Clinical Experience With An Inactivated Hepatitis A Vaccine

Clemens, Ralf; Safary, Assad; Hepburn, Anne; Roche, Ceara; Stanbury, William J.; André, Francis

doi:10.1093/infdis/171.supplement_1.s44

Cited by 203 publications

(82 citation statements)

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“…In this model, it was assumed that all subjects after being in a state of acute hepatitis would acquire natural immunity and would be immune from further infection with hepatitis A. In addition, hepatitis A vaccination is associated with no major adverse side effects, 7 and the medical cost of minor side effects of vaccination are negligible. It was assumed that 80% of the target population would comply with vaccination in strategy I or the initial screening test in strategy II.…”

Section: Methodsmentioning

confidence: 99%

“…With the development of an inactivated hepatitis A vaccine and demonstration of its effectiveness and safety in large, controlled trials, [6][7][8] hepatitis A vaccination for pre-exposure prophylaxis is recommended for groups at high risk for hepatitis A infection, namely travelers to endemic areas, homosexuals, and intravenous drug abusers, persons who are at risk for occupational exposure to HAV, food handlers, and patients with chronic liver disease and clotting disorders. 1,9 Taking a lesson from the experience with hepatitis B vaccination programs along with the fact that 35% to 50% of patients with acute hepatitis A do not have any identifiable risk factor, 10 it is unlikely that the vaccination strategy of targeting the high-risk groups alone will have any significant impact on the overall incidence of acute hepatitis A, and a strategy of universal vaccination will be needed to prevent epidemics and ultimately eradicate this preventable but potentially serious disease.…”

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confidence: 99%

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An Economic Analysis of Different Strategies of Immunization Against Hepatitis A Virus in Developed Countries

Das

1999

Hepatology

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Acute hepatitis A is a major public health problem in developed countries, and because a large proportion of patients with acute hepatitis A do not have any identifiable risk factors, current practice of targeting the high-risk groups for vaccination against hepatitis A virus (HAV) is unlikely to have a significant impact on the overall incidence of acute hepatitis A. No economic analysis of strategies of mass immunization against HAV is available. Three different strategies of immunization against HAV using commercially available inactivated vaccine were compared in a Markov model analysis of a cohort of 2-year-old healthy children in a developed country. In strategy I, universal vaccination was pursued. In strategy II, children were initially screened for antibody and, if susceptible, they were vaccinated. In strategy III, no vaccination was offered. Cost per person and quality adjusted life-years (QALY) gained in each strategy were the outcome measures compared. The baseline analysis showed that strategy II is more costeffective than strategy I, with marginal cost-effectiveness ratios of $7,267.67 and $12,833.34, respectively, compared with a strategy of no intervention. Sensitivity analysis showed that if the cost of the two-dose vaccine could be reduced to less than $57, the strategy of universal vaccination would be the preferred immunization strategy. Different strategies of mass immunization against HAV in the developed countries are cost-effective by current standards of health care interventions and should be considered for incorporation into current childhood immunization programs. (HEPATOLOGY 1999;29:548-552.)

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

An Economic Analysis of Different Strategies of Immunization Against Hepatitis A Virus in Developed Countries

Das

1999

Hepatology

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“…Todas as vacinas disponíveis no Brasil induzem níveis protetores de anti corpos em mais de 90% dos vacinados 30 dias após a aplicação da primeira dose da vacina e prati camente em 100% dos que receberam as duas doses 23,24 . Nesta pesquisa, apenas 11% dos acadêmicos eram vacinados contra a hepati te A e 63% contra a hepati te B.…”

Section: Discussão Tabela 2 Distribuição Dos Acadêmicos Segundo O Counclassified

Conhecimento dos Alunos do Curso de Graduação em Odontologia da Universidade Estadual da Paraíba sobre Hepatites Virais

Diniz¹

2011

Pesq Bras Odontoped Clin Integr

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6Pós-Graduando em Implantodonti a pelo Centro Odontológico de Estudos e Pesquisas (COESP), João Pessoa/PB, Brasil.Objeti vo: Avaliar o conhecimento de acadêmicos do curso de Odontologia sobre hepati tes virais. Método: A amostra foi consti tuída por 109 acadêmicos dos 157 acadêmicos do Curso de Odontologia da Universidade Estadual da Paraíba (UEPB), do terceiro ao quinto anos, selecionados aleatoriamente, os quais estão mais expostos aos fatores de risco inerentes ao não conhecimento das hepati tes virais. Os dados foram coletados através de um questi onário com questões de múlti pla escolha que abordavam o conhecimento sobre hepati tes virais. As variáveis do estudo incluíam questões como: ti po de Equipamento de Proteção Individual usado durante os procedimentos, opinião sobre a exposição ao vírus da hepati te, quais seriam as vias de transmissão da hepati te, se o acadêmico já havia sofrido acidente com instrumental pérfuro-cortante. Os dados foram analisados de forma descriti va. Resultados: Todos os alunos (100%) afi rmaram que usavam luvas,máscara e gorro, porém, apenas 92% deles achavam estar expostos aos vírus da hepati te. Em relação às vias de exposição, 95% dos acadêmicos afi rmaram ser o sangue contaminado uma das principais vias de transmissão da hepati te, porém, 36% apenas afi rmaram que as mucosas poderiam ser uma via de transmissão. De todos os acadêmicos pesquisados, 28% já haviam sofrido algum acidente pérfuro-cortante. Os resultados da investi gação com base no questi onário mostraram que apenas 75% dos acadêmicos eram vacinados, 63% responderam que para a hepati te ti po B. Conclusão: Os estudantes de Odontologia têm consciência dos riscos de contaminação em relação às hepati tes virais, mas os conhecimentos adquiridos sobre os mesmos não estão sendo aplicados na práti ca clínica. Objecti ve:To evaluate the knowledge of undergraduate dental students about viral hepati tes. Methods: The sample was composed of 109 out of 157 3rd-5th undergraduate dental students from the State University of Paraíba (UEPB), Brazil, selected at random, who are more exposed to the risk factors inherent to the unawareness of viral hepati tes. Data were collected using a questi onnaire with multi ple-choice questi ons arguing about the knowledge of viral hepati tes. The study variables included questi ons regarding individual protecti on equipment used during the procedures, opinion about exposure to hepati ti s virus, which would be the transmission routes, and whether the student had already suff ered any accident with perforati ng/cutti ng instruments. Data were subjected to descripti ve analysis. Results: All (100%) students affi rmed to use gloves, mask and cap, but only 92% of them believed to be exposed to the hepati ti s virus. Regarding the forms of exposure, 95% of the undergraduate students affi rmed that contaminated blood is one of the main transmission routes of hepati ti s, but only 36% of them believed that the mucosas could be a transmission route. From all undergraduate students interviewed for th...

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“…9 The longevity of protection after vaccination is not completely known, but protection appears to last for several years in immunocompetent hosts. [10][11][12] The increased morbidity and mortality of HAV infection led the Advisory Committee on Immunization Practices in 1996 to recommend immunization of all patients with CLD (without evidence for previous exposure) against HAV infection. 1 Liver transplant recipients are generally elderly and frequently have CLD related to rejection or recurrence of pre-OLT disease or caused by such post-OLT complications as vascular insufficiency or biliary strictures.…”

Section: Study Of Liver Diseasesmentioning

confidence: 99%

Hepatitis A antibodies in liver transplant recipients: Evidence for loss of immunity posttransplantation

et al. 2000

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Liver transplant recipients frequently have chronic liver diseases and should be considered for vaccination against hepatitis A virus (HAV). However, persistence of protective antibodies after orthotopic liver transplantation (OLT) has not been shown in this population, which may have implications for future vaccine recommendations. We evaluated the prevalence and epidemiological significance of immunoglobulin G (IgG) antibody to HAV (anti-HAV) in a nonvaccinated population before OLT (immunity from previous exposure) and determined the persistence of IgG anti-HAV at 1 and 2 years after OLT. One hundred consecutive patients were identified who underwent OLT and had at least 2 years of follow-up post-OLT. They were not vaccinated against HAV infection at any time. Clinical data were summarized from medical records, and stored sera were tested for IgG anti-HAV before OLT and at 1 and 2 years after OLT by a commercially available enzyme immunoassay. Of 100 patients, 24 had IgG anti-HAV before OLT. No epidemiological differences were noted between those with or without detectable IgG anti-HAV before OLT. Among patients with detectable IgG anti-HAV before OLT, 4 of 22 patients (18%) and 7 of 24 patients (29%) became negative for IgG anti-HAV at 1 and 2 years post-OLT, respectively. None of the patients with undetectable IgG anti-HAV before OLT became positive at any time. Most of our patients with end-stage liver disease had no serological evidence for immunity against HAV. A significant proportion of patients with detectable protective antibodies before OLT lost their antibodies at 2 years after OLT.

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Clinical Experience With An Inactivated Hepatitis A Vaccine

Cited by 203 publications

References 20 publications

An Economic Analysis of Different Strategies of Immunization Against Hepatitis A Virus in Developed Countries

An Economic Analysis of Different Strategies of Immunization Against Hepatitis A Virus in Developed Countries

Conhecimento dos Alunos do Curso de Graduação em Odontologia da Universidade Estadual da Paraíba sobre Hepatites Virais

Hepatitis A antibodies in liver transplant recipients: Evidence for loss of immunity posttransplantation

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