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1.
J Acquir Immune Defic Syndr ; 81(1): e1-e5, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30865187

RESUMO

BACKGROUND: Various recent outbreaks of hepatitis A virus (HAV) have been described in men who have sex with men despite the availability of an effective vaccine. This study aimed to determine the current rates of seroconversion after receiving HAV vaccine (HAV-V) in HIV-infected patients under real-life conditions. SETTING: Patients were selected from a Southern Spanish multicentric cohort of HIV-infected subjects. METHODS: Retrospective analysis of all patients who received 2 doses (standard scheme) from April 2008 to May 2016 or from June 2016 to February 2018 facing an HAV outbreak with shortage of HAV-V, 1 single dose of HAV-V. Response to HAV-V was defined as positive anti-HAV IgG between 1 and 12 months after the last vaccination dose. RESULTS: A total of 522 patients were included, mainly men who have sex with men (86.2%). In the standard-dose group, 303/343 [88.3%; 95% confidence interval (CI): 84.5 to 91.5] patients showed seroconversion as compared with 149/179 (83.2%; 95% CI: 76.9 to 88.4) of the single-dose group (P = 0.107). Undetectable baseline HIV-RNA (adjusted odds ratio: 4.86; 95% CI: 1.86 to 12.75; P = 0.001) and a CD4 T-cell count ≥350/µL (adjusted odds ratio, 3.96; 95% CI: 1.26 to 12.49; P = 0.019) were independently associated with response to both regimens. A higher CD4/CD8 ratio was also associated with response after a single dose. CONCLUSIONS: HIV-infected patients should be encouraged to undergo HAV-V with 2 standard doses 6 months apart; a single dose achieves a high rate of seroconversion in those patients with favorable response factors and may be enough to limit future outbreaks in case of HAV-V shortage until supply is reestablished.


Assuntos
Coinfecção/prevenção & controle , Infecções por HIV/complicações , Vacinas contra Hepatite A/uso terapêutico , Hepatite A/prevenção & controle , Adolescente , Adulto , Idoso , Surtos de Doenças/prevenção & controle , Feminino , Infecções por HIV/virologia , Vacinas contra Hepatite A/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Espanha/epidemiologia , Adulto Jovem
2.
Ann Saudi Med ; 39(1): 37-41, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30712049

RESUMO

BACKGROUND: Since routine immunization could change the epidemiological profile of hepatitis A virus (HAV) infection in the future, it is important to determine the baseline immunity to HAV across Turkey. OBJECTIVE: The aim of this study was to determine the seroprevalence of hepatitis A among individuals 6 years of age and older in Yozgat, Turkey. DESIGN: Cross-sectional. SETTING: Community in central region of Turkey. PATIENTS AND METHODS: Questionnaires and blood specimens were collected and the presence of hepatitis A IgG antibodies against hepatitis A virus was determined quantitatively by ELISA. MAIN OUTCOME MEASURES: The rates of hepatitis A immunity by age group. SAMPLE SIZE: 1862. RESULTS: Immunity to hepatitis A was 79.1% (n=1473). The mean (SD) age was 17.1 (14.7) years in the nonimmune group and 37.8 (19.5) years in the immune group (P less than .001), and immunity increased with age. No significant difference in immunity rate was detected between gen.ders in children and adults. The seropositivity rate for subjects ages 6-19 years was lower than in subjects aged 20-96 years (52.2% versus 93.9%; P less than .001). CONCLUSION: A catch-up vaccination program is needed for persons aged 6-19 years in Yozgat. LIMITATIONS: Single region data which can not be generalized. For this reason, a multi-centered study that can reflect the whole country is recommended. CONFLICT OF INTEREST: None.


Assuntos
Anticorpos Anti-Hepatite A/sangue , Vacinas contra Hepatite A/uso terapêutico , Vírus da Hepatite A/imunologia , Hepatite A/epidemiologia , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Criança , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Hepatite A/prevenção & controle , Hepatite A/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Turquia/epidemiologia , Adulto Jovem
4.
Curr Opin Pediatr ; 30(5): 689-697, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30188873

RESUMO

PURPOSE OF REVIEW: This review describes the impact of recommendations for routine immunization of infants and children against hepatitis A and hepatitis B, the changing epidemiology of these infections, and the remaining challenges to controlling or eliminating these diseases in the United States. RECENT FINDINGS: Rates of hepatitis A and B have significantly declined because of childhood vaccination programs and long-term protection provided by infant immunization. However, hepatitis A immunization rates remain lower than other vaccines, and outbreaks continue to occur in part due to a growing number of susceptible adults. The Advisory Committee on Immunization Practice has updated pre and postexposure prophylaxis and travel recommendations for hepatitis A prevention in young infants, as well as recommendations to reduce ongoing perinatal transmission of hepatitis B. SUMMARY: Pediatric healthcare providers should continue to immunize all infants against hepatitis A and B and ensure that no child outgrows the pediatric practice without being vaccinated. To address hepatitis A, providers should be aware of new recommendations for unimmunized travelers, use vaccines to prevent and control outbreaks, and ensure postexposure prophylaxis. Universal vaccination of infants against hepatitis B should begin before hospital discharge. The prevention of perinatal transmission is critical for control and possible eradication of hepatitis B.


Assuntos
Hepatite A/prevenção & controle , Hepatite B/prevenção & controle , Programas de Imunização/estatística & dados numéricos , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Vacinação/estatística & dados numéricos , Pré-Escolar , Feminino , Hepatite A/epidemiologia , Vacinas contra Hepatite A/uso terapêutico , Hepatite B/epidemiologia , Vacinas contra Hepatite B/uso terapêutico , Humanos , Lactente , Guias de Prática Clínica como Assunto , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Estados Unidos/epidemiologia
5.
J Pediatric Infect Dis Soc ; 7(3): 181-187, 2018 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-29961833

RESUMO

The Advisory Committee on Immunization Practices (ACIP), a group of medical and public health experts, meets 3 times per year to develop recommendations for vaccine use in the United States. There are 15 voting members, and their terms are for 4 years. ACIP members and Centers for Disease Control and Prevention staff discuss the epidemiology of vaccine-preventable diseases and vaccine research, effectiveness, safety data, and clinical trial results. Representatives from the American Academy of Pediatrics (including D. W. K.) and the Pediatric Infectious Diseases Society are present as liaisons to the ACIP. In the February 2018 meeting, important votes on the use of influenza vaccine and hepatitis vaccines were held, and updates on human papillomavirus, meningococcal, and anthrax vaccines, among others, were provided.


Assuntos
Vacinas Virais/uso terapêutico , Adolescente , Adulto , Comitês Consultivos , Vacinas contra Antraz/administração & dosagem , Vacinas contra Antraz/efeitos adversos , Vacinas contra Antraz/uso terapêutico , Criança , Pré-Escolar , Análise Custo-Benefício , Feminino , Vacinas contra Hepatite A/efeitos adversos , Vacinas contra Hepatite A/provisão & distribução , Vacinas contra Hepatite A/uso terapêutico , Humanos , Lactente , Vacinas contra Influenza/efeitos adversos , Vacinas contra Influenza/uso terapêutico , Vacinas contra Encefalite Japonesa/efeitos adversos , Vacinas contra Encefalite Japonesa/uso terapêutico , Masculino , Infecções Meningocócicas/tratamento farmacológico , Infecções Meningocócicas/prevenção & controle , Vacinas Meningocócicas/efeitos adversos , Vacinas Meningocócicas/economia , Vacinas Meningocócicas/uso terapêutico , Vacinas contra Papillomavirus/efeitos adversos , Vacinas contra Papillomavirus/uso terapêutico , Usos Terapêuticos , Estados Unidos , Vacinas Virais/efeitos adversos , Adulto Jovem
9.
Vaccine ; 36(20): 2745-2750, 2018 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-29673941

RESUMO

INTRODUCTION: Hepatitis A can cause widespread outbreaks. Until 2018, postexposure prophylaxis (PEP) in the United States for individuals >40 years consisted of immune globulin (IG) administered as soon as possible after exposure, ideally within 14 days whereas those aged ≤40 should receive hepatitis A (HepA) vaccine. However, state health departments reporting difficulty quickly accessing and administering IG, costs of higher IG doses and importance of long-term HAV protection prompted CDC to review immunogenicity data for use of HepA vaccine for PEP in older adults. We reviewed literature on use of HepA vaccine in adults >40 years and existing recommendations for HepA vaccine for use as PEP in other countries. METHODS: We searched PubMed and EMBASE from January 1, 1992-January 7, 2017 using the terms "hepatitis A vaccine∗" and "HAV vaccine∗." Two reviewers read each abstract and articles were preserved if they included results (seroprotection, mean titers) within 28 days of HepA vaccine administration in adults >40 years. Additionally, we reviewed PEP recommendations from six other jurisdictions. RESULTS: A total of 1,039 unique articles were identified, of which eight were retained and two added from references. Three studies included direct comparisons between individuals aged >40 years and those ≤40 years and one other study included three age groups over 40 years, finding lowest immunogenicity in the oldest adults. All found higher proportions seroprotected (definition varied by study) in younger age groups (ages varied by study) at 15 days post-vaccination but similar seroprotection at 30 days. Most other jurisdictions reviewed recommended vaccine alone or in conjunction with IG for PEP in older adults. CONCLUSIONS: Immunogenicity of HepA vaccine may be diminished in older adults, especially in the very oldest age groups. HepA vaccine should be administered as soon as possible within 14 days after exposure to achieve the best possible immune response.


Assuntos
Vacinas contra Hepatite A/uso terapêutico , Hepatite A/prevenção & controle , Imunoglobulinas Intravenosas/uso terapêutico , Profilaxia Pós-Exposição , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Surtos de Doenças , Vacinas contra Hepatite A/administração & dosagem , Humanos , Imunogenicidade da Vacina , Imunoglobulinas Intravenosas/administração & dosagem , Pessoa de Meia-Idade , Fatores de Tempo , Estados Unidos , Vacinas de Produtos Inativados/administração & dosagem , Vacinas de Produtos Inativados/uso terapêutico
10.
Eur J Contracept Reprod Health Care ; 23(1): 12-17, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29412045

RESUMO

BACKGROUND: The interactions of oral contraceptive (OC) use, risk of human papillomavirus (HPV) infection and associated cellular atypia are complex. We investigated the association between history of OC-use, and cytological or histopathological abnormalities in a cohort of non-HPV vaccinated originally 16-17-year-old women participating the PATRICIA trial for 4 years. METHODS: The total number of hepatitis A-virus (control) vaccine recipients participating in the clinical PATRICIA trial in Finland was 2399. Nine-hundred and ninety-nine women returned questionnaires on living conditions-life habits and sexual health after completing the study. Mean age at answering the questionnaire at the end of the clinical trial was 22 years. Age at sexual debut varied between 12 and 16 years for majority of the women. Cervical cytological samples were obtained every 6 months throughout the PATRICIA trial. The relative risk of cervical atypia associated with time since start of oral contraceptives use was calculated as odds ratio (OR) with 95% confidence interval (CI) using logistic regression. RESULTS: Compared to never-users, the smoking and age-at-sexual-debut adjusted relative risk of cervical intraepithelial neoplasia grade 1 (CIN1) in women who had started the use of oral contraceptives for more than 1 year was low (OR 0.2, 95% CI: 0.1-0.7). Risk of cytological atypia was also reduced (OR 0.6) albeit not significantly (95% CI: 0.3-1.3). CONCLUSIONS: Use of oral contraceptives does not increase the risk of cervical atypia but when established might instead be protective.


Assuntos
Neoplasia Intraepitelial Cervical/induzido quimicamente , Neoplasia Intraepitelial Cervical/epidemiologia , Colo do Útero/patologia , Anticoncepcionais Orais Hormonais/efeitos adversos , Neoplasias do Colo do Útero/induzido quimicamente , Neoplasias do Colo do Útero/epidemiologia , Adolescente , Adulto , Feminino , Finlândia/epidemiologia , Hepatite A/prevenção & controle , Vacinas contra Hepatite A/uso terapêutico , Humanos , Modelos Logísticos , Estudos Longitudinais , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia , Inquéritos e Questionários , Adulto Jovem
11.
Artigo em Inglês | MEDLINE | ID: mdl-29440324

RESUMO

Hepatitis A virus (HAV) is transmitted by the fecal-oral route and is a major cause of acute viral hepatitis. The clinical manifestations of HAV infection range from asymptomatic infection to acute liver failure (ALF), but do not include progression to chronic hepatitis. Risk factors for severe acute hepatitis A are older age (>40 years) and preexisting liver disease. Some patients may show atypical clinical features such as relapsing hepatitis, prolonged cholestasis, or extrahepatic manifestations. Almost all hepatitis A patients spontaneously recover with supportive care. However, in the case of ALF (<1%), intensive care and urgent decision on liver transplantation are required. Liver injury during hepatitis A is not directly caused by HAV but is known to be caused by immune-mediated mechanisms. In this review, the natural history and clinical manifestations of hepatitis A are described. In addition, mechanisms of immunopathogenesis in hepatitis A are discussed.


Assuntos
Hepatite A/patologia , Falência Hepática Aguda/diagnóstico , Transplante de Fígado , Fígado/fisiopatologia , Doença Aguda , Progressão da Doença , Hepatite A/complicações , Vacinas contra Hepatite A/uso terapêutico , Vírus da Hepatite A/imunologia , Humanos , Falência Hepática Aguda/virologia , Fatores de Risco
12.
HIV Med ; 19(6): 369-375, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29380498

RESUMO

OBJECTIVES: Italy is a low-incidence region for hepatitis A; however, during the last 2 years an increase in the incidence of hepatitis A virus (HAV) infection was reported in Europe. The aim of this study was to describe this recent outbreak. METHODS: We retrospectively analysed all cases of acute hepatitis A diagnosed at our laboratory between January 2010 and June 2017. We evaluated the following variables at the time of diagnosis: sex, age, nationality, glutamic oxaloacetic transaminase (GOT/AST), glutamic pyruvic transaminase (GPT/ALT), bilirubin concentration, international normalized ratio (INR) and the presence or absence of anti-HIV-1/2 antibodies. Hospitalization was also considered. We analysed these parameters using the χ2 test and Mann-Whitney U-test. RESULTS: A total of 225 cases were analysed; 82.7% were in male patients, 94.2% were in Italians and the median age of the patients was 36.4 years. At diagnosis, the median GOT value was 306 U/L, the median GPT was 1389 U/L, and the median total bilirubin value was 5.88 mg/dL. Hospitalization was required for 142 patients, with a median duration of hospital stay of 8.5 days. In 2016-2017 we registered 141 cases, with a higher prevalence of male patients, higher GPT values and a higher prevalence of patients aged 20-39 years compared with older (2010-2015) cases. Homosexual intercourse was reported as the HAV risk factor in 70.2% of patients. HIV serology was available for 120 patients: 24 were HIV-positive, four of whom represented new diagnoses. HIV-positive patients showed lower bilirubin and GPT values and fewer hospitalizations than HIV-negative patients. CONCLUSIONS: In 2016-2017, we saw a rise in the number of hepatitis A cases, with a higher prevalence of adult male patients. No significant differences regarding the prevalence of HIV coinfection emerged.


Assuntos
Surtos de Doenças/estatística & dados numéricos , Infecções por HIV/epidemiologia , Vacinas contra Hepatite A/uso terapêutico , Hepatite A/epidemiologia , Hospitais de Ensino , Vacinação/estatística & dados numéricos , Adulto , Feminino , Promoção da Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Roma/epidemiologia
13.
Liver Int ; 38(7): 1198-1205, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29240985

RESUMO

BACKGROUND: Among HIV-positive individuals, seroprotection for hepatitis A virus (HAV) following primary vaccination may wane with time. However, seroresponses to HAV revaccination are rarely investigated among HIV-positive patients who have lost protective antibodies after primary vaccination. METHODS: During the outbreak of acute hepatitis A in Taiwan after June 2015, HAV-seronegative, HIV-positive individuals were advised to receive two doses of HAV vaccines at 24 weeks apart. A retrospective 1:2 matched case-control study was conducted to compare the seroresponses at weeks 4, 24, 28 and 48 of HAV vaccination between those who underwent revaccination after having lost protective antibodies (case patients) and those who underwent primary vaccination (controls). RESULTS: Seventy-five case patients and 150 matched controls were included. The serological response rates were consistently higher among the case patients than controls: 88.1% vs 10.5% at week 4 following the first dose of HAV vaccination (P < .001); 93.3% vs 46.0% at week 24 (immediately before the second dose; P < .001); 98.7% vs 62.7% at week 28 (4 weeks after the second dose; P < .001) and 98.7% vs 92.7% at week 48 (P = .06). The anti-HAV antibody titres as reflected by the semi-quantitative assay for the case patients were also significantly higher than the controls at weeks 24, 28 and 48 following HAV vaccination. CONCLUSIONS: We demonstrated faster and better serological responses to HAV revaccination among the HIV-positive individuals who had lost their anti-HAV antibodies after primary vaccination. Single dose of HAV revaccination may provide rapid and sufficient seroresponses for HAV during the outbreak of acute hepatitis A.


Assuntos
Infecções por HIV/virologia , Anticorpos Anti-Hepatite A/sangue , Vacinas contra Hepatite A/uso terapêutico , Hepatite A/prevenção & controle , Imunização Secundária , Adulto , Estudos de Casos e Controles , Surtos de Doenças , Infecções por HIV/complicações , Soropositividade para HIV , Hepatite A/complicações , Vírus da Hepatite A , Homossexualidade Masculina , Humanos , Masculino , Estudos Retrospectivos , Estudos Soroepidemiológicos , Taiwan/epidemiologia
14.
Liver Int ; 38(4): 594-601, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-28482131

RESUMO

BACKGROUND: An unprecedented outbreak of acute hepatitis A has occurred among MSM in Taiwan since June 2015. We aimed to describe the seroepidemiology of HAV infection and to investigate the relationship between HAV vaccination and the incidence of acute hepatitis A among HIV-positive patients at the largest designated hospital for HIV care during the outbreak. METHODS: Between 2012 and 2016, the HAV serostatus, vaccination history and clinical characteristics of HIV-positive patients were retrospectively reviewed. A case-control study was performed to identify the factors associated with acute hepatitis A. The trends of HAV vaccination rate and incidence of acute hepatitis A among HAV-seronegative patients were examined during the outbreak. RESULTS: During the 4.5-year period, 2088 HIV-positive patients with a mean age of 37.7 years and 90.2% being MSM were included. The overall HAV seroprevalence was 34.3%, which was significantly higher in older and non-MSM patients. The estimated incidence rate of acute hepatitis A was 52.6 cases per 1000 person-years of follow-up during the outbreak. The associated factors with acquiring acute hepatitis A were recent syphilis and having not received HAV vaccines. The HAV vaccination rate during the outbreak increased from 4.7% to 70.6% and the incidence rate of acute hepatitis A declined when up to 65% of the patients were immunized or tested positive for HAV. CONCLUSIONS: The seroprevalence of HAV infection was low in the younger HIV-positive individuals. Prevention of acute hepatitis A was achieved among HIV-positive, HAV-seronegative patients through HAV vaccination and increased herd immunity during the ongoing outbreak.


Assuntos
Infecções por HIV/complicações , Vacinas contra Hepatite A/uso terapêutico , Hepatite A/epidemiologia , Hepatite A/prevenção & controle , Homossexualidade Masculina , Vacinação/estatística & dados numéricos , Doença Aguda , Adulto , Estudos de Casos e Controles , Surtos de Doenças , Feminino , Vírus da Hepatite A Humana , Humanos , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estudos Retrospectivos , Estudos Soroepidemiológicos , Sífilis/complicações , Taiwan/epidemiologia
17.
J Pediatric Infect Dis Soc ; 6(4): 311-316, 2017 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-29036392

RESUMO

The Advisory Committee on Immunization Practices (ACIP), a group of medical and public health experts, meets 3 times per year to develop recommendations for vaccine use in the United States. The group has 15 voting members, and each member's term is 4 years. ACIP members and Centers for Disease Control and Prevention (CDC) staff discuss the epidemiology of vaccine-preventable diseases and vaccine research, effectiveness, safety data, and clinical trial results. Representatives from the American Academy of Pediatrics (Carrie L. Byington and D. W. K.) and the Pediatric Infectious Diseases Society (S. T. O.) are present as liaisons to the ACIP. The ACIP met on June 21 to 22, 2017, to discuss catch-up vaccination for hepatitis A vaccine, influenza surveillance, influenza vaccine effectiveness, herpes zoster vaccine, the effect of varicella vaccination on the incidence of herpes zoster, meningococcal disease in patients taking eculizumab, and considerations for a potential third dose of measles, mumps, and rubella (MMR) vaccine to combat ongoing mumps outbreaks. Updates on dengue virus epidemiology, Zika virus vaccines, anthrax vaccine, yellow fever vaccine, and the Vaccine Adverse Event Reporting System were given also.


Assuntos
Imunização/normas , Adolescente , Adulto , Comitês Consultivos , Vacinas contra Antraz/uso terapêutico , Vacina contra Varicela/normas , Vacina contra Varicela/uso terapêutico , Criança , Pré-Escolar , Vacinas contra Dengue/uso terapêutico , Vacinas contra Hepatite A/administração & dosagem , Vacinas contra Hepatite A/uso terapêutico , Humanos , Lactente , Vacinas contra Influenza/normas , Vacinas contra Influenza/uso terapêutico , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Vacinas Meningocócicas/uso terapêutico , Caxumba/epidemiologia , Caxumba/prevenção & controle , Profilaxia Pré-Exposição/normas , Viagem , Vacina contra Febre Amarela/uso terapêutico , Adulto Jovem
18.
Metas enferm ; 20(8): 18-23, oct. 2017. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-168098

RESUMO

Objetivo: determinar el cumplimiento de la pauta de vacunación de hepatitis A (HA), hepatitis B (HB) y hepatitis A+B (HA+B) en relación al número de dosis administradas e intervalos de separación entre ellas según las recomendaciones de las fichas técnicas. Método: estudio descriptivo transversal entre los viajeros que acudieron al Centro de Vacunación Internacional de Vigo (CVI) entre el 1 de junio de 2011 y el 30 de noviembre de 2013. Se recogieron variables sociodemográficas, del viaje, y vacunales. Resultados: la muestra total fue de 1.028 viajeros, el 62,9% fue hombre, con una edad media de 35,2 años. El total de prescripciones de vacunas iniciadas fue de 1.117, distribuidas de la siguiente manera: HA (58,9%), HA+B (15,9%), HA y HB (13,7%) y HB (11,6%). Un 4,2% de los viajeros rechazó vacunarse. El porcentaje de cumplimiento global fue del 41,4% y en concreto fue del 38,5% para HA, 37,2% para HB y 55,7% para HA+B. Conclusiones: los viajeros aceptan de forma mayoritaria la vacunación, aunque se observa un cumplimiento escaso de las pautas de la misma, lo que conlleva diferentes implicaciones para la salud del viajero. La elevada tasa de inicio de pautas no se corresponde con su continuidad, por lo que el CVI debe implementar medidas para mejorar la adherencia como sistemas de recordatorio de las dosis sucesivas de vacunas, profundización en los motivos del no cumplimiento para eliminar barreras e implantación de pautas vacunales diferentes que faciliten el cumplimiento y una rápida inmunización (AU)


Objective: to determine the compliance with the vaccination schedule against Hepatitis A (HA), Hepatitis B (HB) and Hepatitis A+B (HA+B), regarding the number of doses administered and the intervals between them, according to the recommendations in the product specifications. Method: a descriptive cross-sectional study among those travellers who attended the International Vaccination Centre in Vigo (IVC) between June, 1st, 2011 and November, 30th, 2013. Sociodemographical, travel and vaccination variables were collected. Results: the total sample included 1,028 travellers, 62.9% were male, with 35.2 years as mean age. The total number of prescriptions for vaccination initiation was 1,117, distributed as follows: HA (58.9%), HA+B (15.9%), HA and HB (13.7%) and HB (11.6%). A 4.2% of travellers refused to be vaccinated. The overall compliance rate was 41.4%; and specifically, 38.5% for HA, 37.2% for HB and 55.7% for HA+B. Conclusions: the majority of travellers accept vaccination, though it has been observed that there is poor compliance of its schedule, leading to different consequences for the health of travellers. The high rate of vaccination initiation does not coincide with its continuity, and therefore the IVC must implement measures in order to improve adherence, such as reminder systems for subsequent vaccine doses, probing into the reasons for non-compliance in order to eliminate barriers, and implementation of different vaccination schedules that will facilitate compliance and rapid immunization (AU)


Assuntos
Humanos , Adulto , Vacinas contra Hepatite B/uso terapêutico , Vacinas contra Hepatite A/uso terapêutico , Vacinação/métodos , Vacinação/enfermagem , Saúde do Viajante , Estudos Transversais/métodos , Controle Sanitário de Viajantes , Análise de Dados/métodos
19.
Clin Exp Rheumatol ; 35(4): 711-715, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28721859

RESUMO

OBJECTIVES: To describe the immunogenicity and side effects of immunisation against hepatitis A virus (HAV) in JIA patients on methotrexate treatment, who have not been previously exposed to HAV. METHODS: Case-control study performed in JIA patients and healthy controls matched on age and gender. The subjects received two doses of inactivated anti-HAV vaccine (720 mIU/ml) intramuscularly at 0 and 6 months. Seroconversion, seroprotection rates and anti-HAV-IgG titres were measured at 1, 7 and 18 months. Children were monitored for adverse events. RESULTS: 83 JIA patients and 76 controls were enrolled in the study. At one month, seroprotection rates were lower in children with, as compared to those without JIA (48.2% vs. 65%; p=0.05). At 7 and 18 months, rates of seroprotection rose significantly and were similar in both groups. The titre of anti-HAV-IgG was lower in children with JIA than healthy children at all time points (p<0.001). Vaccines were well tolerated. CONCLUSIONS: Two doses of inactivated HAV vaccine were well tolerated and immunogenic in most immunosuppressed children with JIA; however, a single dose of HAV vaccine was insufficient to induce seroprotection in half of the patients. Further studies are required to analyse the long-term immunity against HAV in this population and optimal HAV immunisation regimen.


Assuntos
Artrite Juvenil/tratamento farmacológico , Anticorpos Anti-Hepatite A/imunologia , Vacinas contra Hepatite A/uso terapêutico , Hepatite A/prevenção & controle , Imunogenicidade da Vacina/imunologia , Imunoglobulina G/imunologia , Imunossupressores/uso terapêutico , Metotrexato/uso terapêutico , Artrite Juvenil/imunologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Vacinas contra Hepatite A/imunologia , Humanos , Masculino , Vacinas de Produtos Inativados/imunologia , Vacinas de Produtos Inativados/uso terapêutico
20.
World J Gastroenterol ; 23(20): 3589-3606, 2017 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-28611512

RESUMO

Hepatitis A virus (HAV) is one of the most common infectious etiologies of acute hepatitis worldwide. The virus is known to be transmitted fecal-orally, resulting in symptoms ranging from asymptomatic infection to fulminant hepatitis. HAV can also be transmitted through oral-anal sex. Residents from regions of low endemicity for HAV infection often remain susceptible in their adulthood. Therefore, clustered HAV infections or outbreaks of acute hepatitis A among men who have sex with men and injecting drug users have been reported in countries of low endemicity for HAV infection. The duration of HAV viremia and stool shedding of HAV may be longer in human immunodeficiency virus (HIV)-positive individuals compared to HIV-negative individuals with acute hepatitis A. Current guidelines recommend HAV vaccination for individuals with increased risks of exposure to HAV (such as from injecting drug use, oral-anal sex, travel to or residence in endemic areas, frequent clotting factor or blood transfusions) or with increased risks of fulminant disease (such as those with chronic hepatitis). The seroconversion rates following the recommended standard adult dosing schedule (2 doses of HAVRIX 1440 U or VAQTA 50 U administered 6-12 mo apart) are lower among HIV-positive individuals compared to HIV-negative individuals. While the response rates may be augmented by adding a booster dose at week 4 sandwiched between the first dose and the 6-mo dose, the need of booster vaccination remain less clear among HIV-positive individuals who have lost anti-HAV antibodies.


Assuntos
Infecções por HIV/virologia , Vacinas contra Hepatite A/uso terapêutico , Hepatite A/prevenção & controle , Adulto , Comorbidade , Surtos de Doenças , Feminino , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Soropositividade para HIV , Hepatite A/complicações , Anticorpos Anti-Hepatite A/sangue , Vírus da Hepatite A , Homossexualidade Masculina , Humanos , Programas de Imunização , Imunização Secundária , Imunossupressores/uso terapêutico , Masculino , Estudos Soroepidemiológicos , Vacinação , Adulto Jovem
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