Population-Based Multicentric Survey of Hepatitis B Infection and Risk Factors in the North, South, and Southeast Regions of Brazil, 10–20 Years After the Beginning of Vaccination

Ximenes, Ricardo A. A.; Figueiredo, Gerusa Maria; Cardoso, Maria Regina Alves; Stein, Airton Tetelbom; Moreira, Regina Célia; Coral, Gabriela Perdomo; Crespo, Déborah; Santos, Alex Alves dos; Montarroyos, Ulísses Ramos; Braga, Cynthia; Pereira, Leila Maria Moreira Beltrão

doi:10.4269/ajtmh.15-0216

Cited by 42 publications

(60 citation statements)

References 33 publications

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“…The impact of catch‐up programmes and additional efforts to target at‐risk population groups may be limited by inequitable uptake and/or incomplete coverage. Thus, HBV transmission among PWID is ongoing in many countries : for example, in the United States, where universal vaccination of infants began in 1991 , there are currently an estimated 19 000 cases of acute HBV infection annually, with 26% of reported cases (with a known risk factor) attributable to injecting drug use . In countries of the European Union/European Economic Area, injecting drug use accounts for 15% of reported acute HBV cases .…”

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confidence: 99%

Association between universal hepatitis B prison vaccination, vaccine uptake and hepatitis B infection among people who inject drugs

et al. 2017

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Section: Introductionmentioning

confidence: 99%

Association between universal hepatitis B prison vaccination, vaccine uptake and hepatitis B infection among people who inject drugs

et al. 2017

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“…No entanto, recentes descobertas destacam a diversidade das rotas de transmissão potenciais para a propagação da hepatite B no Brasil. Além disso, estudos de base populacional têm revelado que a prevalência da infecção no país é mais baixa do que anteriormente citada, inclusive pela Organização Mundial de Saúde (OMS) 2 . A vacinação com o antigénio de superfície do HBV (HBsAg) é a principal medida de proteção.…”

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Exposição ocupacional e vacinação para hepatite B entre trabalhadores da atenção primária e média complexidade

Souza

Araújo

2018

Rev. Bras. Med. Trab.

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RESUMO | Contexto: O Programa Nacional de Imunização (PNI), por meio dos calendários vacinais, garante imunização gratuita contra hepatite B para os profissionais de saúde que possuem risco aumentado para infecção relacionada aos processos laborais. Objetivo: Analisar a associação entre a vacinação completa para hepatite B e as variáveis relacionadas à exposição ocupacional. Método: Estudo de corte transversal realizado com 3.084 trabalhadores da atenção primária e média complexidade de cinco municí-pios da Bahia. Resultados: Os fatores associados à vacinação completa para hepatite B na análise bivariada foram: contato com material biológico, preparo de medicação, utilização de equipamento de proteção individual (EPI), procura de orientação após acidente de trabalho e exigência de habilidade no trabalho. Conclusões: Os trabalhadores do setor da saúde ainda apresentam resistência em aderir a algumas medidas de prevenção. Por isso, estratégias de incentivo à vacinação podem ser potencializadas com a abertura de espaços de discussão no trabalho a respeito das cargas laborais às quais o grupo está exposto. Reais planos e políticas de enfrentamento relacionadas à saúde do trabalhador precisam ser definidos à luz das políticas governamentais que têm sido constituídas para a população geral. Palavras-chave | hepatite B; vacinação; saúde do trabalhador.ABSTRACT | Background: Through its vaccination schedules, the National Immunization Program ensures immunization against hepatitis B gratis to health care professionals at high risk for infection at the workplace. Objective: To analyze the association between variables related to occupational exposure and complete hepatitis B vaccination schedule. Method: Cross-sectional study with 3,084 primary care and medium complexity health care workers from five municipalities in the state of Bahia, Brazil. Results: The factors associated with complete hepatitis B vaccination schedule on bivariate analysis were: contact with biological materials, preparation of medications, use of personal protective equipment (PPE), search for orientation after a work accident and skill demands. Conclusions: Workers in the health sector resist adhering to some preventive measures. Strategies to encourage vaccination might be enhanced by creating room for discussion at work on the burden to which employees are exposed. Plans and policies for workers' health should be formulated in the light of governmental policies set for the overall population.

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“…7 Despite this policy, differences exist in the vaccination uptake across different age groups and low immunization rates are apparent in some groups. 8,9 Also, in older age groups, the immunogenicity of this vaccine is not known, and there are many factors that may affect how immunogenic the vaccine is in these groups. 1 As has been observed for the gold-standard vaccine by other authors, [10][11][12] sex represents a statistically significant difference in terms of vaccine responders and nonresponders.…”

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Low Immunogenicity of Recombinant Hepatitis B Vaccine Derived from Hansenula polymorpha in Adults Aged Over 40 Years

Caetano

Del‐Rios

Pinheiro

et al. 2017

The American Society of Tropical Medicine and Hygiene

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Abstract. The Brazilian recombinant hepatitis B vaccine (VrHB-IB) is based on the expression of the recombinant antigen in Hansenula polymorpha yeast cells. Currently, data on the immunogenicity of this vaccine in older adults are nonexistent. This study aimed to evaluate the immunogenicity of VrHB-IB in adults over 40 years of age. From May to October 2011, 235 rural settlers between 2 and 93 years of age from the State of Goias in Brazil were eligible for vaccination. Of these, 180 accepted the first dose of the vaccine and 106 (58.9%) completed the vaccination schedule. Multivariate analysis revealed that individuals ≥ 40 years of age responded significantly less well to vaccination than younger adults. Also, a greater proportion of male nonresponders was observed (versus women; P = 0.02). These results point to the need for better evaluation of the immunogenicity of VrHB-IB in older adults.Vaccination against hepatitis B is the safest and most effective method of reducing the incidence and prevalence of infection with hepatitis B virus (HBV).1 Indeed, HBV vaccination confers protection in over 90% of subjects who receive it.2 The first-generation HBV vaccine, which was produced from human HBV surface antigen (HBsAg) plasma from chronically infected patients, became commercially available in the early 1980s and is still used in some countries. 3The second-generation vaccine, also marketed in the 1980s, is produced using recombinant DNA technology. This vaccine is safe and effective, and allows for unlimited production and widespread distribution throughout the world. Currently, many countries produce the HBV vaccine using this technology, and various expression systems have been used to obtain recombinant HBsAg.1,4 Engerix-B, the gold-standard vaccine, uses Saccharomyces cerevisiae as the expression system for recombinant HBsAg. In Brazil, the Brazilian recombinant hepatitis B vaccine (VrHB-IB) is obtained by culturing genetically engineered Hansenula polymorpha yeast cells with the HBsAg gene. Initially, this vaccine was produced as a recombinant antigen (concentration 20 μg/mL). However, research has shown that in adults 30-40 years of age, the immunogenicity of the Brazilian vaccine is not equivalent to the gold-standard vaccine (Engerix B), 5 and the concentration of HBsAg was therefore increased to 25 μg/mL. A clinical trial comparing the immunogenicity of VrHB-B with Engerix-B in patients in this age group found that the vaccine produced in Brazil at the current concentration is equivalent to the gold standard. The aim of our study was to evaluate the immunogenicity of VrHB-IB vaccination in rural settlers in central Brazil. Rural settlers who were susceptible to HBV comprised the vaccination group, and most of them were > 40 years of age. At present, published studies on the immunogenicity of the Brazilian HBV vaccine in adults in this age group are rare.From May to October 2011, 467 rural settlers from the southwest region of the State of Goias, central Brazil, were recruited. All agreed to participat...

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Population-Based Multicentric Survey of Hepatitis B Infection and Risk Factors in the North, South, and Southeast Regions of Brazil, 10–20 Years After the Beginning of Vaccination

Cited by 42 publications

References 33 publications

Association between universal hepatitis B prison vaccination, vaccine uptake and hepatitis B infection among people who inject drugs

Association between universal hepatitis B prison vaccination, vaccine uptake and hepatitis B infection among people who inject drugs

Exposição ocupacional e vacinação para hepatite B entre trabalhadores da atenção primária e média complexidade

Low Immunogenicity of Recombinant Hepatitis B Vaccine Derived from Hansenula polymorpha in Adults Aged Over 40 Years

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