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Van Damme P, Pintó RM, Feng Z, Cui F, Gentile A, Shouval D. Hepatitis A virus infection. Nat Rev Dis Primers 2023; 9:51. [PMID: 37770459 DOI: 10.1038/s41572-023-00461-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/23/2023] [Indexed: 09/30/2023]
Abstract
Hepatitis A is a vaccine-preventable infection caused by the hepatitis A virus (HAV). Over 150 million new infections of hepatitis A occur annually. HAV causes an acute inflammatory reaction in the liver that usually resolves spontaneously without chronic sequelae. However, up to 20% of patients experience a prolonged or relapsed course and <1% experience acute liver failure. Host factors, such as immunological status, age, pregnancy and underlying hepatic diseases, can affect the severity of disease. Anti-HAV IgG antibodies produced in response to HAV infection persist for life and protect against re-infection; vaccine-induced antibodies against hepatitis A confer long-term protection. The WHO recommends vaccination for individuals at higher risk of infection and/or severe disease in countries with very low and low hepatitis A virus endemicity, and universal childhood vaccination in intermediate endemicity countries. To date, >25 countries worldwide have implemented such programmes, resulting in a reduction in the incidence of HAV infection. Improving hygiene and sanitation, rapid identification of outbreaks and fast and accurate intervention in outbreak control are essential to reducing HAV transmission.
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Affiliation(s)
- Pierre Van Damme
- Centre for the Evaluation of Vaccination, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
| | - Rosa M Pintó
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Zongdi Feng
- Centre for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Angela Gentile
- Department of Epidemiology, Hospital de Niños Ricardo Gutierrez, University of Buenos Aires, Buenos Aires, Argentina
| | - Daniel Shouval
- Institute of Hepatology, Hadassah-Hebrew University Hospital, Jerusalem, Israel
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Liu J, Mao Q, Wu X, He Q, Bian L, Bai Y, Wang Z, Wang Q, Zhang J, Liang Z, Xu M. Considerations for the Feasibility of Neutralizing Antibodies as a Surrogate Endpoint for COVID-19 Vaccines. Front Immunol 2022; 13:814365. [PMID: 35572565 PMCID: PMC9092276 DOI: 10.3389/fimmu.2022.814365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 03/31/2022] [Indexed: 01/02/2023] Open
Abstract
To effectively control and prevent the pandemic of coronavirus disease 2019 (COVID-19), suitable vaccines have been researched and developed rapidly. Currently, 31 COVID-19 vaccines have been approved for emergency use or authorized for conditional marketing, with more than 9.3 billion doses of vaccines being administered globally. However, the continuous emergence of variants with high transmissibility and an ability to escape the immune responses elicited by vaccines poses severe challenges to the effectiveness of approved vaccines. Hundreds of new COVID-19 vaccines based on different technology platforms are in need of a quick evaluation for their efficiencies. Selection and enrollment of a suitable sample of population for conducting these clinical trials is often challenging because the pandemic so widespread and also due to large scale vaccination. To overcome these hurdles, methods of evaluation of vaccine efficiency based on establishment of surrogate endpoints could expedite the further research and development of vaccines. In this review, we have summarized the studies on neutralizing antibody responses and effectiveness of the various COVID-19 vaccines. Using this data we have analyzed the feasibility of establishing surrogate endpoints for evaluating the efficacy of vaccines based on neutralizing antibody titers. The considerations discussed here open up new avenues for devising novel approaches and strategies for the research and develop as well as application of COVID-19 vaccines.
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Affiliation(s)
- Jianyang Liu
- National Institutes for Food and Drug Control, Beijing, China
- NHC Key Laboratory of Research on Quality and Standardization of Biotech Products, Beijing, China
- NMPA Key Laboratory for Quality Research and Evaluation of Biological Products, Beijing, China
| | - Qunying Mao
- National Institutes for Food and Drug Control, Beijing, China
- NHC Key Laboratory of Research on Quality and Standardization of Biotech Products, Beijing, China
- NMPA Key Laboratory for Quality Research and Evaluation of Biological Products, Beijing, China
| | - Xing Wu
- National Institutes for Food and Drug Control, Beijing, China
- NHC Key Laboratory of Research on Quality and Standardization of Biotech Products, Beijing, China
- NMPA Key Laboratory for Quality Research and Evaluation of Biological Products, Beijing, China
| | - Qian He
- National Institutes for Food and Drug Control, Beijing, China
- NHC Key Laboratory of Research on Quality and Standardization of Biotech Products, Beijing, China
- NMPA Key Laboratory for Quality Research and Evaluation of Biological Products, Beijing, China
| | - Lianlian Bian
- National Institutes for Food and Drug Control, Beijing, China
- NHC Key Laboratory of Research on Quality and Standardization of Biotech Products, Beijing, China
- NMPA Key Laboratory for Quality Research and Evaluation of Biological Products, Beijing, China
| | - Yu Bai
- National Institutes for Food and Drug Control, Beijing, China
- NHC Key Laboratory of Research on Quality and Standardization of Biotech Products, Beijing, China
- NMPA Key Laboratory for Quality Research and Evaluation of Biological Products, Beijing, China
| | | | - Qian Wang
- National Institutes for Food and Drug Control, Beijing, China
- NHC Key Laboratory of Research on Quality and Standardization of Biotech Products, Beijing, China
- NMPA Key Laboratory for Quality Research and Evaluation of Biological Products, Beijing, China
| | - Jialu Zhang
- National Institutes for Food and Drug Control, Beijing, China
- NHC Key Laboratory of Research on Quality and Standardization of Biotech Products, Beijing, China
- NMPA Key Laboratory for Quality Research and Evaluation of Biological Products, Beijing, China
| | - Zhenglun Liang
- National Institutes for Food and Drug Control, Beijing, China
- NHC Key Laboratory of Research on Quality and Standardization of Biotech Products, Beijing, China
- NMPA Key Laboratory for Quality Research and Evaluation of Biological Products, Beijing, China
| | - Miao Xu
- National Institutes for Food and Drug Control, Beijing, China
- NHC Key Laboratory of Research on Quality and Standardization of Biotech Products, Beijing, China
- NMPA Key Laboratory for Quality Research and Evaluation of Biological Products, Beijing, China
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Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021; 70:1-187. [PMID: 34292926 PMCID: PMC8344968 DOI: 10.15585/mmwr.rr7004a1] [Citation(s) in RCA: 697] [Impact Index Per Article: 232.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
These guidelines for the treatment of persons who have or are at risk for
sexually transmitted infections (STIs) were updated by CDC after consultation
with professionals knowledgeable in the field of STIs who met in Atlanta,
Georgia, June 11–14, 2019. The information in this report updates the
2015 guidelines. These guidelines discuss 1) updated recommendations for
treatment of Neisseria gonorrhoeae, Chlamydia trachomatis,
and Trichomonas vaginalis; 2) addition of
metronidazole to the recommended treatment regimen for pelvic inflammatory
disease; 3) alternative treatment options for bacterial vaginosis; 4) management
of Mycoplasma genitalium; 5) human papillomavirus vaccine
recommendations and counseling messages; 6) expanded risk factors for syphilis
testing among pregnant women; 7) one-time testing for hepatitis C infection; 8)
evaluation of men who have sex with men after sexual assault; and 9) two-step
testing for serologic diagnosis of genital herpes simplex virus. Physicians and
other health care providers can use these guidelines to assist in prevention and
treatment of STIs.
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Nelson NP, Weng MK, Hofmeister MG, Moore KL, Doshani M, Kamili S, Koneru A, Haber P, Hagan L, Romero JR, Schillie S, Harris AM. Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020. MMWR Recomm Rep 2020; 69:1-38. [PMID: 32614811 PMCID: PMC8631741 DOI: 10.15585/mmwr.rr6905a1] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
HEPATITIS A IS A VACCINE-PREVENTABLE, COMMUNICABLE DISEASE OF THE LIVER CAUSED BY THE HEPATITIS A VIRUS (HAV). THE INFECTION IS TRANSMITTED VIA THE FECAL-ORAL ROUTE, USUALLY FROM DIRECT PERSON-TO-PERSON CONTACT OR CONSUMPTION OF CONTAMINATED FOOD OR WATER. HEPATITIS A IS AN ACUTE, SELF-LIMITED DISEASE THAT DOES NOT RESULT IN CHRONIC INFECTION. HAV ANTIBODIES (IMMUNOGLOBULIN G [IGG] ANTI-HAV) PRODUCED IN RESPONSE TO HAV INFECTION PERSIST FOR LIFE AND PROTECT AGAINST REINFECTION; IGG ANTI-HAV PRODUCED AFTER VACCINATION CONFER LONG-TERM IMMUNITY. THIS REPORT SUPPLANTS AND SUMMARIZES PREVIOUSLY PUBLISHED RECOMMENDATIONS FROM THE ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES (ACIP) REGARDING THE PREVENTION OF HAV INFECTION IN THE UNITED STATES. ACIP RECOMMENDS ROUTINE VACCINATION OF CHILDREN AGED 12-23 MONTHS AND CATCH-UP VACCINATION FOR CHILDREN AND ADOLESCENTS AGED 2-18 YEARS WHO HAVE NOT PREVIOUSLY RECEIVED HEPATITIS A (HEPA) VACCINE AT ANY AGE. ACIP RECOMMENDS HEPA VACCINATION FOR ADULTS AT RISK FOR HAV INFECTION OR SEVERE DISEASE FROM HAV INFECTION AND FOR ADULTS REQUESTING PROTECTION AGAINST HAV WITHOUT ACKNOWLEDGMENT OF A RISK FACTOR. THESE RECOMMENDATIONS ALSO PROVIDE GUIDANCE FOR VACCINATION BEFORE TRAVEL, FOR POSTEXPOSURE PROPHYLAXIS, IN SETTINGS PROVIDING SERVICES TO ADULTS, AND DURING OUTBREAKS.
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Fritzsche C, Bergmann L, Loebermann M, Glass A, Reisinger EC. Immune response to hepatitis A vaccine in patients with HIV. Vaccine 2019; 37:2278-2283. [PMID: 30890384 DOI: 10.1016/j.vaccine.2019.02.064] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 02/10/2019] [Accepted: 02/19/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the impact of various factors that may influence the immunologic response to hepatitis A mono-vaccine or hepatitis A/B co-vaccine (Twinrix®) in HIV-infected patients. DESIGN Retrospective cross-sectional study. METHODS HIV positive patients with a full course of hepatitis A vaccine were tested for HAV antibodies. The seroconversion rates were determined, and the influence of several factors including CD4 cell counts, CD4/CD8 ratio, plasma viral load, type of vaccine, and antiretroviral therapy at the time of vaccine, was evaluated. RESULTS After vaccination, 80.2% of the patients developed anti-HAV antibodies, 81.5% in the mono-vaccine group and 79.2% in the hepatitis A/B co-vaccine group. In the mono-vaccine group, factors significantly associated with a better response to the vaccine were higher CD4 cell count, higher CD4/CD8 ratio, and shorter time interval from vaccine to serological control. In patients who received the hepatitis A/B co-vaccine, younger age and female sex were significantly associated with better vaccine response. Multivariable logistic regression analysis revealed time interval from vaccine to serological control of more than 5 years vs. less than 1 year to be significantly associated with decrease of seroconversion after HAV vaccine. CONCLUSIONS The response to hepatitis A vaccine is impaired in HIV positive patients. HIV patients, at least those older than 30, should be tested for seroconversion after receiving the hepatitis A vaccine. As hepatitis A titers may rapidly decline, control serology during follow-up should be proposed, possibly within two years. However, vaccine type does not play a role in vaccine response.
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Affiliation(s)
- Carlos Fritzsche
- Division of Tropical Medicine and Infectious Diseases, Department of Medicine, All University Medical School of Rostock, Germany.
| | - Lisa Bergmann
- Division of Tropical Medicine and Infectious Diseases, Department of Medicine, All University Medical School of Rostock, Germany
| | - Micha Loebermann
- Division of Tropical Medicine and Infectious Diseases, Department of Medicine, All University Medical School of Rostock, Germany
| | - Aenne Glass
- Institute for Biostatistics and Informatics in Medicine and Ageing Research, All University Medical School of Rostock, Germany
| | - Emil C Reisinger
- Division of Tropical Medicine and Infectious Diseases, Department of Medicine, All University Medical School of Rostock, Germany
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Sabrià A, Gregori J, Garcia-Cehic D, Guix S, Pumarola T, Manzanares-Laya S, Caylà JA, Bosch A, Quer J, Pintó RM. Evidence for positive selection of hepatitis A virus antigenic variants in vaccinated men-having-sex-with men patients: Implications for immunization policies. EBioMedicine 2018; 39:348-357. [PMID: 30472089 PMCID: PMC6354442 DOI: 10.1016/j.ebiom.2018.11.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/13/2018] [Accepted: 11/13/2018] [Indexed: 01/23/2023] Open
Abstract
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.
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Affiliation(s)
- Aurora Sabrià
- Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, School of Biology, Institute of Nutrition and Food Safety, Campus Torribera, University of Barcelona, Barcelona, Spain
| | - Josep Gregori
- Liver Unit, Internal Medicine Hospital Vall d'Hebron, Autonomous University of Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Roche Diagnostics, S.L., Sant Cugat del Vallés, Barcelona, Spain
| | - Damir Garcia-Cehic
- Liver Unit, Internal Medicine Hospital Vall d'Hebron, Autonomous University of Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) del Instituto de Salud Carlos III, Madrid, Spain
| | - Susana Guix
- Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, School of Biology, Institute of Nutrition and Food Safety, Campus Torribera, University of Barcelona, Barcelona, Spain
| | - Tomàs Pumarola
- Virology Unit, Microbiology Department, Hospital Vall d'Hebron, Autonomous University of Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Sandra Manzanares-Laya
- Epidemiology Service, Public Health Agency of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBEResp) del Instituto de Salud Carlos III, Madrid, Spain
| | - Joan A Caylà
- Epidemiology Service, Public Health Agency of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBEResp) del Instituto de Salud Carlos III, Madrid, Spain
| | - Albert Bosch
- Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, School of Biology, Institute of Nutrition and Food Safety, Campus Torribera, University of Barcelona, Barcelona, Spain
| | - Josep Quer
- Liver Unit, Internal Medicine Hospital Vall d'Hebron, Autonomous University of Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) del Instituto de Salud Carlos III, Madrid, Spain.
| | - Rosa M Pintó
- Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, School of Biology, Institute of Nutrition and Food Safety, Campus Torribera, University of Barcelona, Barcelona, Spain.
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Human respiratory syncytial virus: pathogenesis, immune responses, and current vaccine approaches. Eur J Clin Microbiol Infect Dis 2018; 37:1817-1827. [PMID: 29876771 DOI: 10.1007/s10096-018-3289-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 05/22/2018] [Indexed: 10/14/2022]
Abstract
Respiratory syncytial virus continues to pose a serious threat to the pediatric populations worldwide. With a genomic makeup of 15,200 nucleotides, the virus encodes for 11 proteins serving as envelope spikes, inner envelope proteins, and non-structural and ribonucleocapsid complexes. The fusion (F) and attachment (G) surface glycoproteins are the key targets for neutralizing antibodies. The highly variable G with altered glycosylations and the conformational alternations of F create challenges for vaccine development. The metastable F protein is responsible for RSV-host cell fusion and thus infectivity. Novel antigenic sites were identified on this form following its stabilization and solving its crystal structure. Importantly, site ø displays neutralizing activity exceeding those of post-F-specific and shared antigenic sites, such as site II which is the target for Palivizumab therapeutic antibody. Induction of high neutralizing antibody responses by pre-F immunization in animal models promoted it as a major vaccine candidate. Since RSV infection is more serious at age extremities and in individuals with undermining health conditions, vaccines are being developed to target these populations. Infants below three months of age have a suppressive immune system, making vaccines' immunogenicity weak. Therefore, a suggested strategy to protect newborns from RSV infection would be through passive immunity of maternal antibodies. Hence, pregnant women at their third trimester have been selected as an ideal target for vaccination with RSV pre-F vaccine. This review summarizes the different modes of RSV pathogenesis and host's immune response to the infection, and illustrates on the latest updates of vaccine development and vaccination approaches.
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Initial evaluation of universal immunization with a single dose against hepatitis A virus in Central Brazil. Braz J Infect Dis 2018; 22:166-170. [PMID: 29684320 PMCID: PMC9425659 DOI: 10.1016/j.bjid.2018.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 03/26/2018] [Accepted: 04/02/2018] [Indexed: 01/19/2023] Open
Abstract
Vaccination against the hepatitis A virus (HAV) administered in two doses has been used effectively in universal child immunization programs in several countries. A single-dose vaccination was adopted in some low-income countries in an attempt to reduce costs without losing effectiveness. In 2014, single-dose universal vaccination was introduced in Brazil for children aged two years. Since such strategy is still not universally accepted, its efficacy should be compared to the two-dose strategy. To assess the humoral response after the single-dose HAV vaccination schedule, a cross-sectional study was conducted in Primavera do Leste, in Mato Grosso state, Central Brazil, including 265 children vaccinated through the National Immunization Program. Blood was collected by using a digital puncture and further applied to filter paper cards. Anti-HAV was detected in 218 out of 265 dried blood spots (DBS). Blood venous samples were collected from 34 out of 47 children who were not anti-HAV positive in DBS samples. Eighteen of them tested positive for anti-HAV, giving a final score of 93.6% (236/252) of seropositivity. In conclusion, this study demonstrated a high rate of anti-HAV positivity in the short term after single-dose hepatitis A vaccination in the population investigated. Moreover, the DBS was shown to be a reliable tool for detecting anti-HAV antibodies.
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Chen Y, Zhou CL, Zhang XJ, Hao ZY, Zhang YH, Wang SM, Ma JC, Zhao G, Qiu C, Zhao YL, Wang B, Wang XY. Immune memory at 17-years of follow-up of a single dose of live attenuated hepatitis A vaccine. Vaccine 2017; 36:114-121. [PMID: 29183734 DOI: 10.1016/j.vaccine.2017.11.036] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 09/28/2017] [Accepted: 11/13/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND In recent years, hepatitis A virus (HAV) infection has declined considerably in China, associated with wide deployment of HAV vaccines and improvement in socio-economic indicators. Towards the elimination of HA in the country, we assessed the duration and characteristics of immunity conferred by the widely used, locally manufactured HAV vaccine. METHODS This is a longitudinal cohort study that followed recipients of a live attenuated HAV vaccine 17 years after the initial administration. Blood samples were collected from participants pre- and two-week post-booster HAV vaccine dose. Serum anti-HAV antibody was measured by ELISA method. Memory B and T cells were determined by ELISPOT and Flow Cytometry assays, respectively. RESULTS A robust anamnestic response was observed two-week post-challenge. Both HAV-specific memory B cell and T cells remained, and responded quickly when re-encountering HAV. The magnitude of recall responses was present, regardless of the status of the serum anti-HAV antibody pre-booster. CONCLUSIONS We demonstrated long-term immunity from the live attenuated HAV vaccine, including antibody persistence and immunological memory. Considering the conditions that make elimination of infectious diseases feasible, following polio, hepatitis A could be targeted for elimination in China.
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Affiliation(s)
- Ying Chen
- Key Laboratory of Medical Molecular Virology of MoE & MoH, and Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Chen-Liang Zhou
- Key Laboratory of Medical Molecular Virology of MoE & MoH, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Xin-Jiang Zhang
- Zhengding County Center for Disease Control and Prevention, Zhengding, Hebei, China
| | - Zhi-Yong Hao
- Zhengding County Center for Disease Control and Prevention, Zhengding, Hebei, China
| | - Yan-Hong Zhang
- Zhengding County Center for Disease Control and Prevention, Zhengding, Hebei, China
| | - Song-Mei Wang
- Laboratory of Molecular Biology, Training Center of Medical Experiments, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Jing-Chen Ma
- Hebei Province Center for Disease Control and Prevention, Shijiazhuang, Hebei, China
| | - Gan Zhao
- Key Laboratory of Medical Molecular Virology of MoE & MoH, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Chao Qiu
- Key Laboratory of Medical Molecular Virology of MoE & MoH, and Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Yu-Liang Zhao
- Hebei Province Center for Disease Control and Prevention, Shijiazhuang, Hebei, China
| | - Bin Wang
- Key Laboratory of Medical Molecular Virology of MoE & MoH, School of Basic Medical Sciences, Fudan University, Shanghai, China.
| | - Xuan-Yi Wang
- Key Laboratory of Medical Molecular Virology of MoE & MoH, and Institutes of Biomedical Sciences, Fudan University, Shanghai, China.
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Tsachouridou O, Christaki E, Skoura L, Georgiou A, Nanoudis S, Vasdeki D, Ntziovara MA, Kotoreni G, Forozidou E, Tsoukra P, Germanidis G, Metallidis S. Predictors of humoral response to recommended vaccines in HIV-infected adults. Comp Immunol Microbiol Infect Dis 2017; 54:27-33. [PMID: 28915998 DOI: 10.1016/j.cimid.2017.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 07/17/2017] [Accepted: 07/28/2017] [Indexed: 02/07/2023]
Abstract
Humoral response to vaccination has been found to be inadequate in individuals infected with the human immunodeficiency virus (HIV). We retrospectively assessed antibody responses to three routinely recommended vaccines, against hepatitis B, hepatitis A and S. pneumoniae, in HIV-infected individuals. Data regarding age at HIV diagnosis, years of infection, sex, nationality, HIV mode of transmission, CD4 cell count, nadir CD4 count, plasma viral load, HIV stage, insurance status, educational level and treatment with Highly Active Antiretroviral Therapy (HAART) were collected. Univariate and multivariate analysis was performed in order to detect factors associated with response to vaccination. 437 patients were assessed for hepatitis B, 627 patients for hepatitis A and 66 patients for S. pneumoniae serologic vaccine responsiveness. Regarding hepatitis B and hepatitis A, education level and insurance status were the only predictors of response. As for S. pneumoniae vaccination HAART and control of viremia were correlated with better response to vaccination.
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Affiliation(s)
- Olga Tsachouridou
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Eirini Christaki
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Lemonia Skoura
- Microbiology Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Adamantini Georgiou
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece.
| | - Sideris Nanoudis
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Dimitra Vasdeki
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Maria-Anna Ntziovara
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Georgia Kotoreni
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Evropi Forozidou
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Paraskevi Tsoukra
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Georgios Germanidis
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Symeon Metallidis
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
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Killikelly AM, Kanekiyo M, Graham BS. Pre-fusion F is absent on the surface of formalin-inactivated respiratory syncytial virus. Sci Rep 2016; 6:34108. [PMID: 27682426 PMCID: PMC5040956 DOI: 10.1038/srep34108] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 09/05/2016] [Indexed: 12/15/2022] Open
Abstract
The lack of a licensed vaccine for respiratory syncytial virus (RSV) can be partly attributed to regulatory hurdles resulting from vaccine enhanced respiratory disease (ERD) subsequent to natural RSV infection that was observed in clinical trials of formalin-inactivated RSV (FI-RSV) in antigen-naïve infants. To develop an effective vaccine that does not enhance RSV illness, it is important to understand how formalin and heat inactivation affected the antigenicity and immunogenicity of FI-RSV compared to native virus. Informed by atomic structures of RSV fusion (F) glycoprotein in prefusion (pre-F) and postfusion (post-F) conformations, we demonstrate that FI-RSV predominately presents post-F on the virion surface, whereas infectious RSV presents both pre-F and post-F conformations. This significant antigenic distinction has not been previously appreciated. Thus, a stabilized pre-F antigen is more representative of live RSV than F in its post-F conformation, as displayed on the surface of FI-RSV. This finding has major implications for discriminating current pre-F-based immunogens from FI-RSV used in historical vaccine trials.
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Affiliation(s)
- April M Killikelly
- Vaccine Research Center, National Institute of Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, United States
| | - Masaru Kanekiyo
- Vaccine Research Center, National Institute of Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, United States
| | - Barney S Graham
- Vaccine Research Center, National Institute of Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, United States
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12
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Márquez Pérez L, García Retortillo M. Hepatitis aguda A en paciente previamente vacunada. GASTROENTEROLOGIA Y HEPATOLOGIA 2015; 38:76-8. [DOI: 10.1016/j.gastrohep.2014.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 04/27/2014] [Accepted: 05/14/2014] [Indexed: 10/25/2022]
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Shepherd SM, Shoff WH. Vaccination for the expatriate and long-term traveler. Expert Rev Vaccines 2014; 13:775-800. [DOI: 10.1586/14760584.2014.913485] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Askling HH, Rombo L, van Vollenhoven R, Hallén I, Thörner Å, Nordin M, Herzog C, Kantele A. Hepatitis A vaccine for immunosuppressed patients with rheumatoid arthritis: a prospective, open-label, multi-centre study. Travel Med Infect Dis 2014; 12:134-42. [PMID: 24529746 DOI: 10.1016/j.tmaid.2014.01.005] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 01/08/2014] [Accepted: 01/13/2014] [Indexed: 01/10/2023]
Abstract
BACKGROUND Hepatitis A vaccine is the most frequently used travel vaccine, yet data are scarce about its ability to induce protection in patients with concurrent immunosuppressive treatment. We assessed the immunogenicity of this vaccine in rheumatoid arthritis (RA) patients treated with tumour necrosis factor-inhibitors (TNFi) and/or methotrexate (MTX). METHODS Hepatitis A vaccine was administered to non-immune RA patients at 0 and 6 months. Hepatitis A virus (HAV) antibodies were assessed at 0, 1, 6, 7, 12, and 24 months with a quantitative Chemiluminescent Microparticle Immuno Assay (CMIA) for HAV-IgG. Samples from month 1, 6, and 7 were, in addition, analysed with a microparticle EIA (MEIA) for anti-HAV IgM + IgG. RESULTS The final study population consisted of 53 patients treated with TNFi (n = 15), TNFi + MTX (n = 21) or MTX (n = 17). One and six months after the first dose, 10% and 33% of the patients had attained seroprotection. One and six months after the second dose 83% and 72% were seroprotected. At month 24, 86% of the vaccinees showed protective levels. CONCLUSIONS Two doses of hepatitis A vaccine at a 6-month interval provided protection for most immunosuppressed RA patients. A single dose does not seem to afford sufficient protection to this group of patients.
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Affiliation(s)
- Helena H Askling
- Karolinska Institutet, Dept. of Medicine/Solna, Unit for Infectious Diseases, SE 17176 Stockholm, Sweden; Dept. of Communicable Diseases Control and Prevention, SE 118 91 Stockholm, Sweden.
| | - Lars Rombo
- Karolinska Institutet, Dept. of Medicine/Solna, Unit for Infectious Diseases, SE 17176 Stockholm, Sweden; Centre for Clinical Research, Sörmland, Uppsala University, SE 631 88 Eskilstuna, Sweden.
| | - Ronald van Vollenhoven
- Unit for Clinical Therapy Research, Inflammatory Diseases (ClinTRID), Karolinska Institutet, SE-17176 Stockholm Sweden.
| | - Ingemar Hallén
- Dept. of Infectious Diseases, Karlstad County Hospital, SE 651 85 Karlstad, Sweden.
| | - Åke Thörner
- Dept. of Rheumatology, Mälar Hospital, SE 631 88 Eskilstuna, Sweden.
| | - Margareta Nordin
- Dept. of Clinical Microbiology, Karolinska University Hospital, SE 17176 Stockholm, Sweden.
| | - Christian Herzog
- Swiss Tropical and Public Health Institute, CH-4051 Basel, Switzerland.
| | - Anu Kantele
- Division of Infectious Diseases, Department of Medicine, Helsinki University Central Hospital, FI-00029 HUCH Helsinki, Finland; Department of Medicine, FI-00014 University of Helsinki, Finland.
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Jabłonowska E, Kuydowicz J. Durability of response to vaccination against viral hepatitis A in HIV-infected patients: a 5-year observation. Int J STD AIDS 2014; 25:745-50. [PMID: 24452731 DOI: 10.1177/0956462413518902] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The aim of this study was to estimate the prevalence of total antibodies to hepatitis A virus (anti-HAV-T) in the group of HIV-positive adults in Lodz region of Poland, and to evaluate the response and long-term immunity after vaccination against hepatitis A virus. In the group of 234 HIV-infected patients, 72 persons (30.8%) were anti-HAV-T positive (>20 IU/L). In multivariate analysis, two independent factors associated with the presence of anti-HAV-T were identified: the age of patients (OR = 1.07) and the presence of antibodies to hepatitis C virus (OR = 2.87). Vaccination was completed in 83 patients. Good response (anti-HAV-T >20 IU/L one month after the booster dose) was obtained in 79.5% of patients. In patients with CD4 >200 cells/µL in multivariate analysis only presence of antibodies to hepatitis C virus was a prognostic factor for the response to vaccination (OR = 0.13). Among responders available for the follow-up, 82% (50 out of 61) had detectable anti-HAV-T at 1 year and 75.5% (37 out of 49) at 5 years. Our results demonstrate that most of the studied HIV-positive patients were susceptible to hepatitis A virus infection. Most HIV-infected adults with high CD4 counts had a durable response even up to 5 years after vaccination. Patients with a HIV/hepatitis C virus coinfection displayed a worse response to vaccination.
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Affiliation(s)
- E Jabłonowska
- Department of Infectious Diseases and Hepatology, Medical University of Łódź, Łódź, Poland
| | - J Kuydowicz
- Department of Infectious Diseases and Hepatology, Medical University of Łódź, Łódź, Poland
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Abstract
Identification and vaccination of adults at risk for hepatitis B virus acquisition through sexual contact is a key strategy to reduce new hepatitis B virus infections among at-risk adults. Hepatitis C has emerged as a sexually transmitted infection among men with male sex partners (MSM). Several biological and behavioral factors have been linked to hepatitis C virus transmission among MSM, including human immunodeficiency virus coinfection; participation in sexual practices that result in mucosal damage or result in exposure to blood; presence of sexually transmitted diseases (STIs), particularly ulcerative STIs; multiple/casual sex partners; and unprotected anal intercourse.
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Affiliation(s)
- Linda Gorgos
- Special Immunology Associates, El Rio Health Center, 1701 West St Mary's Road, Suite 160, Tucson, AZ 85745, USA.
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17
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Chen LH, Leder K, Wilson ME. Business travelers: vaccination considerations for this population. Expert Rev Vaccines 2013; 12:453-66. [PMID: 23560925 DOI: 10.1586/erv.13.16] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Illness in business travelers is associated with reduced productivity on the part of the employee as well as the employer. Immunizations offer a reliable method of preventing infectious diseases for international business travelers. The authors review the travel patterns of business travelers, available data on illnesses they encounter, their potential travel-associated risks for vaccine-preventable diseases and recommendations on immunizations for this population. Routine vaccines (e.g., measles, tetanus and influenza) should be reviewed to assure that they provide current coverage. The combined hepatitis A and hepatitis B vaccine with a rapid schedule offers options for those with time constraints. Other vaccine recommendations for business travelers need to focus on their destinations and activities and underlying health, taking into account the concept of cumulative risk for those with frequent travel, multiple trips or long stays.
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Affiliation(s)
- Lin H Chen
- Travel Medicine Center, Mount Auburn Hospital, Cambridge, Massachusetts, and Harvard Medical School, Boston, MA, USA.
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18
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van den Bijllaardt W, Siers HM, Timmerman-Kok C, Pessers FG, Natrop G, van Baars JF, Nutma N, van der Werf D, Gisolf EH. Seroprotection after hepatitis a vaccination in patients with drug-induced immunosuppression. J Travel Med 2013; 20:278-82. [PMID: 23992569 DOI: 10.1111/jtm.12050] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 01/11/2013] [Accepted: 01/31/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Increasing numbers of travelers using immunosuppressive drugs visit hepatitis A endemic countries. Data on protection rates after hepatitis A vaccination in this group are scarce. METHODS In this retrospective study, records of subjects with hepatitis A serology taken after vaccination were searched for in travel clinic databases. Relation between immunosuppressive drug use, age, gender, and time between vaccination and serology was evaluated. RESULTS Seroprotection rates within 4 weeks after primary vaccination (50%) are lower than after 4 weeks (64%). After the complete series of two vaccinations seroprotection rates reach 95% although success depends on the immunosuppressive drug being used. Subjects under anti-TNF alpha treatment have significantly lower seroprotection rates than subjects using classical immunosuppressive drugs after the second vaccination. There is no influence of age or gender on seroprotection rates. CONCLUSIONS Last-minute vaccination in subjects using immunosuppressive medication is not reliable, only 60% of our subjects had a protective antibody level after a single vaccination. When serology was done within 4 weeks after a single vaccination, seroprotection rates were only 50%, after 4 weeks this number rose to 64%. When persons visit a travel clinic in time for a complete vaccination series, satisfactory seroprotection rates can be reached. Seroprotection rate depends on the drug being used, persons using anti-TNF alpha are less protected.
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Affiliation(s)
- Wouter van den Bijllaardt
- Department of Infectious Diseases, Public Health Service (GGD) Gelre-IJssel, Apeldoorn, The Netherlands
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Mena G, García-Basteiro AL, Llupià A, Díez C, Costa J, Gatell JM, García F, Bayas JM. Factors associated with the immune response to hepatitis A vaccination in HIV-infected patients in the era of highly active antiretroviral therapy. Vaccine 2013; 31:3668-74. [PMID: 23777950 DOI: 10.1016/j.vaccine.2013.06.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 05/26/2013] [Accepted: 06/04/2013] [Indexed: 01/13/2023]
Abstract
INTRODUCTION HIV seropositivity is considered a risk factor for complications in hepatitis A virus (HAV) infection. HAV vaccination schedules are widely implemented in HIV-infected patients, but the immune response remains impaired. METHODS We analysed the response to vaccination (antiHAV titres ≥20IU/l) in 282 HIV-infected patients included in a standard (1440 Elisa Units (EU) at 0, 6 months) or rapidly accelerated schedule (720 EU at 0, 7, 21 days and 6 months) between 1997 and 2009. Factors associated with the response to vaccination were analysed using logistic regression. RESULTS The overall response rate was 73.4%. Male sex (OR: 0.16, 95% CI 0.05-0.51) and hepatitis C virus co-infection (OR: 0.30, 95% CI 0.14-0.74) were associated with a lower probability of response. Protective antibody response was associated with a higher CD4/CD8 ratio (OR: 3.69, 95% CI 1.3-10.5) and having received two doses of standard schedule (compared with patients receiving only one dose of the same schedule) (OR: 2.51, 95% CI 1.22-5.15). Three doses of the rapidly accelerated schedule were not more effective than a single dose of 1440 EU (OR: 1.32, 95% CI 0.48-3.63). CONCLUSION The low responses observed in patients receiving a single dose suggest the need to emphasize adhesion to vaccination protocols to avoid failure. The CD4/CD8 ratio may be considered as an immune status marker which could help to better choose the moment of vaccination. Our findings underscore the importance of identifying strategies that optimize the timing and effectiveness of hepatitis A vaccination in HIV-infected patients and of the need for further studies on individual factors such as sex and hepatitis C co-infection that may affect the response to vaccination. Likewise, the sub-optimal effectiveness of three doses of 720 EU in the rapidly accelerated schedule, if confirmed in future studies, might lead to a revision of the current schedule recommended for HIV-infected travellers.
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Affiliation(s)
- Guillermo Mena
- Preventive Medicine and Epidemiology Unit, Hospital Clínic, Barcelona, Spain.
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20
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Lim HS, Choi K, Lee S. Epidemiological investigation of an outbreak of hepatitis A at a residential facility for the disabled, 2011. J Prev Med Public Health 2013; 46:62-73. [PMID: 23573370 PMCID: PMC3615381 DOI: 10.3961/jpmph.2013.46.2.62] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 12/26/2012] [Indexed: 11/25/2022] Open
Abstract
Objectives An outbreak of hepatitis A occurred at a residential facility for the disabled in July 10, 2011. This investigation was carried out to develop a response plan, and to find the infection source of the disease. Methods A field epidemiologist investigated the symptoms, vaccination histories, living environments, and probable infection sources with 51 residents and 31 teachers and staff members. In July 25, 81 subjects were tested for the hepatitis A virus antibody, and specimens of the initial 3 cases and the last case were genetically tested. Results Three cases occurred July 10 to 14, twelve cases August 3 to 9, and the last case on August 29. Among the teachers and staff, no one was IgM positive (on July 25). The base sequences of the initial 3 and of the last case were identical. The vehicle of the outbreak was believed to be a single person. The initial 3 patients were exposed at the same time and they might have disseminated the infection among the patients who developed symptoms in early August, and the last patient might have, in turn, been infected by the early August cases. Conclusions The initial source of infection is not clear, but volunteers could freely come into contact with residents, and an infected volunteer might have been the common infection source of the initial patients. Volunteers' washing their hands only after their activity might be the cause of this outbreak. Although there may be other possible causes, it would be reasonable to ask volunteers to wash their hands both before and after their activities.
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Affiliation(s)
- Hyun-Sul Lim
- Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju 780-714, Korea.
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Liu L, Zhang Y, Wang J, Zhao H, Jiang L, Che Y, Shi H, Li R, Mo Z, Huang T, Liang Z, Mao Q, Wang L, Dong C, Liao Y, Guo L, Yang E, Pu J, Yue L, Zhou Z, Li Q. Study of the integrated immune response induced by an inactivated EV71 vaccine. PLoS One 2013; 8:e54451. [PMID: 23372725 PMCID: PMC3553120 DOI: 10.1371/journal.pone.0054451] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Accepted: 12/11/2012] [Indexed: 12/12/2022] Open
Abstract
Enterovirus 71 (EV71), a major causative agent of hand-foot-and-mouth disease (HFMD), causes outbreaks among children in the Asia-Pacific region. A vaccine is urgently needed. Based on successful pre-clinical work, phase I and II clinical trials of an inactivated EV71 vaccine, which included the participants of 288 and 660 respectively, have been conducted. In the present study, the immune response and the correlated modulation of gene expression in the peripheral blood mononuclear cells (PBMCs) of 30 infants (6 to 11 months) immunized with this vaccine or placebo and consented to join this study in the phase II clinical trial were analyzed. The results showed significantly greater neutralizing antibody and specific T cell responses in vaccine group after two inoculations on days 0 and 28. Additionally, more than 600 functional genes that were up- or down-regulated in PBMCs were identified by the microarray assay, and these genes included 68 genes associated with the immune response in vaccine group. These results emphasize the gene expression profile of the immune system in response to an inactivated EV71 vaccine in humans and confirmed that such an immune response was generated as the result of the positive mobilization of the immune system. Furthermore, the immune response was not accompanied by the development of a remarkable inflammatory response. Clinical Trial Registration: NCT01391494 and NCT01512706.
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MESH Headings
- Animals
- Antibodies, Neutralizing/blood
- Antibodies, Neutralizing/immunology
- Antibodies, Viral/blood
- Antibodies, Viral/immunology
- Cytokines/blood
- Cytokines/genetics
- Cytokines/immunology
- Double-Blind Method
- Enterovirus/immunology
- Gene Expression Profiling
- Gene Expression Regulation/drug effects
- Gene Expression Regulation/immunology
- Hand, Foot and Mouth Disease/genetics
- Hand, Foot and Mouth Disease/immunology
- Hand, Foot and Mouth Disease/prevention & control
- Hand, Foot and Mouth Disease/virology
- Humans
- Immunity, Cellular/drug effects
- Infant
- Leukocytes, Mononuclear/immunology
- Leukocytes, Mononuclear/metabolism
- Leukocytes, Mononuclear/virology
- Microarray Analysis
- Placebos
- Vaccination
- Vaccines, Inactivated
- Viral Vaccines/administration & dosage
- Viral Vaccines/immunology
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Affiliation(s)
- Longding Liu
- Institute of Medical Biology, Chinese Academy of Medicine Science, Peking Union Medical College, Kunming, People’s Republic of China
| | - Ying Zhang
- Institute of Medical Biology, Chinese Academy of Medicine Science, Peking Union Medical College, Kunming, People’s Republic of China
| | - Jingjing Wang
- Institute of Medical Biology, Chinese Academy of Medicine Science, Peking Union Medical College, Kunming, People’s Republic of China
| | - Hongling Zhao
- Institute of Medical Biology, Chinese Academy of Medicine Science, Peking Union Medical College, Kunming, People’s Republic of China
| | - Li Jiang
- Institute of Medical Biology, Chinese Academy of Medicine Science, Peking Union Medical College, Kunming, People’s Republic of China
| | - Yanchun Che
- Institute of Medical Biology, Chinese Academy of Medicine Science, Peking Union Medical College, Kunming, People’s Republic of China
| | - Haijin Shi
- Institute of Medical Biology, Chinese Academy of Medicine Science, Peking Union Medical College, Kunming, People’s Republic of China
| | - Rongcheng Li
- Guangxi Province Centers for Disease Control and Prevention, Nanning, People’s Republic of China
| | - Zhaojun Mo
- Guangxi Province Centers for Disease Control and Prevention, Nanning, People’s Republic of China
| | - Teng Huang
- Guangxi Province Centers for Disease Control and Prevention, Nanning, People’s Republic of China
| | - Zhenglun Liang
- National Institutes for Food and Drug Control, Beijing, People’s Republic of China
| | - Qunying Mao
- National Institutes for Food and Drug Control, Beijing, People’s Republic of China
| | - Lichun Wang
- Institute of Medical Biology, Chinese Academy of Medicine Science, Peking Union Medical College, Kunming, People’s Republic of China
| | - Chenghong Dong
- Institute of Medical Biology, Chinese Academy of Medicine Science, Peking Union Medical College, Kunming, People’s Republic of China
| | - Yun Liao
- Institute of Medical Biology, Chinese Academy of Medicine Science, Peking Union Medical College, Kunming, People’s Republic of China
| | - Lei Guo
- Institute of Medical Biology, Chinese Academy of Medicine Science, Peking Union Medical College, Kunming, People’s Republic of China
| | - Erxia Yang
- Institute of Medical Biology, Chinese Academy of Medicine Science, Peking Union Medical College, Kunming, People’s Republic of China
| | - Jing Pu
- Institute of Medical Biology, Chinese Academy of Medicine Science, Peking Union Medical College, Kunming, People’s Republic of China
| | - Lei Yue
- Institute of Medical Biology, Chinese Academy of Medicine Science, Peking Union Medical College, Kunming, People’s Republic of China
| | - Zhenxin Zhou
- Institute of Medical Biology, Chinese Academy of Medicine Science, Peking Union Medical College, Kunming, People’s Republic of China
| | - Qihan Li
- Institute of Medical Biology, Chinese Academy of Medicine Science, Peking Union Medical College, Kunming, People’s Republic of China
- * E-mail:
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23
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Jimenez HR, Hallit RR, Debari VA, Slim J. Hepatitis A vaccine response in HIV-infected patients: are TWINRIX and HAVRIX interchangeable? Vaccine 2012; 31:1328-33. [PMID: 23277097 DOI: 10.1016/j.vaccine.2012.12.045] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 11/28/2012] [Accepted: 12/15/2012] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Hepatitis A virus (HAV) infection remains a health risk for human immunodeficiency virus (HIV)-infected persons. Seroconversion rates among HAV vaccinated HIV-infected patients have been shown to be reduced compared to the general population. Current guidelines regard HAV vaccines as interchangeable, however there no published data comparing their efficacy in HIV patients. Our study evaluated the impact of different factors, including type of vaccination, on the immunologic response to hepatitis A vaccination in HIV-infected patients in the HAART era. METHODS This was a retrospective review of 226 HIV-infected patients at our clinic in Newark, NJ. Patients were eligible if at least one dose HAVRIX (1440 ELISA units) or TWINRIX (720 ELISA units) was administered and had anti-HAV antibody data pre- and post-vaccination. Numerous variables were evaluated for their effect on seroconversion. RESULTS Seroconversion developed in 53.5% of the population. Responders had higher baseline median CD4 counts (446 versus 362 cells/mm(3); P=0.004) and lower median HIV RNA levels (475 copies/mL versus 5615 copies/mL; P=0.018) than non-responders. Patients with CD4 counts>350 cell/mm(3) were more likely to respond than those with CD4 counts<200 cell/mm(3), 60% and 35%, respectively (P=0.0498). Responders were also more likely to be virologically suppressed (48% versus 32%; P=0.0024). TWINRIX recipients had a 7-fold increased probability of seroconversion when virologically suppressed and less likely to respond if the vaccination series was not completed (OR 0.42; 95% CI 0.18-0.96). DISCUSSION Seroconversion rates to HAV vaccination are significantly impaired among HIV-infected patients. CD4 cell count and virologic suppression at vaccination impact response. Seroconversion among TWINRIX recipients appeared to be more sensitive to these factors and vaccine series completion in comparison to those administered HAVRIX. Among HIV-patients requiring hepatitis a and b vaccination, the advantage of TWINRIX over HAVRIX as a combination product should be reevaluated.
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Affiliation(s)
- Humberto R Jimenez
- Saint Michael's Medical Center, 111 Central Avenue, Newark, NJ 07102, United States.
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Determinants of hepatitis A vaccine immunity in a cohort of human immunodeficiency virus-infected children living in Switzerland. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2012; 19:1751-7. [PMID: 22933400 DOI: 10.1128/cvi.00264-12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Vaccination in HIV-infected children is often less effective than in healthy children. The goal of this study was to assess vaccine responses to hepatitis A virus (HAV) in HIV-infected children. Children of the Swiss Mother and Child HIV Cohort Study (MoCHiV) were enrolled prospectively. Recommendations for initial, catch-up, and additional HAV immunizations were based upon baseline antibody concentrations and vaccine history. HAV IgG was assessed by enzyme-linked immunosorbent assay (ELISA) with a protective cutoff value defined as ≥10 mIU/ml. Eighty-seven patients were included (median age, 11 years; range, 3.4 to 21.2 years). Forty-two patients were seropositive (48.3%) for HAV. Among 45 (51.7%) seronegative patients, 36 had not received any HAV vaccine dose and were considered naïve. Vaccine responses were assessed after the first dose in 29/35 naïve patients and after the second dose in 33/39 children (25 initially naïve patients, 4 seronegative patients, and 4 seropositive patients that had already received 1 dose of vaccine). Seroconversion was 86% after 1 dose and 97% after 2 doses, with a geometric mean concentration of 962 mIU/ml after the second dose. A baseline CD4(+) T cell count below 750 cells/μl significantly reduced the post-2nd-dose response (P = 0.005). Despite a high rate of seroconversion, patients with CD4(+) T cell counts of <750/μl had lower anti-HAV antibody concentrations. This may translate into a shorter protection time. Hence, monitoring humoral immunity may be necessary to provide supplementary doses as needed.
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25
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Sharapov UM, Bulkow LR, Negus SE, Spradling PR, Homan C, Drobeniuc J, Bruce M, Kamili S, Hu DJ, McMahon BJ. Persistence of hepatitis A vaccine induced seropositivity in infants and young children by maternal antibody status: 10-year follow-up. Hepatology 2012; 56:516-22. [PMID: 22371069 DOI: 10.1002/hep.25687] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 02/17/2012] [Indexed: 12/13/2022]
Abstract
UNLABELLED Persistence of seropositivity conferred by hepatitis A vaccine administered to children <2 years of age is unknown and passively transferred maternal antibodies to hepatitis A virus (maternal anti-HAV) may lower the infant's immune response to the vaccine. One hundred ninety-seven infants and young children were randomized into three groups to receive a two-dose hepatitis A vaccine: group 1 at 6 and 12 months, group 2 at 12 and 18 months, and group 3 at 15 and 21 months of age. Within each group, infants were randomized by maternal anti-HAV status. Anti-HAV levels were measured at 1 and 6 months and at 3, 5, 7, and 10 years after the second dose of hepatitis A vaccination. Children in all groups had evidence of seroprotection (>10 mIU/mL) at 1 month after the second dose. At 10 years, all children retained seroprotective anti-HAV levels except for only 7% and 11% of children in group 1 born to anti-HAV-negative and anti-HAV-positive mothers, respectively, and 4% of group 3 children born to anti-HAV-negative mothers. At 10 years, children born to anti-HAV-negative mothers in group 3 had the highest geometric mean concentration (GMC) (97 mIU/mL; 95% confidence interval, 71-133 mIU/mL) and children born to anti-HAV-positive mothers in group 1 had the lowest GMC (29 mIU/mL; 95% confidence interval, 20-40 mIU/mL). Anti-HAV levels through 10 years of age correlated with initial peak anti-HAV levels (tested at 1 month after the second dose). CONCLUSION The seropositivity induced by hepatitis A vaccine given to children <2 years of age persists for at least 10 years regardless of presence of maternal anti-HAV.
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Affiliation(s)
- Umid M Sharapov
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Seybold U, Schelling J, Münchhoff M, Bogner JR. [Vaccination strategies for adults]. MMW Fortschr Med 2012; 154:47-50. [PMID: 22838132 DOI: 10.1007/s15006-012-0746-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Ulrich Seybold
- Sektion Klinische Infektiologie, Medizinische Klinik und Poliklinik IV, Klinikum der Universität Miünchen.
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27
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Chen LH, Hill DR, Wilder-Smith A. Vaccination of travelers: how far have we come and where are we going? Expert Rev Vaccines 2012; 10:1609-20. [PMID: 22043959 DOI: 10.1586/erv.11.138] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Vaccine recommendations are a prominent part of health preparations before international travel. We review progress made in the past decade regarding vaccines used primarily by persons traveling from high-income countries to low- and middle-income countries. The combined hepatitis A-B vaccine, the recently licensed Vero cell-derived Japanese encephalitis vaccine and conjugated quadrivalent meningococcal vaccines are discussed. This article provides updates on yellow fever vaccine-associated visceral and neurologic adverse events, indications for influenza vaccine in travelers, the rapid immunization schedule for tick-borne encephalitis vaccine, schedules for postexposure rabies prophylaxis, and new insights about oral cholera vaccines following the outbreak in Haiti. The future should bring vaccines for serogroup B Neiserria meningitidis, dengue and malaria, as well as an inactivated yellow fever vaccine.
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Affiliation(s)
- Lin H Chen
- Mount Auburn Hospital, Cambridge, MA, USA.
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28
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Abstract
The swine, influenza, H1N1 outbreak in 2009 highlighted the inadequacy of the currently used antibody-based vaccine strategies as a preventive measure for combating influenza pandemics. The ultimate goal for successful control of newly arising influenza outbreaks is to design a single-shot vaccine that will provide long-lasting immunity against all strains of influenza A virus. A large amount of data from animal studies has indicated that the cross-reactive cytotoxic T (Tc) cell response against conserved influenza virus epitopes may be the key immune response needed for a universal influenza vaccine. However, decades of research have shown that the development of safe T-cell-based vaccines for influenza is not an easy task. Here, I discuss the overlooked but potentially highly advantageous inactivation method, namely, γ-ray irradiation, as a mean to reach the Holy Grail of influenza vaccinology.
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Affiliation(s)
- Yoichi Furuya
- Center for Immunology and Microbial Disease, Albany Medical College, Albany, NY 12208-3479, USA.
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Crum-Cianflone NF, Wilkins K, Lee AW, Grosso A, Landrum ML, Weintrob A, Ganesan A, Maguire J, Klopfer S, Brandt C, Bradley WP, Wallace MR, Agan BK. Long-term durability of immune responses after hepatitis A vaccination among HIV-infected adults. J Infect Dis 2011; 203:1815-23. [PMID: 21606540 PMCID: PMC3100512 DOI: 10.1093/infdis/jir180] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Accepted: 01/26/2011] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Vaccination provides long-term immunity to hepatitis A virus (HAV) among the general population, but there are no such data regarding vaccine durability among human immunodeficiency virus (HIV)-infected adults. METHODS We retrospectively studied HIV-infected adults who had received 2 doses of HAV vaccine. We analyzed blood specimens taken at 1 year, 3 years, and, when available, 6-10 years postvaccination. HAV immunoglobulin G (IgG) values of ≥10 mIU/mL were considered seropositive. RESULTS We evaluated specimens from 130 HIV-infected adults with a median age of 35 years and a median CD4 cell count of 461 cells/mm(3) at or before time of vaccination. Of these, 49% had an HIV RNA load <1000 copies/mL. Initial vaccine responses were achieved in 89% of HIV-infected adults (95% confidence interval [CI], 83%-94%), compared with 100% (95% CI, 99%-100%) of historical HIV-uninfected adults. Among initial HIV-infected responders with available specimens, 90% (104 of 116; 95% CI, 83%-95%) remained seropositive at 3 years and 85% (63 of 74; 95% CI, 75%-92%) at 6-10 years. Geometric mean concentrations (GMCs) among HIV-infected adults were 154, 111, and 64 mIU/mL at 1, 3, and 6-10 years, respectively, compared with 1734, 687, and 684 mIU/mL among HIV-uninfected persons. Higher GMCs over time among HIV-infected adults were associated with lower log(10) HIV RNA levels (β = -.12, P = .04). CONCLUSIONS Most adults with well-controlled HIV infections had durable seropositive responses up to 6-10 years after HAV vaccination. Suppressed HIV RNA levels are associated with durable HAV responses.
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Affiliation(s)
- Nancy F Crum-Cianflone
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
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Torresi J, Johnson D. Hepatitis A and E Infection in International Travellers. Curr Infect Dis Rep 2011; 13:248-55. [DOI: 10.1007/s11908-011-0179-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Yezli S, Otter JA. Minimum Infective Dose of the Major Human Respiratory and Enteric Viruses Transmitted Through Food and the Environment. FOOD AND ENVIRONMENTAL VIROLOGY 2011; 3:1-30. [PMID: 35255645 PMCID: PMC7090536 DOI: 10.1007/s12560-011-9056-7] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 02/26/2011] [Indexed: 05/18/2023]
Abstract
Viruses are a significant cause of morbidity and mortality around the world. Determining the minimum dose of virus particles that can initiate infection, termed the minimum infective dose (MID), is important for the development of risk assessment models in the fields of food and water treatment and the implementation of appropriate infection control strategies in healthcare settings. Both respiratory and enteric viruses can be shed at high titers from infected individuals even when the infection is asymptomatic. Presence of pre-existing antibodies has been shown to affect the infectious dose and to be protective against reinfection for many, but not all viruses. Most respiratory viruses appear to be as infective in humans as in tissue culture. Doses of <1 TCID50 of influenza virus, rhinovirus, and adenovirus were reported to infect 50% of the tested population. Similarly, low doses of the enteric viruses, norovirus, rotavirus, echovirus, poliovirus, and hepatitis A virus, caused infection in at least some of the volunteers tested. A number of factors may influence viruses' infectivity in experimentally infected human volunteers. These include host and pathogen factors as well as the experimental methodology. As a result, the reported infective doses of human viruses have to be interpreted with caution.
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Affiliation(s)
- Saber Yezli
- Bioquell UK Ltd, 52 Royce Close, West Portway, Andover, Hampshire, SP10 3TS, UK.
| | - Jonathan A Otter
- Bioquell UK Ltd, 52 Royce Close, West Portway, Andover, Hampshire, SP10 3TS, UK
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Boukhvalova MS, Prince GA, Blanco JCG. Inactivation of respiratory syncytial virus by zinc finger reactive compounds. Virol J 2010; 7:20. [PMID: 20102602 PMCID: PMC2823672 DOI: 10.1186/1743-422x-7-20] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Accepted: 01/26/2010] [Indexed: 11/26/2022] Open
Abstract
Background Infectivity of retroviruses such as HIV-1 and MuLV can be abrogated by compounds targeting zinc finger motif in viral nucleocapsid protein (NC), involved in controlling the processivity of reverse transcription and virus infectivity. Although a member of a different viral family (Pneumoviridae), respiratory syncytial virus (RSV) contains a zinc finger protein M2-1 also involved in control of viral polymerase processivity. Given the functional similarity between the two proteins, it was possible that zinc finger-reactive compounds inactivating retroviruses would have a similar effect against RSV by targeting RSV M2-1 protein. Moreover, inactivation of RSV through modification of an internal protein could yield a safer whole virus vaccine than that produced by RSV inactivation with formalin which modifies surface proteins. Results Three compounds were evaluated for their ability to reduce RSV infectivity: 2,2'-dithiodipyridine (AT-2), tetraethylthiuram disulfide and tetramethylthiuram disulfide. All three were capable of inactivating RSV, with AT-2 being the most potent. The mechanism of action of AT-2 was analyzed and it was found that AT-2 treatment indeed results in the modification of RSV M2-1. Altered intramolecular disulfide bond formation in M2-1 protein of AT-2-treated RSV virions might have been responsible for abrogation of RSV infectivity. AT-2-inactivated RSV was found to be moderately immunogenic in the cotton rats S.hispidus and did not cause a vaccine-enhancement seen in animals vaccinated with formalin-inactivated RSV. Increasing immunogenicity of AT-2-inactivated RSV by adjuvant (Ribi), however, led to vaccine-enhanced disease. Conclusions This work presents evidence that compounds that inactivate retroviruses by targeting the zinc finger motif in their nucleocapsid proteins are also effective against RSV. AT-2-inactivated RSV vaccine is not strongly immunogenic in the absence of adjuvants. In the adjuvanted form, however, vaccine induces immunopathologic response. The mere preservation of surface antigens of RSV, therefore may not be sufficient to produce a highly-efficacious inactivated virus vaccine that does not lead to an atypical disease.
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Silva LMD, Souza EHD, Arrebola TM, Jesus GDAD. [Occurrence of a hepatitis A outbreak in three neighborhoods of the city of Vitória, Espírito Santo State, and its relation with the quality of the water for human consumption]. CIENCIA & SAUDE COLETIVA 2010; 14:2163-7. [PMID: 20069184 DOI: 10.1590/s1413-81232009000600023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2007] [Accepted: 12/14/2007] [Indexed: 11/22/2022] Open
Abstract
This work had as purpose to analyze the possible factors related with the occurrences of Hepatitis in the neighborhoods of Grande Vitória, Estrelinha and Inhanguetá located in the city of Vitória, State of the Espírito Santo, from April the June, 2006, and the quality of the water consumed by the population. The indicators for the water quality used were the Free Residual Chlorine concentrations (FRC) and the presence of thermotolerant coliforms. The microbiological analyses performed in the water consumed for the studied communities did not presented results indicating contamination by thermotolerants coliforms and the percentage of FRC determined between January and June were always above of the minimum limit demanded by the legislation (Act 518/2004). The results showed that the occurrence of a Hepatitis A outbreak can be related with the absence of physical barriers that impede the contact of people with the contaminated water and the practical deficiencies in the hygienic practices adopted, individually, by the local population.
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Nelson JC, Bittner RCL, Bounds L, Zhao S, Baggs J, Donahue JG, Hambidge SJ, Jacobsen SJ, Klein NP, Naleway AL, Zangwill KM, Jackson LA. Compliance with multiple-dose vaccine schedules among older children, adolescents, and adults: results from a vaccine safety datalink study. Am J Public Health 2009; 99 Suppl 2:S389-97. [PMID: 19797753 PMCID: PMC4504385 DOI: 10.2105/ajph.2008.151332] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2008] [Indexed: 01/01/2023]
Abstract
OBJECTIVES We studied compliance with multiple-dose vaccine schedules, assessed factors associated with noncompliance, and examined timeliness of series completion among older children, adolescents, and adults. METHODS We conducted a large, multisite, retrospective cohort study of older children, adolescents, and adults in the Vaccine Safety Datalink population from 1996 through 2004. We quantified the rates of completion of all required doses for varicella, hepatitis A, and hepatitis B vaccines according to their recommended schedules. RESULTS Among those who received a first dose of varicella (n = 16 075), hepatitis A (n = 594 917), and hepatitis B (n = 590 445) vaccine, relatively few completed the series (55%-65% for hepatitis B vaccine and 40%-50% for hepatitis A and varicella vaccines in most age groups). Compliance was lowest among adolescents (35.9%) and Medicaid recipients (29.7%) who received varicella vaccine and among younger adult age groups who received hepatitis A vaccine (25%-35% across those age groups). Even among series completers, there was a relatively long interval of undervaccination between the first and last doses. CONCLUSIONS Compliance with multiple-dose vaccine series among older children, adolescents, and adults is suboptimal. Further evaluations of strategies to improve compliance in these populations are needed.
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Rafiq SM, Rashid H, Haworth E, Booy R. Hazards of hepatitis at the Hajj. Travel Med Infect Dis 2009; 7:239-46. [DOI: 10.1016/j.tmaid.2008.09.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Accepted: 09/08/2008] [Indexed: 12/18/2022]
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Seroprevalence of hepatitis A virus infection in persons with HIV infection in Taiwan: implications for hepatitis A vaccination. Int J Infect Dis 2009; 13:e199-205. [PMID: 19208490 DOI: 10.1016/j.ijid.2008.12.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2008] [Revised: 11/04/2008] [Accepted: 12/02/2008] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To retrospectively determine the prevalence of anti-hepatitis A virus (HAV) antibody in HIV-positive persons with different routes of HIV exposure and to describe its characteristics in order to guide vaccination policy. METHODS The prevalence of anti-HAV antibody was compared between 1580 HIV-positive persons seeking medical attention and 2581 HIV-negative controls seeking health check-ups, who had undergone anti-HAV tests between 2004 and 2007. Comparisons were also made among groups of the HIV-positive patients who had acquired HIV via different routes of transmission. A multivariate logistic regression model was built to identify independent variables associated with anti-HAV seropositivity. RESULTS The overall prevalence of anti-HAV antibody was 60.9% in the HIV-positive and 48.0% in the controls (p<0.001). The overall adjusted odds ratio (AOR) for positive anti-HAV antibody was 2.604 (95% confidence interval (CI) 2.106-3.219) in HIV-positive persons compared with HIV-negative persons. In addition, HIV-positive men who have sex with men (MSM), heterosexuals, and injecting drug users (IDU) all had significantly higher AOR for positive anti-HAV antibody than HIV-negative persons. In HIV-positive persons, older age (AOR 1.284, 95% CI 1.246-1.322) and IDU (AOR 5.137, 95% CI 3.499-7.542) were independently associated with an increased prevalence of anti-HAV antibody. Nearly 90% of the IDU had become seropositive for HAV after age 36-40 years, compared with heterosexuals and MSM after age 46-50 years, and controls after age 51-55 years. CONCLUSION Our findings suggest that age groups to be targeted for HAV vaccination vary with the different routes of HIV exposure.
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Affiliation(s)
- Sang Hoon Park
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hallym University College of Medicine, Korea.
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Jung YK, Kim JH. Epidemiology and clinical features of acute hepatitis A: from the domestic perspective. THE KOREAN JOURNAL OF HEPATOLOGY 2009; 15:438-45. [DOI: 10.3350/kjhep.2009.15.4.438] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Young Kul Jung
- Department of Internal Medicine, Gachon University of Medicine and Science Gil Medical Center, Inchon, Korea
| | - Ju Hyun Kim
- Department of Internal Medicine, Gachon University of Medicine and Science Gil Medical Center, Inchon, Korea
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Kim MS, Kim ES, Chang YJ, Huh HJ, Chae SL, Lee JH. Seroepidemiology of Hepatitis A among Healthcare Workers and Their Response to Vaccination Recommendation at a Korean Hospital. Infect Chemother 2009. [DOI: 10.3947/ic.2009.41.5.272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Min Soo Kim
- Department of Internal Medicine, Dongguk University College of Medicine, Goyang, Korea
| | - Eu Suk Kim
- Department of Internal Medicine, Dongguk University College of Medicine, Goyang, Korea
- Infection Control Office, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Yun Jung Chang
- Infection Control Office, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Hee Jin Huh
- Department of Laboratory Medicine, Dongguk University College of Medicine, Goyang, Korea
| | - Seok Lae Chae
- Department of Laboratory Medicine, Dongguk University College of Medicine, Goyang, Korea
| | - Jin Ho Lee
- Department of Internal Medicine, Dongguk University College of Medicine, Goyang, Korea
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Immunological efficacy of a three-dose schedule of hepatitis A vaccine in HIV-infected adults: HEPAVAC study. J Acquir Immune Defic Syndr 2008; 49:272-5. [PMID: 18845961 DOI: 10.1097/qai.0b013e318183a9c0] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The immunogenicity of vaccines, including vaccine against hepatitis A virus (HAV), is impaired in patients with HIV infection, requiring revised immunization regimens. METHODS We evaluated the immunological efficacy and safety of a 3-dose schedule of hepatitis A vaccine in HIV-infected adults. HAV-seronegative HIV-infected adults were randomized to receive either 3 doses of 1440 UI of hepatitis A vaccine (HAVRIX; GlaxoSmithKline, Marly le Roi, France) at weeks 0, 4, and 24 (46 patients) or 2 doses 24 weeks apart (49 patients). RESULTS At week 28, seroconversion, defined as an anti-HAV antibody >or=20 mIU/mL, occurred in 82.6% and 69.4% of patients in the 3-dose and the 2-dose group, respectively (P = 0.13, intent-to-treat analysis, missing data = nonresponder), and in 88.4% and 72.3% of patients in the 3-dose and the 2-dose group, respectively (P = 0.06, observed analysis). Only 37.9% of patients experienced seroconversion after 1 vaccine dose (intent-to-treat analysis). Anti-HAV antibody geometric mean titers were 323 and 132 mIU/mL in the 3-dose group and 138 and 67 mIU/mL in the 2-dose group, respectively, 28 (P = 0.03) and 72 weeks (P = 0.05) after the first vaccine dose. There were no serious adverse events associated with the vaccine. Multivariate analysis showed no treatment group effect but indicated that absence of tobacco smoking (odds ratio = 2.92, 95% confidence interval: 1.07 to 7.97; P = 0.04) was an independent predictor of response to HAV vaccine. CONCLUSIONS In HIV-infected adults, immunogenicity of hepatitis A vaccine is poor. Three doses of vaccine were safe and increased antibody titers.
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Aloise R, de Almeida AJ, Sion FS, Morais-de-Sá CA, Gaspar AMC, de Paula VS. Changes in hepatitis A virus seroepidemiology in HIV-infected Brazilian patients. Int J STD AIDS 2008; 19:321-6. [PMID: 18482962 DOI: 10.1258/ijsa.2007.007100] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Shifting of hepatitis A virus (HAV) epidemiology from a high towards an intermediate endemicity pattern and use of antiretroviral therapy increased the risk of HIV/HAV coinfection in developing countries. The aim of this study was to investigate the presence of HAV markers in a cohort of HIV-infected patients from 1988 to 2004. The presence of serum anti-HAV antibodies and HAV-RNA by real-time polymerase chain reaction was investigated in 581 patients. Total anti-HAV antibodies was found in 464/581 (79.8%) patients, however, a changing epidemiologic pattern of hepatitis A among HIV-infected patients from 1988 to 2004 was observed. Among patients susceptible to HAV (n = 117), 5 (4.2%) were coinfected with HAV, all of them had IgM anti-HAV antibodies and were serum HAV-RNA-positive. The high prevalence of anti-HAV antibodies in HIV-infected patients suggests that screening tests for anti-HAV antibodies should be performed before implementation of hepatitis A vaccination, especially in those patients from endemic countries.
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Affiliation(s)
- R Aloise
- Department of Virology, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, RJ, Brazil
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Barnett ED, Kozarsky PE, Steffen R. Vaccines for international travel. Vaccines (Basel) 2008. [DOI: 10.1016/b978-1-4160-3611-1.50069-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Jiang WP, Chen JT, Wang X, Wang YL, Liu Y, Chen WY, Xu WG, Qiu YZ, Yin WD. Immunogenicity and safety of three consecutive lots of a new preservative-free inactivated hepatitis A vaccine (Healive): a double-blind, randomized and controlled trial. Vaccine 2007; 26:2297-301. [PMID: 18395305 DOI: 10.1016/j.vaccine.2007.11.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2007] [Revised: 10/30/2007] [Accepted: 11/03/2007] [Indexed: 01/10/2023]
Abstract
Immunization is considered as the most effective way for the prophylaxis of hepatitis A virus (HAV) infection. This study aimed to evaluate the immunogenicity and safety of three consecutive lots of a new preservative-free inactivated hepatitis A vaccine (Healive) in healthy children. A double-blind, randomized and controlled clinical trial was conducted in healthy volunteers aged from 1 to 8 years. Total 400 subjects were enrolled and assigned into four groups, receiving one of the three lots of Healive or an established control vaccine. The vaccination was two-dose regimen with 6 months apart. Anti-HAV titers were determined at the 1st, 6th and 7th month. The results showed that Healive was highly immunogenic in children with 100% seroconversion rate (SR) and 3237-3814 mIU/ml geometry mean titer (GMT) 1 month after the second dose. The immunogenicity of Healive was statistically higher than that of the control vaccine with respect to GMT and SR (P=0.037 to P<0.001). Both Healive and control vaccine were well tolerated with 1-5% incidence of overall adverse reactions (P>0.298). Severe adverse reaction was not reported. Both SRs (1, 6 and 7 months) and GMTs (1 and 7 months) in subjects receiving one of the three consecutive lots of Healive had not statistical difference (P=0.114-0.710), suggesting that Healive was well consistent. The immune responses in younger children (1-3 years) and older children (4-8 years) were similar to each other (P=0.187-0.963). The present study indicated that Healive was greatly consistent between production lots, well tolerated and highly immunogenic in children, which made the preservative-free inactivated hepatitis A vaccine well suitable for inclusion in the routine programme of children vaccination.
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Affiliation(s)
- Wei-Ping Jiang
- Changzhou City Center for Diseases Control and Prevention, Changzhou 213003, Jiangsu Province, China
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Stauffer F, De Miranda J, Schechter MC, Queiroz FA, Santos NO, Alves AMB, Da Poian AT. New chemical method of viral inactivation for vaccine development based on membrane fusion inhibition. Vaccine 2007; 25:7885-92. [PMID: 17949864 DOI: 10.1016/j.vaccine.2007.09.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2007] [Revised: 08/30/2007] [Accepted: 09/03/2007] [Indexed: 11/15/2022]
Abstract
Membrane fusion is an essential step in the entry of enveloped viruses into their host cells. This process is triggered by conformational changes in viral surface glycoproteins. We have demonstrated previously that modification of vesicular stomatitis virus (VSV) with diethylpyrocarbonate (DEPC) abolished the conformational changes on VSV glycoprotein and the fusion reaction induced by the virus. Moreover, we observed that viral treatment with DEPC inactivates the virus, preserving the conformational integrity of its surface proteins. In the present work, we evaluated the potential use of DEPC as a viral inactivating chemical agent for the development of useful vaccines. Pathogenicity and viral replication in Balb/c mice were abolished by viral treatment with 0.5mM DEPC. In addition, antibodies elicited in mice after intraperitoneal immunization with DEPC-inactivated VSV mixed with adjuvants were able to recognize and neutralize the native virus and efficiently protected animals against the challenge with lethal doses of VSV. These results together suggest that viral inactivation with DEPC seems to be a suitable method for the development of safe vaccines.
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Affiliation(s)
- Fausto Stauffer
- Instituto de Bioquímica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ 21941-590, Brazil
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Abstract
Since licensure in 1995 of a hepatitis A vaccine, the Centers for Disease Control and Prevention and the American Academy of Pediatrics have been implementing an incremental hepatitis A immunization strategy for children. In 1996, children living in populations with the highest rates of disease were targeted for immunization, and in 1999 the program was expanded to immunization of children 2 years and older living in states and counties with rates of hepatitis A that historically have been higher than the national average. The 1999 program has been successful; the current rate of hepatitis A is the lowest ever reported in the United States. Regional, ethnic, and racial differences in the incidence of hepatitis A have been eliminated. The incidence of hepatitis A in adults in immunizing states has decreased significantly, suggesting a strong herd-immunity effect associated with immunization. In 2005, the US Food and Drug Administration changed the youngest approved age of administration of hepatitis A vaccine from 24 to 12 months of age, which facilitated incorporation of the vaccine into the recommended childhood immunization schedule. As the next step in the implementation of the incremental vaccine immunization strategy, the American Academy of Pediatrics now recommends routine administration of a Food and Drug Administration-licensed hepatitis A vaccine to all children 12 to 23 months of age in all states according to a Centers for Disease Control and Prevention-approved immunization schedule. Available data suggest that hepatitis A vaccine can be coadministered with other childhood vaccines without decreasing immunogenicity. Hepatitis A vaccines have proven to be extremely safe. In prelicensure clinical trials of both Havrix (GlaxoSmithKline, Rixensart, Belgium) and Vaqta (Merck & Co Inc, Whitehouse Station, NJ), adverse events were uncommon and mild when they occurred, with resolution typically in less than 1 day. Hepatitis A vaccine is contraindicated in people with a history of severe allergic reaction to a previous dose of hepatitis A vaccine or to a vaccine component. Because the hepatitis A vaccine is an inactivated product, no special precautions are needed for administration to people who are immunocompromised. No data exist about administration of the hepatitis A vaccine to pregnant women, but because it is not a live vaccine, the risk to mother and fetus should be extremely low to nonexistent.
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Overton ET, Nurutdinova D, Sungkanuparph S, Seyfried W, Groger RK, Powderly WG. Predictors of immunity after hepatitis A vaccination in HIV-infected persons. J Viral Hepat 2007; 14:189-93. [PMID: 17305885 DOI: 10.1111/j.1365-2893.2006.00822.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Hepatitis A virus (HAV) infection remains a health risk for human immunodeficiency virus (HIV)-infected persons. While the inactivated HAV vaccine affords protection to immunocompetent persons >95% of the time, rates of developing protective antibody (anti-HAV) in HIV+ persons are considerably lower. Although low CD4+ T-cell counts have previously been reported to be correlated with this poor response, the effect of HIV viraemia on HAV vaccine response has not previously been reported. The medical records of HIV-infected patients who had received at least one dose of HAV vaccine (Havrix, 1440 EIU) were reviewed for factors associated with the development of a protective anti-HAV response. Serological data with regard to anti-HAV status after vaccination were available in 238 patients with 133 individuals (49.6%) developing immunity after vaccination. In a logistic regression model, the only factors associated with a protective antibody response were an HIV plasma RNA level <1000 copies/mL at the time of vaccination (P = 0.011) and male gender (P = 0.016). Neither nadir CD4+ T cell count nor CD4+ T-cell count at time of vaccination were predictive of the development of anti-HAV. Suppression of HIV replication at time of vaccination is associated with a protective antibody response to HAV vaccination in HIV-infected adults. The low rate of response warrants further research in alternative strategies for HAV vaccination among HIV-infected persons.
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Affiliation(s)
- E T Overton
- Washington University School of Medicine, St Louis, MO, USA.
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Connor BA, Blatter MM, Beran J, Zou B, Trofa AF. Rapid and sustained immune response against hepatitis A and B achieved with combined vaccine using an accelerated administration schedule. J Travel Med 2007; 14:9-15. [PMID: 17241248 DOI: 10.1111/j.1708-8305.2006.00106.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Combined hepatitis A and B vaccine administered on an accelerated schedule provides a rapid immune response against both hepatitis A and B viruses, which might be especially relevant for individuals who need protection quickly. METHODS A prospective, open-label, randomized study to compare the immunogenicity and reactogenicity of the combined hepatitis A and B vaccine Twinrix (GlaxoSmithKline Biologicals, Rixensart, Belgium) (>or=720 EL.U/mL inactivated hepatitis A antigen and 20 microg/mL recombinant hepatitis B surface antigen [HBsAg]) administered at 0, 7, 21 to 30 days, and 12 months compared with concurrent administration of Havrix [GlaxoSmithKline Biologicals, Rixensart, Belgium (>or=1440 EL.U/mL inactivated hepatitis A antigen)] at 0 and 12 months, and Engerix-B [GlaxoSmithKline Biologicals, Rixensart, Belgium (20 microg/mL recombinant HBsAg)] at 0, 1, 2, and 12 months in seronegative healthy adults. RESULTS At month 13, the anti-hepatitis B seroprotection rates (>10 mIU/mL) for the combined vaccine compared to the monovalent hepatitis B vaccine were 96.4% (95% CI: 92.7-98.5) and 93.4% (95% CI: 89.0-96.4), respectively. The anti-hepatitis A seroconversion rates were 100% in both groups (95% CI: 98.1-100). At day 37, the anti-hepatitis A seroconversion rates were similar in both groups (98.5% for combined vaccine, 98.6% for the monovalent vaccine group), but the combined vaccine resulted in a statistically significantly ( p < 0.001) better anti-hepatitis B seroprotection compared to monovalent hepatitis B vaccine, 63.2% versus 43.5%, respectively. The reactogenicity profile was similar in both study groups. CONCLUSIONS The combined hepatitis A and B vaccine administered on an accelerated schedule was at least as immunogenic and as well tolerated as the corresponding monovalent vaccines.
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Affiliation(s)
- Bradley A Connor
- Division of Gastroenterology and Hepatology, The Weill Medical College of Cornell University, New York, NY, USA
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Kwon YO, Choi IJ, Jung JW, Park JH. An epidemiologic study on the seropositive rate of hepatitis A virus among a selected group of children and adults in Busan. KOREAN JOURNAL OF PEDIATRICS 2007. [DOI: 10.3345/kjp.2007.50.3.262] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Young Ok Kwon
- Department of Pediatrics, Maryknol Hospital, Busan, Korea
| | - Im Jeong Choi
- Department of Pediatrics, Maryknol Hospital, Busan, Korea
| | - Jin Wha Jung
- Department of Pediatrics, Maryknol Hospital, Busan, Korea
| | - Ji Hyun Park
- Department of Pediatrics, Maryknol Hospital, Busan, Korea
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El-Karaksy HM, El-Hawary MI, El-Koofy NM, El-Sayed R, El-Raziky MAS, Mansour SA, Taha GM, El-Mougy F. Safety and efficacy of hepatitis A vaccine in children with chronic liver disease. World J Gastroenterol 2006; 12:7337-40. [PMID: 17143952 PMCID: PMC4087494 DOI: 10.3748/wjg.v12.i45.7337] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To study the safety and efficacy of hepatitis A vaccine (HAV) in children with chronic liver disease of various etiologies.
METHODS: Eleven children with chronic liver disease and thirteen age- and sex-matched controls negative for HAV antibodies were vaccinated against hepatitis A after they gave their informed consent. Children with uncontrolled coagulopathy or signs of hepatic decompensation were excluded. The vaccine (Havrix: 720 ELISA units in 0.5 mL, from GlaxoSmithKline Biologicals) was given intramuscularly in the deltoid in 2 doses 6 mo apart. Children were tested for HAV antibodies one and six months after the 1st dose and one month after the 2nd dose. Total serum bilirubin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were determined immediately before and after one month of the 1st dose of the vaccine.
RESULTS: Only 7 out of the 11 patients were positive for HAV antibodies after the 1st dose of the vaccine, as compared to 100% of the controls. One month after the 2nd dose, all patients tested were positive for HAV antibodies. No deterioration in liver functions of patients was noted after vaccination. No adverse events, immediate or late, were reported by the mothers after each dose of the vaccine.
CONCLUSION: Hepatitis A vaccine is both safe and effective in this small studied group of children with chronic liver disease. Given the high seroconversion rate, post-vaccination testing for HAV antibodies is not needed.
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Affiliation(s)
- Hanaa-Mostafa El-Karaksy
- Department of Pediatrics, Cairo University, 44 Mohei El-Deen Abu El-Ezz Street, Dokki, Cairo 12311, Egypt.
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