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Hercun J, Alvarez F, Vincent C, Bilodeau M. Cystic fibrosis liver disease: A condition in need of structured transition and continuity of care. CANADIAN LIVER JOURNAL 2019; 2:71-83. [PMID: 35990223 PMCID: PMC9202747 DOI: 10.3138/canlivj-2018-0019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/10/2018] [Indexed: 08/05/2023]
Abstract
Liver disease affects one-third of patients with cystic fibrosis (CF) and it is one of the major causes of morbidity and mortality in these patients. Historically considered a disease of childhood, its impact is now seen more often in adulthood. The heterogeneous pattern of CF liver disease and its rapid progression to cirrhosis remain a diagnostic challenge and new questions pertaining to the nature of liver involvement have recently been raised. Non-invasive measures to stratify the severity of liver involvement are increasingly used to predict clinical outcomes. A single treatment, ursodeoxycholic acid, has been used to slow progression of liver disease while recent advances in the field of CF treatments are promising. Management of portal hypertension remains challenging but outcomes after liver transplantation are encouraging. While many questions remain unanswered, a growing number of CF patients reach adulthood and will require care for CF liver disease.
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Affiliation(s)
- Julian Hercun
- Hepatology Department, Centre Hospitalier de l’Université de Montréal, Montréal, Québec;
| | - Fernando Alvarez
- Gastroenterology, Hepatology and Nutrition Division, CHU Sainte-Justine, Montréal, Québec
| | - Catherine Vincent
- Hepatology Department, Centre Hospitalier de l’Université de Montréal, Montréal, Québec;
| | - Marc Bilodeau
- Hepatology Department, Centre Hospitalier de l’Université de Montréal, Montréal, Québec;
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Leung DH, Narkewicz MR. Cystic Fibrosis-related cirrhosis. J Cyst Fibros 2017; 16 Suppl 2:S50-S61. [DOI: 10.1016/j.jcf.2017.07.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/01/2017] [Accepted: 07/03/2017] [Indexed: 12/14/2022]
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Maltezou HC, Doudounakis S, Lekaditi M, Tanou K, Katerelos P, Theodoridou M. Study of Greek children and youths with cystic fibrosis identifies immunisation gaps and delays. Acta Paediatr 2017; 106:288-291. [PMID: 27862309 DOI: 10.1111/apa.13663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 10/18/2016] [Accepted: 11/07/2016] [Indexed: 11/29/2022]
Abstract
AIM Data about immunisation rates in cystic fibrosis (CF) patients are scarce. We estimated the rates and timeliness of immunisations in CF patients aged 0.55-22 years. METHODS We studied 122 subjects at a hospital in Greece in 2014. A standard questionnaire was used to collect data and parents' opinions about immunisations. RESULTS The complete immunisation rates were 92.6% for diphtheria-tetanus-acellular pertussis-inactivated poliomyelitis-Haemophilus influenzae (DTaP-IPV-Hib), 96.7% for hepatitis A, 97.4% for hepatitis B, 97.4% for measles-mumps-rubella, 85.1% for the varicella zoster virus, 85.1% for the meningococcus C conjugate, 84.3% for the pneumococcus conjugate and 58.9% for the bacillus Calmette-Guérin vaccine. Immunisation rates in youths were 64.4% for DTaP-IPV, 26.8% for the tetravalent meningococcus conjugate vaccine and 54.1% for the human papilloma virus vaccine. In addition, 30.1% received the 23-valent pneumococcal polysaccharide vaccine and 45.6% received annual influenza vaccines. Complete, up-to-date immunisation rates fell from 61.4% at 12 months of age to 14.5% at six and 12 years. All vaccines experienced delays. Most parents believed vaccines were necessary to protect their child's health. CONCLUSION Our study of children with CF found immunisation gaps with no catch-up immunisations and these need to be administered at follow-up visits.
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Affiliation(s)
- Helena C. Maltezou
- Department for Interventions in Health‐Care Facilities Hellenic Center for Disease Control and Prevention Athens Greece
| | - Stavros Doudounakis
- Cystic Fibrosis Department University of Athens, Aghia Sophia Children's Hospital Athens Greece
| | - Maria Lekaditi
- Cystic Fibrosis Department University of Athens, Aghia Sophia Children's Hospital Athens Greece
| | - Kalliopi Tanou
- Cystic Fibrosis Department University of Athens, Aghia Sophia Children's Hospital Athens Greece
| | - Panos Katerelos
- Department for Interventions in Health‐Care Facilities Hellenic Center for Disease Control and Prevention Athens Greece
| | - Maria Theodoridou
- First Department of Pediatrics University of Athens, Aghia Sophia Children's Hospital Athens Greece
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Masson A, Launay O, Delaisi B, Bassinet L, Remus N, Lebourgeois M, Chedevergne F, Bailly C, Foucaud P, Corvol H, deBlic J, Sermet-Gaudelus I. Vaccine coverage in CF children: A French multicenter study. J Cyst Fibros 2015; 14:615-20. [DOI: 10.1016/j.jcf.2015.04.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 04/27/2015] [Accepted: 04/27/2015] [Indexed: 11/30/2022]
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Launay O, Boelle PY, Krivine A, Grenet D, Boussaud V, Rémus N, Corvol H, Chedevergne F, Hubert D, Sermet-Gaudelus I. Factors associated with humoral immune response to pandemic A/H1N1(v) 2009 influenza vaccine in cystic fibrosis. Vaccine 2014; 32:4515-4521. [PMID: 24950362 DOI: 10.1016/j.vaccine.2014.06.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 05/28/2014] [Accepted: 06/06/2014] [Indexed: 11/25/2022]
Abstract
Influenza vaccination is recommended in cystic fibrosis patients. The objective of this study was to assess the immunogenicity of vaccination against 2009 pandemic A/H1N1 influenza and to study the factors associated with the immune response in patients with cystic fibrosis. 122 patients with cystic fibrosis were enrolled in a prospective study and received 1 dose of 2009/H1N1v adjuvanted vaccine, or for children <2 years and lung-transplanted patients, two doses of non-adjuvanted 2009/H1N1v vaccine administered 21 days apart. Hemagglutination inhibition antibodies were assessed before and 21 days after vaccination and at least 6 months after vaccination. After vaccination, 85% of the patients had an influenza antibody titer ≥1:40 and 69% seroconverted. 13% of the transplanted patients seroconverted compared with 72% of the non-transplanted patients. In this latter group, non-adjuvanted vaccine and low body mass index were independently associated with lower response to vaccination. 86% of the non-transplanted patients with normal BMI and receiving adjuvanted vaccine seroconverted. Persistence of seroprotection 10 months after vaccination was found in 50% of the patients. In patients with cystic fibrosis, malnutrition and receipt of non-adjuvanted vaccine were associated with lower immune response to pandemic influenza vaccination. Our data also suggest a potential defect in the immune response to influenza vaccination of patients with cystic fibrosis and raise the question of whether a different immunization strategy is needed.
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Affiliation(s)
- O Launay
- Inserm, CIC 1417, Paris, France; Université Paris Descartes, Paris Sorbonne Cité, Paris, France; Assistance-Publique Hôpitaux de Paris, Hôpital Cochin, CIC Cochin-Pasteur, Paris, France
| | | | - A Krivine
- Assistance-Publique Hôpitaux de Paris, Hôpital Cochin, Service de Virologie, Paris, France
| | - D Grenet
- Hôpital Foch, Service de Pneumologie, Suresnes, France
| | - V Boussaud
- Assistance-Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Chirurgie Thoracique, Paris, France
| | - N Rémus
- Centre Hospitalier Intercommunal de Créteil, Centre de Ressources et de Compétences en Mucoviscidose, Créteil, France
| | - H Corvol
- Assistance-Publique Hôpitaux de Paris, Hôpital Trousseau, Centre de Ressources et de Compétences en Mucoviscidose, Paris, France
| | - F Chedevergne
- Assistance-Publique Hôpitaux de Paris, Hôpital Necker, Service de Pneumologie- Allergologie Pediatrique et Centre de Ressources et de Compétences en Mucoviscidose, Paris, France
| | - D Hubert
- Assistance-Publique Hôpitaux de Paris, Hôpital Cochin, Service de Pneumologie, Centre de Ressources et de Compétences en Mucoviscidose, Paris, France
| | - I Sermet-Gaudelus
- Université Paris Descartes, Paris Sorbonne Cité, Paris, France; Assistance-Publique Hôpitaux de Paris, Hôpital Necker, Service de Pneumologie- Allergologie Pediatrique et Centre de Ressources et de Compétences en Mucoviscidose, Paris, France; INSERM U 1151, Paris, France.
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