and interactions that may occur between certain vaccines and/or prophylaxis and their base therapy. Counseling the traveler represents a challenge for clinicians who have to tailor vaccinations and other recommended preventive measures to the immunosuppressed patients. Thus, pre-travel assessment of patients receiving immunosuppressive therapy should be performed in a specialized Traveler's Medical Unit, working closely with the specialist doctor in charge of treating the patient's underlying medical condition. The purpose of this article is to review available evidence on the health recommendations indicated in the pre-travel administration of vaccines, antimalarial chemoprophylaxis and other measures to prevent communicable diseases in travelers receiving immunosuppressive therapy (AU)


Assuntos
Humanos , Masculino , Feminino , Medicina de Viagem/organização & administração , Qualidade de Vida , Vacinas/imunologia , Imunossupressores/uso terapêutico , Hospedeiro Imunocomprometido/imunologia , Saúde do Viajante , Doenças Transmissíveis/imunologia , Programas de Imunização/tendências , Hepatite A/imunologia , Encefalite Japonesa/imunologia , Raiva/imunologia , Poliomielite/imunologia , Hepatite B/imunologia , Cólera/imunologia , Vacinas de Produtos Inativados/uso terapêutico
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