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1.
Arq Gastroenterol ; 57(1): 69-73, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32294738

RESUMO

BACKGROUND: Patients with inflammatory bowel disease (IBD) vaccinated for hepatitis B have a low success rate in achieving protective antibody levels. The main factors suggested for this are IBD itself and the use of immunosuppressive drugs. OBJECTIVE: To evaluate the concentration of anti-HBs antibodies and to verify factors associated with the effectiveness of hepatitis B vaccination in patients with IBD. METHODS: This is a prospective, consecutive, observational, descriptive and analytical, non-randomized, qualitative study that evaluated the levels of anti-HBs antibodies in IBD patients at the Interdisciplinary Inflammatory Bowel Disease Clinic of the Family and Community Health Unit of UNIVALI - Itajaí, Santa Catarina. RESULTS: Thirty-six patients were vaccinated against hepatitis B virus (HBV), of which 29 were female. The average age was 46.2 years. Regarding the type of IBD, twenty-four patients had Crohn's disease and the duration of inflammatory bowel disease was 74 months. Fifteen patients were on concomitant immunosuppressive therapy. The effective response rate to HBV vaccine was 72.2%, verified by anti-HBs titration ≥10 UI/L. Statistical analysis revealed a negative response to vaccination in patients with Crohn's disease and immunosuppressive drugs. CONCLUSION: The success rate of HBV immunization in IBD patients is low compared to the general population. Type of disease and use of immunosuppressive drugs appear to influence the vaccine response.


Assuntos
Colite Ulcerativa/imunologia , Doença de Crohn/imunologia , Anticorpos Anti-Hepatite B/sangue , Vacinas contra Hepatite B/imunologia , Vírus da Hepatite B/imunologia , Hepatite B/diagnóstico , Hepatite B/prevenção & controle , Adulto , Colite Ulcerativa/tratamento farmacológico , Doença de Crohn/tratamento farmacológico , Feminino , Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/imunologia , Vacinas contra Hepatite B/administração & dosagem , Humanos , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Pesquisa Qualitativa , Soroconversão
2.
BMC Infect Dis ; 20(1): 46, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31941454

RESUMO

BACKGROUND: This study sought to provide up-to-date hepatitis B (HBV) and C (HCV) seroprevalence in rural Burkina Faso decade after hepatitis B vaccine was introduced in the national immunization scheduled for children. METHODS: In 2018, a community-based, random sampling strategy with probability proportional to population size was conducted in Nanoro to investigate the prevalence of viral hepatitis in children and their mothers. Sociodemographic, vaccination history and risk factors were assessed by interview and health books. HBsAg rapid tests were done by finger prick and Dried Blood Spots (DBS) were collected for hepatitis seromarkers by chemiluminescence enzyme immunoassay. Positive samples underwent confirmatory PCR and phylogenetic analysis. RESULTS: Data were presented on 240 mother-child pairs. HBsAg Prevalence was 0.8% in children and 6.3% in mothers. Hepatitis B core antibody positivity was 89.2% in mothers, 59.2% in children and was associated with age, sex and scarification. Hepatitis B surface antibodies prevalence was 37.5% in children and 5.8% in mothers. Good vaccination coverage was limited by home delivery. Phylogenetic analysis of HBV strains based on full genome sequences (n = 7) and s-fragment sequences (n = 6) revealed genotype A, E, and recombinant A3/E. Viral genome homology was reported in one mother-child pair. Anti-HCV prevalence was 5.4% in mothers, 2.1% in children and strains belonged to genotype 2. CONCLUSIONS: In Nanoro, HBsAg prevalence was low in children, intermediate in mothers and mother-to-child transmission persists. Home delivery was a limiting factor of Hepatitis B vaccination coverage. HBV genotype E was predominant and genotype A3/E is reported for the first time in Burkina Faso.


Assuntos
Hepacivirus/genética , Vírus da Hepatite B/genética , Hepatite B/epidemiologia , Hepatite C/epidemiologia , População Rural , Adolescente , Adulto , Burkina Faso/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Genoma Viral , Genótipo , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Vacinas contra Hepatite B/imunologia , Anticorpos Anti-Hepatite C/sangue , Humanos , Lactente , Transmissão Vertical de Doença Infecciosa , Masculino , Pessoa de Meia-Idade , Mães , Filogenia , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos , Vacinação , Adulto Jovem
3.
Gut ; 69(2): 343-354, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-30926653

RESUMO

OBJECTIVE: This study aimed to develop a novel therapeutic vaccine based on a unique B cell epitope and investigate its therapeutic potential against chronic hepatitis B (CHB) in animal models. METHODS: A series of peptides and carrier proteins were evaluated in HBV-tolerant mice to obtain an optimised therapeutic molecule. The immunogenicity, therapeutic efficacy and mechanism of the candidate were investigated systematically. RESULTS: Among the HBsAg-aa119-125-containing peptides evaluated in this study, HBsAg-aa113-135 (SEQ13) exhibited the most striking therapeutic effects. A novel immunoenhanced virus-like particle carrier (CR-T3) derived from the roundleaf bat HBV core antigen (RBHBcAg) was created and used to display SEQ13, forming candidate molecule CR-T3-SEQ13. Multiple copies of SEQ13 displayed on the surface of this particulate antigen promote the induction of a potent anti-HBs antibody response in mice, rabbits and cynomolgus monkeys. Sera and purified polyclonal IgG from the immunised animals neutralised HBV infection in vitro and mediated efficient HBV/hepatitis B virus surface antigen (HBsAg) clearance in the mice. CR-T3-SEQ13-based vaccination induced long-term suppression of HBsAg and HBV DNA in HBV transgenic mice and eradicated the virus completely in hydrodynamic-based HBV carrier mice. The suppressive effects on HBsAg were strongly correlated with the anti-HBs level after vaccination, suggesting that the main mechanism of CR-T3-SEQ13 vaccination therapy was the induction of a SEQ13-specific antibody response that mediated HBV/HBsAg clearance. CONCLUSIONS: The novel particulate protein CR-T3-SEQ13 suppressed HBsAg effectively through induction of a humoural immune response in HBV-tolerant mice. This B cell epitope-based therapeutic vaccine may provide a novel immunotherapeutic agent against chronic HBV infection in humans.


Assuntos
Epitopos de Linfócito B/imunologia , Antígenos de Superfície da Hepatite B/sangue , Vacinas contra Hepatite B/imunologia , Hepatite B Crônica/imunologia , Adjuvantes Imunológicos , Animais , Antivirais/uso terapêutico , Terapia Combinada , DNA Viral/sangue , Relação Dose-Resposta Imunológica , Feminino , Anticorpos Anti-Hepatite B/biossíntese , Vacinas contra Hepatite B/uso terapêutico , Vírus da Hepatite B/genética , Hepatite B Crônica/terapia , Hepatite B Crônica/virologia , Imunidade Humoral/imunologia , Imunoterapia/métodos , Macaca fascicularis , Masculino , Camundongos Endogâmicos BALB C , Camundongos Transgênicos , Coelhos
4.
J Immunoassay Immunochem ; 41(1): 20-27, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31590597

RESUMO

The present study aimed to find out the levels of anti-HBsAb among vaccinated children in a rural community in Fars Province, Southern Iran. Blood samples were taken from 550 children, aged 1-12 years (mean 6.4 ± 3.5), in 2017 from three villages in the area. A structured questionnaire was used to get the sociodemographic data of the subjects along with determinants concerning the Hepatitis B. Sera samples were examined for anti-HBsAb, using an ELISA commercial kit. Anti-HBsAb were detected in 468 (85.1%) of the subjects. Of the seropositive subjects, 37 (45.1%) were female and 45 (54.9%) were male. In the age group of 0-5 years, 88.7% of the subjects were seropositive. This rate was 84.3% and 78.1% in the age group of 6-10 years old and older than 10 years, respectively. There was a significant association (p < .05) between the anti-HBsAb and age. Findings of the current study revealed that children living in a rural community in southern Iran have appropriate protection against HBV even more than 10 years after being vaccinated. The decline in seropositivity rate of anti-HBsAb with age may further point out the need for a booster dose of HBV vaccine.


Assuntos
Anticorpos Anti-Hepatite B/sangue , Vacinas contra Hepatite B/sangue , Vacinas contra Hepatite B/imunologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Anticorpos Anti-Hepatite B/imunologia , Humanos , Lactente , Recém-Nascido , Irã (Geográfico) , Masculino
5.
Arq Gastroenterol ; 56(4): 440-446, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31721974

RESUMO

BACKGROUND: Although liver transplantation is considered to be a high-risk procedure, it is well-established as a treatment option for the cure and quality of life enhancement for individuals who suffer from diseases. Preventing an infection by hepatitis B virus through immunization schedules has been the most effective way to reduce complications, since it decreases the number of people who suffer from chronic hepatitis caused by the hepatitis B virus and eradicates its transmission. OBJECTIVE: 1. Analyzing evidence in the literature on various schedules employed for immunization against hepatitis B in patients who have received a liver transplantation. 2. Suggesting potential immunization schedules against hepatitis B in patients who suffer from liver cirrhosis, without previous verifying documentation, using the Child-Turcotte Pugh score, according to evidences found in the literature. METHODS: Systematic review of the literature, conducted on the data bases MedLine, PubMed, and Lilacs, between September, 2017 and January, 2018, by using the following keywords: "Liver Transplantation, "Immunization Schedule", "Hepatitis B Vaccines". In order to analyze the articles, a summary figure was especially designed and both the results and discussion were presented in a descriptive way. RESULTS: We included 24 studies; among them, eight had accelerated immunization schedules, 13 followed the conventional schedules, and three had super accelerated schedules. Regarding immunization, 21 studies were conducted with patients in the pre-transplant period, one with a transplanted patient, one with a pre-transplant group, and one with a post-transplant group. Found articles suggest that, disregarding the chosen immunization schedule, seroconversion rates tended to be lower as the liver disease advanced, compared to the healthy population. CONCLUSION: The studies did not find seroconversion superiority between the different immunization schedules (conventional and unconventional). However, since candidates to liver transplantation are usually very vulnerable, results show that super accelerated immunization schedules are possibly recommended for such group of patients; serologic test results will be higher when the immunization schedule is completed in the pre-transplant period.


Assuntos
Vacinas contra Hepatite B/administração & dosagem , Hepatite B/prevenção & controle , Esquemas de Imunização , Transplante de Fígado , Vacinas contra Hepatite B/imunologia , Humanos
6.
J Med Microbiol ; 68(11): 1686-1693, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31592765

RESUMO

Introduction. Tunisia is an intermediate hepatitis B virus (HBV) endemic country. The vaccination against hepatitis B was introduced in 1995 including four doses with a first dose administrated at birth. Decreasing the level of antibodies against hepatitis B surface antigen (anti-HBs) over time can be alarming. This study was conducted to explore the anti-HBV immune response among children under 6 years old, vaccinated according to the national vaccination schedule, by evaluating the immunological response to primary vaccination and by exploring the anamnestic immune response to a booster dose.Methods. We conducted a cross-sectional prospective study from June 2016 to June 2017 (n=180), based on voluntary participation. Children were recruited from the public pediatric ward sectors in Sahloul University Hospital of Sousse in Central Tunisia. An anti-HB titre was determined based on electro-chemiluminescence micro-particle immunoassay (ECLIA), using Elecsys Anti-HBs II kit, Roche.Results. Mean age at the time of enrollment in the study was 33±14.8 months. The seroprotection rate was 77.2 %. The anti-HB titre differed significantly between the different age groups (P=0.002). The predicting variable for having no seroprotective antibody level was older age. Children with anti-HB levels <10 IU l- 1 were offered an additional dose of HBV vaccine. Anamnestic response 1 month after the challenge dose was observed in 100 % of subjects. The probability of developing a high antibody response, following the booster dose increased in conjunction with an increased pre-booster antibody level.Conclusion. The response to a booster dose suggests the persistence of immune memory in almost all vaccinated individuals. Although a booster dose increases substantially anti-HB titre, the clinical relevance of such an increase remains unknown.


Assuntos
Anticorpos Anti-Hepatite B/imunologia , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/imunologia , Hepatite B/imunologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Hepatite B/virologia , Antígenos de Superfície da Hepatite B/administração & dosagem , Antígenos de Superfície da Hepatite B/imunologia , Vacinas contra Hepatite B/imunologia , Humanos , Memória Imunológica , Lactente , Masculino , Estudos Prospectivos , Tunísia , Vacinação
7.
Biomed Res Int ; 2019: 7645106, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31485444

RESUMO

Background: Hepatitis B virus (HBV) infection is a serious public health problem in many parts of the world. The risk of acquiring the infection through exposure to blood, semen, and other bodily fluids is highest among health care workers (HCW) including trainees. Ghana is considered a high risk country for HBV; however little is known about the knowledge and prevention practices of the infection in the country. This study assessed the knowledge, testing, and vaccination history of HBV and their related factors among undergraduate public health students of University of Health and Allied Sciences in Ghana. Methods: A cross-sectional study was conducted among 226 students using a pretested questionnaire to assess Hepatitis B knowledge, testing, and vaccination history of the students. We performed logistic regression analysis to examine the relationship between Hepatitis B testing and vaccination history and participants' characteristics. Data was analysed using Stata Version 12. Results: Majority 169 (73.9%) of the 226 participants studied had moderate knowledge regarding HBV infection. About half 114 (50.4%) of them had never been tested for HBV infection, and 100 (44.2%) had received at least a single dose of Hepatitis B vaccine. The completed vaccination rate among the students was 30.5%. Students in their 2nd year (Adjusted Odds Ratio [AOR]: 3.13; 95% Confidence Interval [CI]: 1.13, 7.52; p<0.011) and those with moderate (AOR: 4.76; 95% CI; 1.35, 16.82; P=0.015) and good (AOR: 5.40; 95% CI: 1.31, 22.36; P=0.020) level of knowledge were more likely to be tested for HBV. With regard to vaccination, females (AOR: 1.85; 95%CI: 1.04-3.29; P=0.037) and regular students (AOR: 0.37; 95%CI: 0.19, 0.70; p=0.002) were associated with receiving the full dose of Hepatitis B vaccine. Conclusion: This study highlights the urgent need for continued health education on HBV infection and strategies that ensure that health trainees are screened and fully vaccinated against the infection to prevent potential future exposure to the virus. The students' representative council can organize free HBV testing and vaccination for all fresh students.


Assuntos
Vacinas contra Hepatite B/imunologia , Vírus da Hepatite B/imunologia , Hepatite B/imunologia , Estudantes de Saúde Pública/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Gana , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Inquéritos e Questionários , Adulto Jovem
8.
Arch Virol ; 164(11): 2645-2658, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31399876

RESUMO

Anti-HBs antibodies develop after natural infection with hepatitis B virus (HBV) or vaccination against this virus, as a result of activation of the human immune system by the HBV surface antigen (HBsAg). Anti-HBs-positive individuals are immunologically competent against HBV infection. This immunity is determined by the antibody levels in the bloodstream after resolution of natural infection or after vaccination. Anti-HBs antibody levels have been observed to decrease to below the protective level years after natural infection or vaccination, and there is reason to doubt that protective immunity to HBV is maintained after that. Factors that affect the maintenance of the anti-HBs antibody level in the bloodstream have been reported. Maintenance of immunity to HBV has been reported in anti-HBs negative individuals and those with detectable but low levels after natural infection or after vaccination. On the other hand, detection of anti-HBs antibodies without protective activity has also been observed. The presence or absence of anti-HBs antibodies in the context of HBV immunity has been the subject of extensive discussion and clinical, laboratory and epidemiological interest. These three scenarios of the anti-HBs response are discussed in this review article.


Assuntos
Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/imunologia , Vacinas contra Hepatite B/imunologia , Vírus da Hepatite B/imunologia , Hepatite B/imunologia , Anticorpos Anti-Hepatite B/imunologia , Humanos , Vacinação
9.
Biomed Res Int ; 2019: 3453105, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31317025

RESUMO

Background: This study assesses the prevalence of Vietnamese children receiving the hepatitis B (HepB) vaccine birth dose and explores its associated socioeconomic factors. Methods: We used the data of the Multiple Indicator Cluster Survey, 2014. We estimated the overall percentage of HepB birth dose vaccination among 0-23-month-old children and its percentages according to selected characteristics. Multiple logistic regression was applied. Results: 62.8% of children received the HepB vaccine birth dose. The prevalence rates by selected factors ranged from 35.3% to 76.7%. The categories with the lowest prevalence rates were children who had low birth weight (41.6%), had a mother aged less than 20 years (35.3%), had a mother with primary or less education (42.7%), belonged to ethnic minorities (30.3%), resided in rural areas (59.9%), and were in the 1st quintile of mother's socioeconomic status (38.6%). Receiving HepB vaccine birth dose was associated with child's birth weight, mother's age, mother's education, socioeconomic status, and ethnicity. Conclusions: This study identified vulnerable groups, upon which policy-makers should focus their efforts to equitably and sustainably tackle birth dose HepB vaccine coverage as well as the full vaccination coverage, thereby promoting long-lasting herd immunity in this country.


Assuntos
Vacinas contra Hepatite B/uso terapêutico , Hepatite B/prevenção & controle , Programas de Imunização , Adulto , Relação Dose-Resposta a Droga , Feminino , Hepatite B/epidemiologia , Hepatite B/imunologia , Hepatite B/virologia , Vacinas contra Hepatite B/imunologia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Mães , Parto/imunologia , Gravidez , Classe Social , Vacinação , Vietnã/epidemiologia
10.
BMC Infect Dis ; 19(1): 614, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31299917

RESUMO

BACKGROUND: To evaluate the efficacy and safety of telbivudine in chronic hepatitis B women during the second and third trimesters of pregnancy. METHODS: The week 12-34 of pregnant women were screened in this prospective non-intervention study, with HBV DNA > 106 IU/mL and alanine aminotransferase > 50 IU/L. The patients were received telbivudine treatment as a treatment group or without antiviral treatment as a control group. All infants were received recombinant hepatitis B vaccine 10 µg within 12 h of birth, at week 4 and week 24, immunoglobulin G within 12 h of birth and were detected HBV markers at the range from 7 to 12 months after delivery. RESULTS: A total of 241 patients were finally enrolled, 139 patients in telbivudine group and 102 patients in control group. HBsAg negative rate of infants was 99.3% (135/136) in telbivudine group and was 91.9% (91/99) in control group after 7 months (P = 0.005), respectively. The incidence of undetectable HBV DNA levels (47.5%) was significantly lower in telbivudine-treated mothers than that in the controls (0%), and 75.5% patients alanine aminotransferase returned to normal in telbivudine group, and 51% in control group at delivery (P < 0.001), respectively. CONCLUSIONS: Telbivudine can safely reduce mother-to-child transmission in chronic hepatitis B women after 12 weeks of gestation.


Assuntos
Antivirais/uso terapêutico , Vacinas contra Hepatite B/imunologia , Hepatite B Crônica/tratamento farmacológico , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Telbivudina/uso terapêutico , Adulto , Alanina Transaminase/sangue , Estudos de Casos e Controles , DNA Viral/sangue , Feminino , Idade Gestacional , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/genética , Vírus da Hepatite B/isolamento & purificação , Humanos , Imunoglobulina G/sangue , Lactente , Recém-Nascido , Gravidez , Estudos Prospectivos , Adulto Jovem
11.
Clin Nephrol ; 92(4): 190-200, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31347499

RESUMO

BACKGROUND: Patients on dialysis are at risk of hepatitis B virus (HBV) infection, and antibodies against the hepatitis B surface antigen (anti-HBs) ≥ 10 IU/L are required. However, a high percentages of HBV vaccine nonresponders have been reported. We aimed to determine the optimal HBV vaccination protocol. MATERIALS AND METHODS: Kidney transplant waitlisted patients were followed for 12 months and categorized into two groups. Group A included patients with sustained anti-HBs ≥ 10 IU/L who did not require vaccination. Group B consisted of patients with anti-HBs < 10 IU/L who were treated with a course of 4 double-dose HBV vaccinations. Without seroconversion after the first course, a second course was initiated. A third course, coadministered with the tetanus-diphtheria (Td) vaccine, was performed upon failure of the second course. RESULTS: A total of 266 patients were included, 140 were categorized into group A and 126 into group B. Higher serum phosphorus, hemoglobin, and antibodies against the hepatitis core antigen (anti-HBc) were associated with sustaining anti-HBs ≥ 10 IU/L without vaccination. Diabetes mellitus (DM) was associated with the need for vaccination. For group B, 107 patients required 1 course of vaccination, 15 patients required 2 courses, and 4 patients required the third course with Td vaccine coadministration. Long dialysis vintage and low hemoglobin level were associated with seroconversion failure after the first course. CONCLUSION: Serum phosphorus, hemoglobin, DM, anti-HBc, and dialysis vintage were associated with the anti-HBs seroresponsiveness and sustainability. Our 3-course of 4 double-dose HBV vaccines regimen (with Td vaccine in the final course) conferred immunity to all patients.


Assuntos
Anticorpos Anti-Hepatite B/sangue , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Vacinas contra Hepatite B/imunologia , Transplante de Rim , Vacinação , Listas de Espera , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
12.
BMC Infect Dis ; 19(1): 507, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31182043

RESUMO

BACKGROUND: Population immunity against hepatitis B virus (HBV) in Lao People's Demographic Republic (PDR) has not been examined since the national HBV vaccination program was started in 2002. Vaccine has been observed to be frozen at times during cold-chain transport in vaccination programs in Lao PDR and other developing countries, which will inactivate the vaccine. Therefore, this study used post-vaccination serologic testing to evaluate the effects of HBV immunization in Lao PDR. METHODS: A cross-sectional serologic study was conducted among children (age range, 5-9 years) and mothers (15-45 years) who were randomly selected using probability-proportional-to-size sampling from central Lao PDR. Blood samples were collected as dried blood spots (DBS) and analyzed using chemiluminescent microparticle immunoassay to detect anti-hepatitis B surface (HBs) titers. We also evaluated the correlation between anti-HBs levels measured in DBS and serum among healthy healthcare workers in Vientiane. RESULTS: Anti-HBs titers from DBS were strongly correlated with serum levels (correlation coefficient = 0.999) in all 12 healthcare workers evaluated. A linear regression model showed that 10 mIU/mL of serum anti-HBs was equivalent to 3.45 mIU/mL (95% CI: 3.06-3.85) of DBS. Among 911 mother-child pairs tested, 171 children had documentation of vaccination. Of the 147 children who had received ≥3 doses of the hepatitis B vaccine, 1 (0.7%) was positive for anti-HBs. The remaining 24 children received the hepatitis B vaccine only twice, once or no dose. CONCLUSIONS: The results showed extremely low positivity for anti-HBs among vaccinated children in central Lao PDR. Therefore, post-vaccination serologic testing is important to evaluate population immunity against HBV infection. DBS testing is a potential low-cost tool to evaluating the effectiveness of HBV vaccination programs.


Assuntos
Anticorpos Anti-Hepatite B/sangue , Vacinas contra Hepatite B/imunologia , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Teste em Amostras de Sangue Seco , Feminino , Antígenos de Superfície da Hepatite B/sangue , Antígenos de Superfície da Hepatite B/imunologia , Humanos , Laos/epidemiologia , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Vacinação , Adulto Jovem
13.
PLoS One ; 14(5): e0217415, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31150445

RESUMO

INTRODUCTION AND METHODS: Hepatitis B is a vaccine preventable disease and is notifiable in South Africa. Hepatitis B vaccination was incorporated into the Expanded Programme on Immunisation in South Africa in 1995. We used a convenience sample from community-based febrile rash surveillance in 2013 to estimate hepatitis B sero-prevalence. Of samples serologically negative for acute measles infection, 450 samples spanning nine provinces of South Africa were tested for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs) and hepatitis B core antibody (anti-HBc). RESULTS: Two children (2/450; 0.4%) tested positive for HBsAg. Three hundred and three children (67.3%) had evidence of vaccine induced immunity. Vaccine induced immunity was present in 80.2% of 1-5 year olds, but only 60.3% of 10-14 year olds. Natural immunity, indicating exposure to circulating hepatitis B, was present in 13/450 (2.9%) children. CONCLUSION: Chronic hepatitis B in South African has decreased in prevalence from highly endemic levels prior to vaccine introduction to approximately 0.4% in this sample, demonstrating impact of a successful vaccination programme 18 years after introduction. Decreased vaccine-induced immunity with increasing age may reflect waning antibody titres over time.


Assuntos
Exantema/virologia , Vacinas contra Hepatite B/imunologia , Hepatite B/epidemiologia , Hepatite B/imunologia , Adolescente , Criança , Pré-Escolar , Feminino , Anticorpos Anti-Hepatite B/imunologia , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/imunologia , Humanos , Programas de Imunização/métodos , Lactente , Recém-Nascido , Masculino , Sarampo/virologia , Prevalência , África do Sul/epidemiologia , Vacinação/métodos
14.
BMC Infect Dis ; 19(1): 482, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31146699

RESUMO

BACKGROUND: To assess the immune persistence conferred by a Chinese hamster ovary (CHO)-derived hepatitis B vaccine (HepB) 17 to 20 years after primary immunization during early life. METHODS: Participants born between 1997 and 1999 who received a full course of primary vaccination with HepB (CHO) and who had no experience with booster vaccination were enrolled. Blood samples were required from each participant for measurement of hepatitis B surface antibody (anti-HBs), surface antigen and core antibody levels. For those who possessed an anti-HBs antibody < 10 mIU/mL, a single dose of HepB was administered, and 30 days later, serum specimens were collected to assess the booster effects. RESULTS: A total of 1352 participants were included in this study. Of these, 1007 (74.5%) participants could retain an anti-HBs antibody ≥10 mIU/mL, with a geometric mean concentration (GMC) of 57.4 mIU/mL. HBsAg was detected in six participants, resulting in a HBsAg carrier rate of 0.4% (6/1352). Of those participants with anti-HBs antibodies < 10 mIU/mL, after a challenge dose, 231 (93.1%) presented an anti-HBs antibody ≥10 mIU/mL, with a GMC of 368.7 mIU/mL. A significant increase in the anti-HBs positive rate (≥ 10 mIU/mL) after challenge was observed in participants with anti-HBs antibodies between 2.5 and 10 mIU/mL and participants boosted with HepB (CHO), rather than those with anti-HBs antibodies < 2.5 mIU/mL and those boosted with HepB (SC). CONCLUSION: Since satisfactory immune protection against HBV infection conferred by primary vaccination administered 17-20 years ago was demonstrated, there is currently no urgent need for booster immunization.


Assuntos
Anticorpos Anti-Hepatite B/sangue , Vacinas contra Hepatite B/administração & dosagem , Hepatite B/prevenção & controle , Imunização Secundária , Prevenção Primária , Vacinas Sintéticas/imunologia , Vacinas Sintéticas/uso terapêutico , Adolescente , Adulto , Animais , Células CHO , Cricetinae , Cricetulus , Feminino , Seguimentos , Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/imunologia , Vacinas contra Hepatite B/imunologia , Humanos , Recém-Nascido , Masculino , Prevenção Primária/métodos , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
15.
Rev Soc Bras Med Trop ; 52: e20180132, 2019 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-31141041

RESUMO

INTRODUCTION: Medical students have an occupational risk for hepatitis B (HB). This study sought to determine anti-HBs and anti-HBc IgG levels in vaccinated students, check their seroconversion, and correlate this with vaccination. METHODS: One hundred and forty-three students' blood samples and their vaccination schedules were analyzed. RESULTS: 65.7% were positive for anti-HBs; however, anti-HBs was absent in 34.3%. Only two samples were positive for anti-HBc IgG. CONCLUSIONS: More than 30% of students did not have minimum protective levels. Comparing HBV vaccination and anti-HBs reactivity, the majority of reactive individuals received their last dose within the past 16 years.


Assuntos
Vacinas contra Hepatite B/imunologia , Vírus da Hepatite B/imunologia , Hepatite B/prevenção & controle , Estudantes de Medicina , Adolescente , Adulto , Estudos Transversais , Feminino , Anticorpos Anti-Hepatite B/sangue , Anticorpos Anti-Hepatite B/imunologia , Antígenos do Núcleo do Vírus da Hepatite B/sangue , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/sangue , Antígenos de Superfície da Hepatite B/imunologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Masculino , Adulto Jovem
16.
AIDS Res Ther ; 16(1): 10, 2019 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-31053142

RESUMO

BACKGROUND: Presence of isolated anti-HBc antibody is common in HIV-infected patients in endemic areas and could be caused by prior HBV infection with loss of anti-HBs antibody. The role of vaccination in these patients remains controversial and is based largely on limited and low quality data. We, therefore, conducted this study to determine immunogenicity and safety of 4 vs. 3 standard doses of HBV vaccination in HIV-infected adults with isolated anti-HBc antibody. METHODS: An open-label, randomized controlled trial was conducted among HIV-infected patients visiting HIV clinic of the Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand between July and September 2017. Inclusion criteria included ≥ 18 years of age, currently on a stable antiretroviral regimen, CD4+ cell count ≥ 200 cells/mm3, plasma HIV-1 RNA < 20 copies/mL, and isolated anti-HBc antibody. The participants were randomized to receive either 3 standard doses (20 µg at month 0, 1, 6) or 4 standard-doses (20 µg at month 0, 1, 2, 6) of IM HBV vaccination, and were evaluated for anamnestic response at week 4 and vaccine response at week 28. RESULTS: Of the 97 patients screened, 54 (32 male, mean age of 46 years) were enrolled and 27 were allocated to each of the vaccination groups. Anamnestic response occurred in 25.9% vs. 33.3% in 3-dose group vs. 4-dose group, respectively (p = 0.551). The vaccine response rates at week 28 were 85.2% in 3-dose group vs. 88.9% in 4-dose group (p = 1.000); geometric mean titer of anti-HBs antibody at week 28 was 63.8 and 209.8 mIU/mL in 3-dose group and 4-dose group, respectively (p = 0.030). No adverse events were reported. CONCLUSIONS: An anamnestic response occurred in one-third of Thai HIV-infected patients with isolated anti-HBc antibody who received one dose of HBV vaccination; however, the majority were still unprotected. The use of either 3 or 4 standard-doses of vaccination was highly effective and should be recommended in all HIV-infected individuals with isolated anti-HBc antibody. Trial registration ClinicalTrials.gov; NCT03212911. Registered 11 July 2019, https://clinicaltrials.gov/ct2/show/NCT03212911.


Assuntos
Infecções por HIV/complicações , Anticorpos Anti-Hepatite B/sangue , Vacinas contra Hepatite B/administração & dosagem , Vacinas contra Hepatite B/imunologia , Imunogenicidade da Vacina , Adulto , Feminino , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Vírus da Hepatite B , Humanos , Memória Imunológica , Masculino , Pessoa de Meia-Idade
17.
BMC Infect Dis ; 19(1): 372, 2019 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-31046683

RESUMO

BACKGROUND: In the UK, hepatitis B virus (HBV) incidence is associated with migrants from particular high-burden countries and population groups deemed 'hard-to-reach' by standard healthcare services: the homeless, people who inject drugs and ex-prisoners. Currently, there is a national targeted HBV vaccine policy for such at-risk groups, but there is limited recent evidence about 1) the levels of vaccine uptake, 2) the factors associated with incomplete vaccination, and 3) reasons for incomplete vaccination. METHODS: A questionnaire capturing social and medical history, demographic factors and information about HBV vaccination status was completed by individuals deemed hard-to-reach due to socio-structural factors that criminalise, isolate and stigmatise who consented to participate in a randomised controlled trial of a peer intervention to promote engagement with hepatitis C services. The questionnaire also captured the reasons for incomplete vaccination. Descriptive, univariable and multivariable regression analyses were undertaken. RESULTS: Three hundred fourty six participants completed the questionnaire. 1) 52.3% (n = 181) reported full HBV vaccination. 2) Within a multivariable model adjusting for sociodemographic variables, the presence of one or two or more socio-structural factors that are included in the national targeted vaccination policy was associated with protection against incomplete HBV vaccination (51.7% vaccine coverage in those with one factor, odds ratio 0.43 [95% confidence interval 0.20-0.92]); 70.1% coverage with two or more factors, 0.19 [0.09-0.39]; overall p-value < 0.001). Being female was also associated with lower vaccine uptake (2.37 [1.24-4.57], 0.01). Examining the socio-structural factors individually, intravenous drug use was associated with protection against incomplete HBV vaccination. 3) The most common reasons declared for incomplete vaccination were never being offered the vaccine or not returning for further doses. CONCLUSION: Within this study of HBV vaccination uptake among hard-to-reach population groups in London, UK, we document 52.3% coverage of the full vaccine course. Critically, although participants recommended for immunisation within national guidelines had an increased likelihood of receiving a complete vaccine course, we note surprisingly low coverage in the presence of the risk factors that are national indicators for vaccination. Public health bodies should make additional efforts to improve coverage in the hard-to-reach through improved vaccine delivery systems. TRIAL REGISTRATION: ISRCTN24707359 , Registered 19th October 2012.


Assuntos
Vacinas contra Hepatite B/imunologia , Hepatite B/prevenção & controle , Vacinação/estatística & dados numéricos , Adulto , Idoso , Estudos Transversais , Demografia , Feminino , Hepatite B/epidemiologia , Vírus da Hepatite B/imunologia , Humanos , Londres , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
18.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(5): 497-502, 2019 May 06.
Artigo em Chinês | MEDLINE | ID: mdl-31091608

RESUMO

Objective: To estimate the immune memory at 12 years after hepatitis B vaccination and its risk factors among adults. Methods: The study was conducted in 20 villages of Qudi town in Jiyang county, Shandong province, China in 2003. Hepatitis B surface antigen (HBsAg), antibody against HBsAg (anti-HBs) and antibody against hepatitis B core antigen (anti-HBc) were tested for all healthy residents aged 15-40 years in these villages. Those who had no history of hepatitis B vaccination and were negative for all three indicators were divided into two groups randomly. Hepatitis B vaccine (HepB) was administrated to them on 0-6 month schedule or 0-1-6 month schedule respectively. Blood samples were obtained at one month after the last dose for each receipt and were quantitatively detected for anti-HBs. Finally a total of 629 participants completed HepB vaccination and anti-HBs testing, including 288 of two-dose group and 341 of three-dose group respectively. In 2015, an additional dose of HepB (challenge dose) was administrated to those who were negative for anti-HBs at follow-up (anti-HBs <10 mIU/ml) to evaluate the immune memory. A total of 93 blood samples, including 50 of two-dose group and 43 of three-dose group respectively, were drawn at 14 days after the challenge dose and anti-HBs was quantitatively detected. The anti-HBs geometric mean concentrations (GMCs) after the challenge dose were compared between the two groups. Multivariate linear regression model was built to find the independent risk factors associated with immune memory response (anti-HBs GMC after the challenge dose). Results: The challenge dose of HepB and post-challenge anti-HBs detection were completed among 93 participants. Totally 92 (98.92%, 92/93) participants were found holding immune memory (anti-HBs after the challenge dose was ≥10 mIU/ml). The immune memory positive rates were 100% (50/50) and 97.67% (42/43) in the two-dose group and three-dose group respectively and the corresponding anti-HBs GMC after challenge dose were 2 684.30 (95%CI: 1 721.71-4 185.08) mIU/ml and 3 527.48 (95%CI: 2 145.15-5 800.58) mIU/ml (P=0.410). The anti-HBs GMC after the challenge dose were 1 908.33 (95%CI: 1 190.01-3 060.27) mIU/ml, 4 004.20 (95%CI: 2 257.90-7 101.12) mIU/ml and 8 682.16 (95%CI: 5 813.94-12 965.36) mIU/ml among the participants whose anti-HBs titer was<4, 4-6 and 7-9 mIU/ml at follow-up, respectively (P=0.002). There was no correlation between immune schedule and anti-HBs GMC after the challenge dose; ß (95%CI) was -0.07 (-0.34-0.20), P=0.601. Conclusion: The immune memory after primary hepatitis B vaccination lasted for at least 12 years among adults. The immune memory response was independently associated with ant-HBs titer at follow-up, but might be similar between 0-6 month schedule and 0-1-6 month schedule.


Assuntos
Vacinas contra Hepatite B/imunologia , Hepatite B/imunologia , Memória Imunológica , Adolescente , Adulto , China , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Humanos , Adulto Jovem
19.
Am J Trop Med Hyg ; 101(1): 226-229, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31074406

RESUMO

Hepatitis B virus (HBV) is endemic throughout Africa, but its prevalence in the Democratic Republic of the Congo (DRC) is incompletely understood. We used dried blood spot (DBS) samples from the 2013 to 2014 Demographic and Health Survey in the DRC to measure the prevalence of HBV using the Abbott ARCHITECT HBV surface antigen (HBsAg) qualitative assay. We then attempted to sequence and genotype HBsAg-positive samples. The weighted national prevalence of HBV was 3.3% (95% CI: 1.8-4.7%), with a prevalence of 2.2% (95% CI: 0.3-4.1%) among children. Hepatitis B virus cases occurred countrywide and across age strata. Genotype E predominated (60%), and we found a unique cluster of genotype A isolates (30%). In conclusion, DBS-based HBsAg testing from a nationally representative survey found that HBV is common and widely distributed among Congolese adults and children. The distribution of cases across ages suggests ongoing transmission and underscores the need for additional interventions to prevent HBV infection.


Assuntos
Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/imunologia , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Adolescente , Adulto , Criança , Pré-Escolar , República Democrática do Congo/epidemiologia , Feminino , Técnicas de Genotipagem , Hepatite B/transmissão , Vacinas contra Hepatite B/imunologia , Vírus da Hepatite B/classificação , Vírus da Hepatite B/genética , Humanos , Lactente , Masculino , Prevalência , Estudos Soroepidemiológicos , Fatores Socioeconômicos , Vacinação , Adulto Jovem
20.
Artigo em Inglês | MEDLINE | ID: mdl-31035698

RESUMO

Background: Immunization of healthcare workers (HCWs) and medical students for the hepatitis B virus (HBV) is a crucial part of the hospital infection control programs. The aim of our study was to evaluate the persistence of anti-HBV specific antibodies in HCWs vaccinated during infancy or adolescence. Methods: Medical records of 734 consecutive subjects born after 1980 (481 females, 65.5% and 253 males, 34.5%) who underwent serological testing for anti-hepatitis B surface antibodies (anti-HBs) were evaluated. Results: A non-protective titer (<10 mUI) was found in 88/734 (12.0%) subjects; 84 (47.8%) of them received a booster dose of anti-hepatitis B vaccine and the anti-HBs titer of 58 subjects was measured 1 month after administration. A protective titer (anti-HBs >10 mIU/mL) was observed in almost 90% of subjects receiving the booster dose. Conclusions: A substantial percentage of HCWs had a non-protective anti-HBs titer at the time of the first employment, especially those vaccinated at birth age. However, the response to the booster dose showed that in these subjects, an anti-HBs titer <10 mIU/mL was due to the physiological decline of antibodies over the years. Therefore, primary immunization in childhood is highly effective and provides lasting immunity against HBV infection.


Assuntos
Pessoal de Saúde , Anticorpos Anti-Hepatite B/sangue , Vacinas contra Hepatite B/imunologia , Hepatite B/prevenção & controle , Estudantes de Medicina , Adolescente , Adulto , Criança , Feminino , Antígenos de Superfície da Hepatite B , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/imunologia , Humanos , Imunização Secundária , Lactente , Itália , Masculino , Testes Sorológicos , Vacinação , Adulto Jovem
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