Immunogenicity of standard and low dose vaccination using yeast-derived recombinant hepatitis B surface antigen in elderly volunteers

There is no conclusive evidence that age influences the response to vaccination against hepatitis B virus. We therefore studied the immunogenicity of yeast-derived rHBsAg vaccine in elderly volunteers. The study was conducted in the outpatient clinics of an academic and a regional hospital, in a rural family practice and in an urban community centre. We recruited 112 healthy volunteers aged 59 years and over, to whom 10 or 20 μg yeast-derived HBsAg was given at 0, 1 and 6 months. Anti-HBs titres were measured by radioimmunoassay at 2, 6 and 7 months. Responders and non-responders were compared using univariate non-parametric tests and multivariate logistic regression analysis. Of the 116 subjects who volunteered to take part in the study, 106 vaccinees completed it. The percentage of subjects with an anti-HBs titre ⩾10 1U1−1 at 7 months was 60% (95% confidence interval: 51–70%; geometric mean titre: 253 1U1−1). Of the factors studied, i.e. setting, age, sex, alcohol consumption, current medication and vaccine dose, the use of medication at the time of the first vaccination was the only independent factor related to the response to vaccination, with a response rate of 78% (95% confidence interval: 66–89%) in those without medication. In elderly subjects, the proportion with protective concentrations of anti-HBs after vaccination with 10 or 20 μg yeast-derived recombinant HBsAg in a standard scheme is lower than in healthy adolescents. Within the older age group studied here, the use of medication, probably reflecting general health, is the only significant factor influencing the response to vaccination

Forma HBsAg negativă a maladiei ficatului, condiţionate de virusul hepatic B sau infecţia cu VHB ocultă

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“Au fost investigaţi 225 de bolnavi cu infecţie cu virus hepatic B (VHB). Infecţia B ocultă fără hepatită (IBO) a fost depistată în 12,44% cazuri, infecţia ocultă B cu hepatită (HBO) – la 19,56% pacienţi. Lotul-martor a fost constituit din 31 de persoane sănătoase. Particularitatea studiului constă în cercetarea activităţii ALT, AST şi fructozo-monofosfataldolazei (F-1-FA) în dinamica testului original cu eufi lină şi glucoză (TEG). În grupul cu IBO a fost stabilită modifi carea enzimogramelor ALT, AST şi F-1-FA, în comparaţie cu parametrii similari din lotul-martor. În HBO activitatea transaminazelor şi a F-1-FA în dinamica TEG se deosebeşte veridic de curbele enzimatice dinamice apreciate în IBO şi la persoanele sănătoase. Este justifi cată propunerea de a folosi această metodă pentru diagnosticarea timpurie a dereglărilor funcţiei fi catului în caz de infecţie VHB ocultă. We examined 225 patients with HBV infection. Presence of occult HBV infection without hepatitis (OBI) was revealed – in 12.44%, and with hepatitis B (OHB) – in 19.56%. 31practically healthy persons served as a control group. A feature of this study was the examination of the ALT, AST and fructose-1-mono-phosphataldolase (F-1-FA) activity in the dynamics of the original euphylline-glucose test (GET). A signifi cant change of ALT, AST, and F-1-FA enzymogramms was found in the OBI group in comparison with similar data in control group. The transaminase and F-1-FA activity was signifi cantly different in OHB in the dynamics of GET from the enzymogramms in OBI and control group. The proposed method is useful for early diagnosis of liver function in occult HBV infection. Обследовано 225 больных с HBV инфекцией. Оккультная инфекции без гепатита (OBI) была выявлена в 12,44% и оккультная инфекция с HBV гепатитом (OHB) – в 19,56% случаев. Контролем служили практически здоровые лица (31). Особенностью данного исследования является изучение активности АЛТ, АСТ и фруктозомонофосфатальдолазы (Ф-1-ФА) в динамике оригинального глюкозо-эуфиллинного теста (ГЭП). В группе OBI выявлено значимое изменение ферментограмм АЛТ, АСТ и Ф-1-ФА в сравнении с аналогичными данными группы контроля. При оккультном HBV гепатите (OHB) активность трансаминаз и Ф-1-ФА в динамике ГЭП достоверно отличается от показателей ферментограмм при OBI и от соответствующих значений в группе контроля. Предложенный метод целесообразно использовать для своевременной диагностики нарушения функции печени при оккультной HBV инфекции

Forma HBsAg negativă a maladiei ficatului, condiţionate de virusul hepatic B sau infecţia cu VHB ocultă

Au fost investigaţi 225 de bolnavi cu infecţie cu virus hepatic B (VHB). Infecţia B ocultă fără hepatită (IBO) a fost depistată în 12,44% cazuri, infecţia ocultă B cu hepatită (HBO) – la 19,56% pacienţi. Lotul-martor a fost constituit din 31 de persoane sănătoase. Particularitatea studiului constă în cercetarea activităţii ALT, AST şi fructozo-monofosfataldolazei (F-1-FA) în dinamica testului original cu eufi lină şi glucoză (TEG). În grupul cu IBO a fost stabilită modifi carea enzimogramelor ALT, AST şi F-1-FA, în comparaţie cu parametrii similari din lotul-martor. În HBO activitatea transaminazelor şi a F-1-FA în dinamica TEG se deosebeşte veridic de curbele enzimatice dinamice apreciate în IBO şi la persoanele sănătoase. Este justifi cată propunerea de a folosi această metodă pentru diagnosticarea timpurie a dereglărilor funcţiei fi catului în caz de infecţie VHB ocultă

Hepatitis A Antibody Seroprevalence in a Selected Kenyan Pediatric Population

The incidence of infection by Hepatitis A virus shows regional variation being highest in developing countries. Determination of age specific Hepatitis A virus (HAV) seroprevalence and the associated risk factors would help better plan for national preventive strategies including vaccination. We carried out a cross-sectional study on 300 children from Nairobi city, Kenya during the years 2003-2004. The age range of the children was 2 - 14 years and were from low and high socioeconomic status (SES) families. The indicators of SES included employment status, residence, number of children per patient’s household, parents’ level of education and source of drinking water. SES was encoded and analysed using Statistical Program for Social Sciences (SSPS) version 16.0. Seroprevalence increased significantly with advancing age. Seropositivity of HAV antibodies was significantly higher among children of low SES, 77.6% by the age of 14 years compared to children of high SES, 38.9% by the same age. Crowded household and parental education were significantly associated with high seropositivity and seronegativity respectively. There is significant rate of seronegativity amongst the studied population especially those from richer backgrounds making them more susceptible to severe infection in future with concomitant complications. We propose that revision of national vaccination program should be considered to include Hepatitis A vaccination

Soroprevalência da infecção pelo vírus da hepatite B em indivíduos com evidência clínica de hepatite em Goiânia, Goiás: detecção do DNA viral e determinação dos subtipos

The presence of serological markers for hepatitis B virus (HBsAg, anti-HBc IgM and Anti-HBc total) was investigated in the serum of 1,396 individuals who had clinical suspect of hepatitis. It was observed that 50.7% of the individuals were positive and, from the total of the studied individuals, 14.5% were positive for HBsAg. From these, 8.5% were also positive for anti-HBc IgM. The analysis in relation to gender showed a higher seroprevalence index among male individuals (p < 0.0001). It was observed the occurrence of subtypes adw2 (62.7%), ayw3 (23.5%), ayw2 (9.8%) and adw4 (3.9%). The viral DNA was detected in 61 (33.9%) HBsAg positive samples and in one sample positive only for anti-HBc total. These results indicate an important incidence of the HBV infection in this population, and reinforce previous studies regarding this virus in the central west region of Brazil.Investigou-se a presença dos marcadores sorológicos AgHBs, anti-HBc IgM e anti-HBc total no soro de 1.396 indivíduos com suspeita clínica de hepatite. Observou-se uma soroprevalência para a infecção pelo VHB de 50,7%, sendo que do total dos 1.396 indivíduos, 14,5% eram positivos para AgHBs e 8,5% eram também positivos para anti-HBc IgM, tendo ainda sido observado que a soroprevalência foi maior em indivíduos do sexo masculino (p < 0,0001). Por subtipagem foram identificados os seguintes subtipos: adw2 (62,7%), ayw3 (23,5%), ayw2 (9,8%) e adw4 (3,9%). O DNA viral foi detectado em 61 (33,9%) amostras positivas para o AgHBs e em uma amostra positiva somente para anti-HBc total. Estes resultados indicam importante índice de ocorrência da infecção pelo VHB nesta população e reforça dados de estudos anteriores a respeito da importante circulação do vírus na região Centro-Oeste do Brasil

Prevalence of HBsAg Among Prospective Blood Donors and Pregnant Women in Kebbi State, Nigeria

This study was aimed at determining the prevalence of Hepatitis B surface antigen (HBsAg) among prospective blood donors and pregnant women in Kebbi State, Nigeria. Three hundred and sixty one (361) apparently healthy prospective blood donors were recruited and screened for HBsAg using HBsAg rapid test kit. Those that tested positive for HBsAg (16.6%) were further assessed for liver function. The prevalence by gender was 23.4% and 13.1% for male and female subjects respectively. Prevalence by the three senatorial zones of the state is in the order Kebbi South (21.8%) &gt; Kebbi North (15.1%) &gt; Kebbi Central (13.6%). Subjects within the age group 26-30 years had the highest HBsAg prevalence of 20.9% compared to the other age groups. Single males have higher prevalence (26.1%) of HBV infection than their married counterparts (16.7%). Local government workers had highest prevalence (29.2%) followed by self-employed (27.6%) and then state government employees (14.3%). In females, occupational exposure (healthcare worker) and polygamy are risk factors with highest prevalence of 40.0% and 23.2% respectively. The levels of serum liver enzymes and bilirubin were significantly higher (p &lt; 0.05) in HBsAg positive subjects compared to the HBsAg negative subjects. The reverse was, however, the case for albumin. Our result suggests that Kebbi State is one of the HBsAg hyper-endemic areas in Nigeria.Keywords: Hepatitis B, Prevalence, Liver function test, Kebbi State