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Buonaguro L, Cavalluzzo B, Mauriello A, Ragone C, Tornesello AL, Buonaguro FM, Tornesello ML, Tagliamonte M. Microorganisms-derived antigens for preventive anti-cancer vaccines. Mol Aspects Med 2023; 92:101192. [PMID: 37295175 DOI: 10.1016/j.mam.2023.101192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/24/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023]
Abstract
Cancer prevention is one of the aim with the highest priority in order to reduce the burden of cancer diagnosis and treatment on individuals as well as on healthcare systems. To this aim, vaccines represent the most efficient primary cancer prevention strategy. Indeed, anti-cancer immunological memory elicited by preventive vaccines might promptly expand and prevent tumor from progressing. Antigens derived from microorganisms (MoAs), represent the obvious target for developing highly effective preventive vaccines for virus-induced cancers. In this respect, the drastic reduction in cancer incidence following HBV and HPV preventive vaccines are the paradigmatic example of such evidence. More recently, experimental evidences suggest that MoAs may represent a "natural" anti-cancer preventive vaccination or can be exploited for developing vaccines to prevent cancers presenting highly homologous tumor-associated antigens (TAAs) (e.g. molecular mimicry). The present review describes the different preventive anti-cancer vaccines based on antigens derived from pathogens at the different stages of development.
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Affiliation(s)
- Luigi Buonaguro
- Innovative Immunological Models Unit, Istituto Nazionale Tumori - IRCCS - "Fond G. Pascale", Naples, Italy
| | - Beatrice Cavalluzzo
- Innovative Immunological Models Unit, Istituto Nazionale Tumori - IRCCS - "Fond G. Pascale", Naples, Italy
| | - Angela Mauriello
- Innovative Immunological Models Unit, Istituto Nazionale Tumori - IRCCS - "Fond G. Pascale", Naples, Italy
| | - Concetta Ragone
- Innovative Immunological Models Unit, Istituto Nazionale Tumori - IRCCS - "Fond G. Pascale", Naples, Italy
| | - Anna Lucia Tornesello
- Molecular Biology and Viral Oncogenesis Unit, Istituto Nazionale Tumori - IRCCS - "Fond G. Pascale", Naples, Italy
| | - Franco M Buonaguro
- Molecular Biology and Viral Oncogenesis Unit, Istituto Nazionale Tumori - IRCCS - "Fond G. Pascale", Naples, Italy
| | - Maria Lina Tornesello
- Molecular Biology and Viral Oncogenesis Unit, Istituto Nazionale Tumori - IRCCS - "Fond G. Pascale", Naples, Italy
| | - Maria Tagliamonte
- Innovative Immunological Models Unit, Istituto Nazionale Tumori - IRCCS - "Fond G. Pascale", Naples, Italy.
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Fonzo M, Bertoncello C, Trevisan A. Factors influencing long-term persistence of anti-HBs after hepatitis B vaccination. NPJ Vaccines 2022; 7:173. [PMID: 36572682 PMCID: PMC9792585 DOI: 10.1038/s41541-022-00596-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/07/2022] [Indexed: 12/27/2022] Open
Abstract
Long-term immunity after HBV vaccination is still debated. When assessing immune persistence, several variables must be considered, the clear definition of which is crucial. Our aim was to assess protection 10-20 years after primary vaccination and to estimate the effect of age at first dose, sex and time elapsed between doses on long-term protection. We conducted a retrospective cohort study between January 2004 and December 2020. Antibody titres above 10 IU/L were considered protective. Geometric mean titres (GMT) were calculated. The effect of the above variables on long-term protection was assessed by logistic regression analysis. Included participants were 9459. Among those vaccinated during infancy, GMT gradually increased from 11 IU/L (first dose in 1st trimester of life) to 68 IU/L (4th trimester), while the proportion of individuals <10 IU/L remained stable between 1st and 2nd trimester (51%) and it decreased substantially in 3rd (28%) and even more so in the 4th (18%). A one-month delay in first and third dose administration was correlated with a -16% (AOR: 0.84; 95% CI: 0.78-0.91) and a -11% (AOR: 0.89; 95% CI: 0.85-0.94) risk of a titre <10 IU/L, respectively, ~20 years after immunisation. In contrast, similar changes do not comparably affect vaccination in adolescence. The start of vaccination at the third month of age is a compromise between the development of acceptable immunogenicity and the need to protect the infant as early as possible. However, the chance of slightly delaying the vaccine administration within the first year of life may be considered given the impact on long-term persistence of anti-HBs.
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Affiliation(s)
- Marco Fonzo
- grid.5608.b0000 0004 1757 3470Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Chiara Bertoncello
- grid.5608.b0000 0004 1757 3470Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Andrea Trevisan
- grid.5608.b0000 0004 1757 3470Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
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Rahmani A, Montecucco A, Kusznir Vitturi B, Debarbieri N, Dini G, Durando P. Long-Term Effectiveness of Hepatitis B Vaccination in the Protection of Healthcare Students in Highly Developed Countries: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:1841. [PMID: 36366350 PMCID: PMC9695994 DOI: 10.3390/vaccines10111841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 09/05/2023] Open
Abstract
Hepatitis B virus represents an important global health problem. In highly developed countries, mass vaccination campaigns of newborns in recent decades have drastically reduced the proportion of carriers. However, workers exposed to blood and body fluids, including healthcare students, can be at risk of exposure. In order to assess the proportion of susceptible individuals in the specific population of healthcare students in highly developed countries, a systematic review and meta-analysis was performed to summarize the evidence on the persistence of humoral immune protection induced by the primary cycle of hepatitis B vaccination, as well as the proportion of true non-responders. Forty-six studies were included in the final analysis (52,749 participants). Overall, the seroprotection prevalence at the pre-exposure assessment was equal to 73.8% (95% CI 69.1-78.0); the prevalence of anamnestic response following the administration of a challenge dose was 90.9% (95% CI 87.7-93.3), demonstrating a high proportion of persistence of vaccination-induced immunity. Among those without evidence of anamnestic response, 5.0% (95% CI 2.1-11.5) were non-responders following the completion of a secondary immunization cycle. These findings demonstrate that the majority of healthcare students vaccinated with the complete HBV primary cycle maintain an effective humoral immunity against this pathogen for over two decades.
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Affiliation(s)
- Alborz Rahmani
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
| | - Alfredo Montecucco
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | | | - Nicoletta Debarbieri
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Guglielmo Dini
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Paolo Durando
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
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Night Shift Work Is Associated with Reduced Rate of Humoral Response Following Vaccination for HBV. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148834. [PMID: 35886686 PMCID: PMC9320326 DOI: 10.3390/ijerph19148834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 11/17/2022]
Abstract
Night shift work has been associated with cardiovascular and metabolic disease, endocrine and immunological disorders. Published studies have reported that a reduced total sleep time with sleep-wake cycle alterations were associated with a reduced rate of humoral response following vaccination. Our study aimed to evaluate the association between night shift work and serological status for HBV among workers employed in a university hospital in Rome. We evaluated medical records of 986 HCWs working at Tor Vergata Policlinic of Rome. We screened all study subjects for anti-HBs IgG, anti-HBc IgG and HBsAg. Serological protection for HBV was evaluated in relation to sex, age group, job task, risk setting and night shift work status. Protective titer was found in 856 (86.8%) study participants and the mean titer was significantly high in females, in subjects aged less than 40 years, in night shift workers and in high-risk setting workers. After adjustment for study covariates, night shift work was no longer associated with an HBV-protective titer. This finding suggests that a vaccination strategy for dampening HBV transmission should be carefully addressed in health care workers (HCWs) doing night shift.
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Fonzo M, Nicolli A, Maso S, Carrer L, Trevisan A, Bertoncello C. Body Mass Index and Antibody Persistence after Measles, Mumps, Rubella and Hepatitis B Vaccinations. Vaccines (Basel) 2022; 10:vaccines10071152. [PMID: 35891316 PMCID: PMC9315673 DOI: 10.3390/vaccines10071152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 12/27/2022] Open
Abstract
Overweight and obesity may cause a reduced response to vaccination. The purpose of the present research was to study the relationship between current body mass index (BMI) and antibody persistence after vaccination against measles, mumps, and rubella (MMR) and hepatitis B virus (HBV) given during childhood, as per the current vaccination schedule. The study was conducted on 2185 students at the School of Medicine, University of Padua, Italy. The mean age of the participants was 20.3 years. After adjusting for sex, age at first dose of vaccine administered, age at last dose, and age at study enrollment, no significant association was found between lack of serologic protection and BMI for either the HBV vaccine or each component of the MMR vaccine. For the first time, the absence of this relationship was demonstrated for the MMR vaccine. Given the evidence currently available, further research on BMI and vaccines in general remains desirable.
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The effectiveness of 20 μg hepatitis B vaccine used for the prevention of HBV vertical transmission. Sci Rep 2022; 12:11759. [PMID: 35817837 PMCID: PMC9273617 DOI: 10.1038/s41598-022-15744-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 06/28/2022] [Indexed: 12/02/2022] Open
Abstract
To evaluate the efficiency of a 20 μg hepatitis B vaccine(HepB) for disease prevention in two counties in Henan Province, China. A questionnaire was designed to examine the information of hepatitis B surface antigen (HBsAg) positive pregnant women, and their blood samples were collected to test for hepatitis B e antigen (HBeAg), hepatitis B e antibody, and hepatitis B virus (HBV) DNA. Three doses of 20 μg HepB and one dose of hepatitis B immune globulin(HBIG) were administered to newborns. Blood samples were collected from children one month after their complete immunization to test for HBsAg and hepatitis B surface antibody(HBsAb). A total of 419 HBsAg positive-pregnant women and 430 newborns were investigated. The average age of pregnant women was 29.6 ± 4.3 years, with an HBeAg positive rate of 29.1% (122/419). All newborns received their first dose of 20 μg hepatitis B vaccine and 100 IU HBIG within 12 h after birth. Six infants (1.9%, 6/319) tested positive for HBsAg and negative for HBsAb after one month of receiving the three basic doses of HepB. The geometric mean concentration(GMC) of HBsAb-positive infants was 861.6 mIU/mL, and their HBsAb antibody titers decreased with age. Immunization of children born to HBsAg-positive mothers with 20 μg HepB got the satisfactory effect on preventing mother-to-child transmission.
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Trevisan A, Mason P, Nicolli A, Maso S, Fonzo M, Scarpa B, Bertoncello C. Future Healthcare Workers and Hepatitis B Vaccination: A New Generation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157783. [PMID: 34360071 PMCID: PMC8345783 DOI: 10.3390/ijerph18157783] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/08/2021] [Accepted: 07/21/2021] [Indexed: 12/19/2022]
Abstract
Before the introduction of universal vaccination, hepatitis B caused high morbidity and mortality, especially among healthcare workers. In the present study, the immune status against hepatitis B was assessed in a cohort of 11,188 students of the degree courses of the School of Medicine of the University of Padua (Italy) who had been subjected to mandatory vaccination in childhood or adolescence and who will be future healthcare workers. The variables that influence the antibody response to vaccination are mainly the age at which the vaccine was administered and sex. If vaccination was administered before one year of age, there is a high probability (around 50%) of having an antibody titer lower than 10 IU/L compared to those vaccinated after one year of age (12.8%). The time between vaccine and analysis is not decisive. Furthermore, female sex, but only if vaccination was administered after one year of age, shows a significant (p = 0.0008) lower percentage of anti-HBs below 10 IU/L and a greater antibody titer (p < 0.0001). In conclusion, the differences related to the age of vaccination induce more doubts than answers. The only plausible hypothesis, in addition to the different immune responses (innate and adaptive), is the type of vaccine. This is not easy to verify because vaccination certificates rarely report it.
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Affiliation(s)
- Andrea Trevisan
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (P.M.); (A.N.); (S.M.); (M.F.); (C.B.)
- Correspondence:
| | - Paola Mason
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (P.M.); (A.N.); (S.M.); (M.F.); (C.B.)
| | - Annamaria Nicolli
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (P.M.); (A.N.); (S.M.); (M.F.); (C.B.)
| | - Stefano Maso
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (P.M.); (A.N.); (S.M.); (M.F.); (C.B.)
| | - Marco Fonzo
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (P.M.); (A.N.); (S.M.); (M.F.); (C.B.)
| | - Bruno Scarpa
- Department of Statistical Sciences, University of Padova, 35128 Padova, Italy;
| | - Chiara Bertoncello
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (P.M.); (A.N.); (S.M.); (M.F.); (C.B.)
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Cornberg M, Sandmann L, Protzer U, Niederau C, Tacke F, Berg T, Glebe D, Jilg W, Wedemeyer H, Wirth S, Höner Zu Siederdissen C, Lynen-Jansen P, van Leeuwen P, Petersen J. S3-Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) zur Prophylaxe, Diagnostik und Therapie der Hepatitis-B-Virusinfektion – (AWMF-Register-Nr. 021-11). ZEITSCHRIFT FUR GASTROENTEROLOGIE 2021; 59:691-776. [PMID: 34255317 DOI: 10.1055/a-1498-2512] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Markus Cornberg
- Deutsches Zentrum für Infektionsforschung (DZIF), Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Hannover; Centre for individualised infection Medicine (CiiM), Hannover.,Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Hannover
| | - Lisa Sandmann
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Hannover
| | - Ulrike Protzer
- Institut für Virologie, Technische Universität München/Helmholtz Zentrum München, München
| | | | - Frank Tacke
- Medizinische Klinik m. S. Hepatologie und Gastroenterologie, Charité Universitätsmedizin Berlin, Berlin
| | - Thomas Berg
- Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Universitätsklinikum Leipzig, Leipzig
| | - Dieter Glebe
- Institut für Medizinische Virologie, Nationales Referenzzentrum für Hepatitis-B-Viren und Hepatitis-D-Viren, Justus-Liebig-Universität Gießen, Gießen
| | - Wolfgang Jilg
- Institut für Medizinische Mikrobiologie und Hygiene, Universität Regensberg, Regensburg
| | - Heiner Wedemeyer
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Hannover
| | - Stefan Wirth
- Zentrum für Kinder- und Jugendmedizin, Helios Universitätsklinikum Wuppertal, Wuppertal
| | | | - Petra Lynen-Jansen
- Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS), Berlin
| | - Pia van Leeuwen
- Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS), Berlin
| | - Jörg Petersen
- IFI Institut für Interdisziplinäre Medizin an der Asklepios Klinik St. Georg, Hamburg
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Cocchio S, Baldo V, Volpin A, Fonzo M, Floreani A, Furlan P, Mason P, Trevisan A, Scapellato ML. Persistence of Anti-Hbs after up to 30 Years in Health Care Workers Vaccinated against Hepatitis B Virus. Vaccines (Basel) 2021; 9:vaccines9040323. [PMID: 33915763 PMCID: PMC8067181 DOI: 10.3390/vaccines9040323] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/17/2021] [Accepted: 03/24/2021] [Indexed: 12/20/2022] Open
Abstract
The burden of hepatitis B virus (HBV) infection is a serious public health problem all over the world. Vaccination remains the most effective prevention measure, and safe and effective HBV vaccines have been available since 1982. Health care workers (HCWs) vaccinated against HBV and prospectively followed up for at least 14 years were classified by their antibody titers after primary vaccination as: poor responders (10–99 mIU/mL); moderate responders (100–999 mIU/mL); and good responders (≥1000 mIU/mL). The incidence of antibody loss was calculated for 1000 person-years and the anti-HBs persistence was calculated. The analysis concerned 539 HCWs: 494 good responders (91.7%); 37 moderate responders (6.9%); and eight poor responders (1.5%). The incidence of anti-HBs loss was 52.1 per 1000 person-years for the poor responders, 11.3 per 1000 person-years for the moderate responders, and 1.4 per 1000 person-years for the good responders. The mean persistence of anti-HBs differed significantly between the three groups, being: 19.2 years (95% CI: 15.6–22.8), 25.4 years (95% CI: 23.0–27.9), and 31.0 years (95% CI: 30.5–31.5) for the poor, moderate and good responders, respectively. In conclusion, our findings demonstrate a good persistence of protective anti-HBs titers in HCWs exposed to occupational risk for up to 30 years after a primary vaccination cycle (even without a booster dose) if their titer was initially higher than 100 mIU/mL.
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Affiliation(s)
- Silvia Cocchio
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
| | - Vincenzo Baldo
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
- Correspondence:
| | - Anna Volpin
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
| | - Marco Fonzo
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
| | - Annarosa Floreani
- Scientific Institute for Research, Hospitalization and Healthcare Negrar, 37024 Negrar, Italy;
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, 35124 Padova, Italy
| | - Patrizia Furlan
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
| | - Paola Mason
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
| | - Andrea Trevisan
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
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Mastrodomenico M, Muselli M, Provvidenti L, Scatigna M, Bianchi S, Fabiani L. Long-term immune protection against HBV: associated factors and determinants. Hum Vaccin Immunother 2021; 17:2268-2272. [PMID: 33522392 PMCID: PMC8189074 DOI: 10.1080/21645515.2020.1852869] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
In Italy, vaccination against hepatitis B became compulsory for all the newborns and 12-years-old adolescents in 1991. The main purpose of this study was to evaluate the persistence of long-term protection against HBV in medical students of the University of L’Aquila and in postgraduates Medical Doctors (HCWs) working in San Salvatore Hospital. The second aim was to study the variables associated with a protective anti-HBs antibody level, such as age at vaccination, gender, time elapsed from the last dose of vaccination. Three hundred and forty-two subjects were enrolled from January 2017 to January 2019 and a blood sample was collected to evaluate the levels of serum HBsAg, anti-HBs and anti-HBc. Statistical analysis calculated a multivariable logistic regression model to examine predictors of a protective anti-HBs titer. The larger part (239, 70%) of the students had an anti-HBs titer >10 mIU/mL, those were statistically significant older (26.7 vs 24.5 years, p < .001), vaccinated at age 12 years (83.5% vs 59.9% among vaccinate at infancy, p < .001) and more frequently attending postgraduate medical school (80.8% vs 57.5% among healthcare profession school, p < .001). The multivariable logistic regression model showed that HBV vaccination at age of 12 was significantly and independently associated with protective titers (OR = 10.27, p = .019). The results agreed with literature on HBV vaccination, confirming the efficacy of vaccination after 20 years. In particular, our results suggest that adolescent administration is the main predictor of a protective title, regardless of gender, course and years since vaccinations.
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Affiliation(s)
- Marianna Mastrodomenico
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Mario Muselli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Luca Provvidenti
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Maria Scatigna
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Serena Bianchi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Leila Fabiani
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
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Kinetics of Anti-Hepatitis B Surface Antigen Titers in Nurse Students after a Two-Year Follow-Up. Vaccines (Basel) 2020; 8:vaccines8030467. [PMID: 32839391 PMCID: PMC7563960 DOI: 10.3390/vaccines8030467] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/14/2020] [Accepted: 08/18/2020] [Indexed: 12/14/2022] Open
Abstract
Infection caused by hepatitis B virus (HBV) can be prevented through a safe and effective vaccine. This study analysed the kinetics of serum antibodies against hepatitis B surface antigen (HBsAg) (anti-HBs) titers in relation to previous vaccine boosters in Italian nursing students who were followed up for two years. Serum anti-HBs titers were evaluated at the first visit, after vaccine booster (if required) and at visit after two years. Overall, 483 students (mean age = 21.7 years; SD = 3.7) with median anti-HBs IgG titer of 6 mUI/mL (interquartile range (IQR) = 0–34) were enrolled. A total of 254 (52.5%) students with a titer lower than 10 mIU/mL were offered an anti-HBV booster at the first visit. Among these students, an exponential relation between anti-HBs IgG titer, one month after HBV booster and anti-HBs IgG titer two years later was found (y = 3.32 exp (0.0045x); R2 = 0.48; p < 0.001). Students with anti-HBV titer higher than 10 mIU/mL (N = 229) were followed up, and anti-HBs IgG titers at follow-up visit linearly correlated with anti-HBV baseline titers (y = 0.86x + 26.2; R2 = 0.67; p < 0.001). A decrease in anti-HBs titers can be expected a few years after the anti-HBV booster dose. This reduction is more pronounced than that observed in students not administered the booster dose and is exponential with respect to basal titers assessed after the booster dose.
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Trevisan A, Giuliani A, Scapellato ML, Anticoli S, Carsetti R, Zaffina S, Brugaletta R, Vonesch N, Tomao P, Ruggieri A. Sex Disparity in Response to Hepatitis B Vaccine Related to the Age of Vaccination. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17010327. [PMID: 31906550 PMCID: PMC6981715 DOI: 10.3390/ijerph17010327] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 12/24/2019] [Accepted: 12/31/2019] [Indexed: 12/27/2022]
Abstract
Hepatitis B virus (HBV) infection is one of the major infectious hazards for health-care workers (HCWs) because of the frequency of percutaneous exposures to blood or body fluids. For this reason, all HCWs should be vaccinated, including students in medicine and health professional degree programs. The aim of this study was to assess the immune coverage to anti-HBV vaccine and long-lasting protective titres of anti-HBs antibodies in female and male students to evaluate gender-related differences in response to HBV vaccination. Data relative to anti-HBs antibody titre, sex, age, and age at vaccination were collected and analyzed from 5291 Italian students (1812 males and 3479 females) of the graduate courses at the School of Medicine, who underwent the mandatory health surveillance of workers exposed to biological risk. The results indicated that gender affects the immune response to HBV vaccine, particularly evident in the case of females vaccinated after one year of age who exhibited a statistically significant (p = 0.0023) 1.21-fold increase in median antibody titre with respect to males. Our findings could contribute to the optimization of HBV vaccination schedules in health surveillance of HCWs.
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Affiliation(s)
- Andrea Trevisan
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy;
- Correspondence: (A.T.); (A.R.)
| | - Alessandro Giuliani
- Environment and Health Department, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy;
| | - Simona Anticoli
- Istituto Superiore di Sanità, Center for Gender Specific Medicine, 00161 Rome, Italy;
| | - Rita Carsetti
- Diagnostic Immunology Unit, Department of Laboratories and B cell Pathophysiology Unit, Immunology Research Area, Bambino Gesù Children Hospital, 00165 Rome, Italy;
| | - Salvatore Zaffina
- Occupational Medicine, Health Directorate, Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (S.Z.); (R.B.)
| | - Rita Brugaletta
- Occupational Medicine, Health Directorate, Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (S.Z.); (R.B.)
| | - Nicoletta Vonesch
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian National Workers Compensation Authority, Monte Porzio Catone, 00078 Rome, Italy; (N.V.); (P.T.)
| | - Paola Tomao
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian National Workers Compensation Authority, Monte Porzio Catone, 00078 Rome, Italy; (N.V.); (P.T.)
| | - Anna Ruggieri
- Istituto Superiore di Sanità, Center for Gender Specific Medicine, 00161 Rome, Italy;
- Correspondence: (A.T.); (A.R.)
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Garzillo EM, Arnese A, Coppola N, Corvino A, Feola D, Monaco MGL, Signoriello G, Marsella LT, Arena P, Lamberti M. HBV vaccination status among healthcare workers: A cross-sectional study. J Infect Prev 2019; 21:23-27. [PMID: 32030100 DOI: 10.1177/1757177419873043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 07/28/2019] [Indexed: 01/13/2023] Open
Abstract
Objective The development of a vaccine against hepatitis B virus (HBV) is one of the improvements in strategy prevention during the last decades. Aim To evaluate HBV-related vaccine status in healthcare workers (HCW) exposed to biological risk. Methods The serum markers for HBV were collected from HCWs in two tertiary care hospitals in Naples (Italy). Multivariate statistical analysis was then performed to identify associated factors linked to the long-term immunogenicity of the HCWs. Results All HBV vaccinated individuals were screened for whole marker patterns; all were HBsAg/anti-HBc negative. Of individuals, 20% had an anti-HB antibody titre < 10 IU/L. Multivariate statistical analysis highlighted that women were more protected than men (73.6% vs. 26.4%, P < 0.05). Additionally, nurses seem to maintain a higher antibody titre than doctors and other staff, such as auxiliary technicians (P < 0.05). Conclusions Our data support the evidence of a strong immunogenicity against HBV, assessed through the circulating antibody titre, when prophylactic vaccination is conducted in non-infantile age, particularly for women. The outcome of the study supports the central role of occupational physicians within the hospital districts in terms of primary prevention and maximum protection of HCWs.
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Affiliation(s)
- Elpidio Maria Garzillo
- Department of Experimental Medicine- University of Campania L. Vanvitelli, Naples, Italy
| | - Antonio Arnese
- Department of Experimental Medicine- University of Campania L. Vanvitelli, Naples, Italy
| | - Nicola Coppola
- Department of Mental and Physical Health and Preventive Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - AnnaRita Corvino
- Department of Experimental Medicine- University of Campania L. Vanvitelli, Naples, Italy
| | - Daniela Feola
- Department of Experimental Medicine- University of Campania L. Vanvitelli, Naples, Italy
| | | | - Giuseppe Signoriello
- Department of Mental and Physical Health and Preventive Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - Luigi Tonino Marsella
- Departiment of Biomedicine and Prevention, Università di Roma Tor Vergata, Rome, Italy
| | - Paola Arena
- Department of Experimental Medicine- University of Campania L. Vanvitelli, Naples, Italy
| | - Monica Lamberti
- Department of Experimental Medicine- University of Campania L. Vanvitelli, Naples, Italy
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Trevisan A, Frasson C, De Nuzzo D, Nicolli A, Scapellato ML. Significance of anti-HB levels below 10 IU/L after vaccination against hepatitis B in infancy or adolescence: an update in relation to sex. Hum Vaccin Immunother 2019; 16:460-464. [PMID: 31487228 PMCID: PMC7062447 DOI: 10.1080/21645515.2019.1656483] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Hepatitis B vaccination (three-dose series) induces long-term immunity, but it is not uncommon to find antibody levels below 10 IU/L long after vaccination. However, the majority of the subjects with low antibody levels have a prompt response to a booster dose. A population of 10,294 students at Padua University Medical School, who were subjected to hepatitis B vaccination during infancy or adolescence according to the law, was tested for the presence of anti-HBs, usually during the first year of matriculation. Among the students offered a booster dose, 1,030 were vaccinated, and the antibody titre was re-tested. The present research provides further evidence from a larger number of students (1,030) that an anti-HB level higher than 2 IU/L is predictive of a prompt response to a booster. There are also differences related to sex. The results clearly confirm that an antibody titre equal to or greater than 2 IU/L is enough to prompt a response after a booster dose, even several years after the initial vaccination cycle, and to predict effective immune protection. The length of the interval between the booster/post-booster analyses increases the probability of finding a low response to the booster; furthermore, females show a more rapid response to the booster than males. The importance for healthcare workers of measuring the antibody titre four weeks after a booster is highlighted, and the results suggest that females have a better response than males to booster vaccination.
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Affiliation(s)
- Andrea Trevisan
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Unit of Preventive Medicine and Risk Assessment, University of Padova, Padova, Italy
| | - Clara Frasson
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Unit of Preventive Medicine and Risk Assessment, University of Padova, Padova, Italy
| | - Davide De Nuzzo
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Unit of Preventive Medicine and Risk Assessment, University of Padova, Padova, Italy
| | - Annamaria Nicolli
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Unit of Preventive Medicine and Risk Assessment, University of Padova, Padova, Italy
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Unit of Preventive Medicine and Risk Assessment, University of Padova, Padova, Italy
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Bianchi FP, Gallone MS, Gallone MF, Larocca AMV, Vimercati L, Quarto M, Tafuri S. HBV seroprevalence after 25 years of universal mass vaccination and management of non-responders to the anti-Hepatitis B vaccine: An Italian study among medical students. J Viral Hepat 2019; 26:136-144. [PMID: 30199579 DOI: 10.1111/jvh.13001] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/09/2018] [Accepted: 08/13/2018] [Indexed: 12/17/2022]
Abstract
According to international guidelines, healthcare workers and medical students immunized against HBV are periodically tested for anti-HBs IgG. Subjects who show an anti-HBs titre <10 mUI/mL must receive additional vaccine doses to induce a measurable antibody response. This study aimed to evaluate the long-time immunogenicity of anti-hepatitis B vaccination in a sample of medical students and residents of the University of Bari who attended the Hygiene Department for biological risk assessment (April 2014-June 2017). The strategy for the management of nonresponder subjects was evaluated. A total of 3676 students and residents were invited for testing according to a standardized protocol. Anti-HBs IgG was tested for in 3140 (85.4%) subjects: 1174/3140 (37.7%) subjects were negative. 14.6% (128/808) of subjects who received the vaccine during their 12th year of life and 45.8% (1056/2305) of subjects immunized during the first year of life (P < 0.0001) were negative. 1005/1174 (85.6%) seronegative subjects received a booster dose, and 903/1005 (89.9%) were tested for anti-HBs 1 month after the booster dose: 82/903 (9.1%) subjects were still negative. Of these, 56/82 (68.3%) received 2 additional doses of vaccine and 52/56 (92.9%) were tested 1 month after the third dose: 50/52 subjects (96.2%) developed a positive titre. In conclusion, several medical students, immunized at birth or at young age against HBV, did not develop protective titres against the virus. Our management strategy (booster retest; for negative subjects, 2 doses and retest) seems consistent with the purpose of evidencing immunological memory.
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Affiliation(s)
- Francesco P Bianchi
- Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
| | - Maria S Gallone
- Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
| | - Maria F Gallone
- Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
| | | | - Luigi Vimercati
- Department of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari, Italy
| | - Michele Quarto
- Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
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Zhao H, Zhou YH. Revaccination against hepatitis B in late teenagers who received vaccination during infancy: Yes or no? Hum Vaccin Immunother 2017; 14:456-463. [PMID: 29083945 PMCID: PMC5806661 DOI: 10.1080/21645515.2017.1397243] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The significance of vaccination against hepatitis B during infancy is recognized worldwide, however, whether booster or revaccination after a period of time following the primary vaccination is required remains controversial. Recently, cross-sectional epidemiological surveys found that HBsAg prevalence in subjects born after the implementation of mass vaccination was increased with age, which was attributed to waning of anti-HBs over time. However, comprehensive analysis of the closely related cross-sectional surveys showed that the age-specific increased HBsAg prevalence was more likely associated with the carry-over of the infection occurred in early life, likely due to imperfect coverage of hepatitis B vaccination at the beginning of its introduction. Latest studies showed that booster response could be observed in the majority of individuals vaccinated 30 years ago. Moreover, confirmed breakthrough HBV infection with severe consequences in successfully vaccinated individuals is extremely rare. Thus far no compelling evidence has been acquired to support booster vaccination in adolescence. The uncertainty regarding the duration of protection of hepatitis B vaccination, especially beyond 30 years after the primary vaccination, merits a systematically designed study to follow the same cohort of participants longitudinally, which differs from the cross-sectional studies reported previously, can hopefully offer more direct evidence to help us to determine whether revaccination of hepatitis B vaccine is necessary.
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Affiliation(s)
- Hong Zhao
- a Department of Infectious Diseases , The Second Hospital of Nanjing, The Second Affiliated Hospital of Southeast University , Nanjing , Jiangsu , China
| | - Yi-Hua Zhou
- b Departments of Laboratory Medicine and Infectious Diseases , Nanjing Drum Tower Hospital and Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School , Nanjing , Jiangsu , China
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Dini G, Toletone A, Barberis I, Debarbieri N, Massa E, Paganino C, Bersi F, Montecucco A, Alicino C, Durando P. Persistence of protective anti-HBs antibody levels and anamnestic response to HBV booster vaccination: A cross-sectional study among healthcare students 20 years following the universal immunization campaign in Italy. Hum Vaccin Immunother 2017; 13:440-444. [PMID: 27925503 PMCID: PMC5328216 DOI: 10.1080/21645515.2017.1264788] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Vaccination against Hepatitis B Virus (HBV) became mandatory in Italy for all newborns and 12 years-old individuals in the 1991. The immunogenicity of HBV vaccine and the effectiveness of the universal immunization strategy have been widely demonstrated. However the need to assess the antibody concentrations above the well known serological correlate of protection for HBV infection (≥10 mIU/mL), established in individuals immunized with a 3 doses vaccination course, is still recommended in subjects exposed to occupational risks in different settings, particularly the healthcare services. This practice has to be performed during the preventive medical examination, before the worker's exposure to biological hazards, as a fundamental part of Occupational Health Surveillance Programs in several Countries, including Italy: the goal is to assure individual protection, also providing booster doses when needed, after many years following the primary vaccination. During the 2011–2013 period, an observational study was performed in Healthcare students (HCSs) trained at a regional university acute-care hospital in North-Western Italy, properly immunized against HBV during infancy or adolescence, in order to evaluate the persistence of seroprotection and to assess the anamnestic response to booster vaccination. Data from 717 subjects undergoing HbsAg Ab and HBc Ab testing during the preventive medical examination, and receiving a booster dose of HBV vaccine when resulting with a non-protective titer (<10 mIU/mL), were collected and analyzed. Most of the HCSs (74.6%) included in the survey, mean age 24.8 y ( ± 4.6 SD), had received the primary vaccination course during the first year of life (3–5–11 months). Globally, 507 (70.7%) HCSs showed protective antibody titres, and an anamnestic response was observed in more than 95% subjects receiving the booster dose. Our study demonstrated the long-term persistence of protection of HBV vaccine, more than 20 y following the primary immunization, in HCSs who are exposed to occupational health risk. The anamnestic response observed in non-seroprotected subjects who received the booster further confirms the capability of the HBV vaccine to create a strong immunological memory.
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Affiliation(s)
- Guglielmo Dini
- a Department of Health Sciences , Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, I.R.C.C.S. University Hospital San Martino - IST National Institute for Cancer Research , Genoa , Italy
| | - Alessandra Toletone
- a Department of Health Sciences , Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, I.R.C.C.S. University Hospital San Martino - IST National Institute for Cancer Research , Genoa , Italy
| | - Ilaria Barberis
- b Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Nicoletta Debarbieri
- a Department of Health Sciences , Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, I.R.C.C.S. University Hospital San Martino - IST National Institute for Cancer Research , Genoa , Italy
| | - Emanuela Massa
- a Department of Health Sciences , Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, I.R.C.C.S. University Hospital San Martino - IST National Institute for Cancer Research , Genoa , Italy
| | - Chiara Paganino
- b Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Francesca Bersi
- a Department of Health Sciences , Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, I.R.C.C.S. University Hospital San Martino - IST National Institute for Cancer Research , Genoa , Italy
| | - Alfredo Montecucco
- a Department of Health Sciences , Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, I.R.C.C.S. University Hospital San Martino - IST National Institute for Cancer Research , Genoa , Italy
| | - Cristiano Alicino
- b Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Paolo Durando
- a Department of Health Sciences , Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, I.R.C.C.S. University Hospital San Martino - IST National Institute for Cancer Research , Genoa , Italy
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Trevisan A. Long-term persistence of immunity after hepatitis B vaccination: A fact, not a fancy. Hum Vaccin Immunother 2016; 13:916-917. [PMID: 27905837 DOI: 10.1080/21645515.2016.1257451] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
On the basis of an article previously published in the journal regarding immune persistence after hepatitis B vaccination in infancy, I discuss why this persistence is a fact and not a fancy. Immune memory after a primary vaccination series has been widely demonstrated by prompt response to booster doses and the proliferation of T cells secreting IFNγ. In a large cohort of medical students, 79% of subjects were positive for anti-HBs antibodies, and only 1.9% of the subjects had serological evidence of past hepatitis B infection. To prevent severe diseases, such as hepatitis B, it is very important that the majority of the population is vaccinated, especially those employed in health care, as vaccination is the most effective weapon to hepatitis B, which is still widespread worldwide.
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Affiliation(s)
- Andrea Trevisan
- a Department of Cardiologic , Thoracic and Vascular Sciences, Unit of Preventive Medicine and Risk Assessment, University of Padova , Padova , Italy
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Lamberti M, De Rosa A, Garzillo EM, Corvino AR, Sannolo N, De Pascalis S, Di Fiore E, Westermann C, Arnese A, Gabriella DG, Nienhaus A, Sobrinho APR, Coppola N. Vaccination against hepatitis b virus: are Italian medical students sufficiently protected after the public vaccination programme? J Occup Med Toxicol 2015; 10:41. [PMID: 26539242 PMCID: PMC4632277 DOI: 10.1186/s12995-015-0083-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 10/26/2015] [Indexed: 01/02/2023] Open
Abstract
Background The development of a vaccine against hepatitis B virus (HBV) has been a major achievement in terms of prevention of HBV infection. For the present study, we analysed the long-term immunogenicity and effectiveness of HBV vaccination among healthcare students with different working seniorities. Methods A cross-sectional study of undergraduate and postgraduate students attending the Medical School of the Second University of Naples was conducted between September 2012 and December 2014. HBV serum markers were determined and multivariate logistic regression analysis was used to identify factors associated with the level of long-term immunogenicity. Results Of the 2,932 subjects evaluated, only 33 (1.1 %) declared no history of vaccination. All vaccinated subjects were HBsAg/anti-HBc negative, 459 of which had an anti-HBs titre <10 IU/L. The latter were younger, more likely to be attending a healthcare profession school (i.e., dental hygienists, nursing, paediatric nursing, radiography and midwifery) than a medical school (at either undergraduate or postgraduate level) and more likely to have been vaccinated in infancy. Conclusion The results of this study suggest that assessment of HBV serum markers in workers potentially exposed to hospital infections is useful to identify small numbers of unvaccinated subjects or vaccinated subjects with low antibody titre, all of whom should be referred to a booster series of vaccinations.
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Affiliation(s)
- Monica Lamberti
- Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy
| | - Alfredo De Rosa
- Department of Orthodontics, Second University of Naples, Naples, Italy
| | - Elpidio Maria Garzillo
- Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy
| | - Anna Rita Corvino
- Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy
| | - Nicola Sannolo
- Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy
| | - Stefania De Pascalis
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Naples, Italy
| | - Eliana Di Fiore
- Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy
| | - Claudia Westermann
- Institute for Health Services, Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Antonio Arnese
- Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy
| | - Di Giuseppe Gabriella
- Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy
| | - Albert Nienhaus
- Institute for Health Services, Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.,Institution for Statutory Accident Insurance and Prevention in Healthcare and Welfare Services, Hamburg, Germany
| | | | - Nicola Coppola
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Naples, Italy
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Levels of anti-HBs antibody in HBV-vaccinated students enrolled in the faculty of medicine, dentistry and health professions of a large Italian University. BIOMED RESEARCH INTERNATIONAL 2015; 2015:712020. [PMID: 25629052 PMCID: PMC4299313 DOI: 10.1155/2015/712020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 05/28/2014] [Accepted: 06/16/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Prophylaxis against hepatitis B virus (HBV) addressed to students of the faculties of health professions has received great attention. Objectives. The present study aims to assess vaccination coverage against hepatitis B in healthcare professionals in training. MATERIALS AND METHODS A retrospective study was carried out using data from the students of medicine, dentistry, and health professions. RESULTS 4180 vaccination certifications were examined through the internal database. Significant differences (<0.0001) emerge between the number of doses applied and the antibody level. 50.4% of the students have nonprotective antibody levels (<10 IU). The age of the first dose significantly influences the level of coverage, resulting in more coverage in those vaccinated with earlier onset (1-10 years). Antibody levels are not significantly different by type of course; the levels of noncoverage are present in 44.4% of the students of medicine and dentistry and in 50.6% among those belonging to the health professions. CONCLUSIONS This study represents one of the first experiences in Italy on vaccination against HBV and the relationship between doses of vaccination and antibody titer in the biomedical students that can configure a step forward in the real-time monitoring in order to establish a register of vaccination.
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Trevisan A, Nicolli A, Chiara F. Hepatitis B: prevention, protection and occupational risk. Future Virol 2015. [DOI: 10.2217/fvl.14.90] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
ABSTRACT Since 1992, the inclusion of HBV vaccination has been recommended by the WHO for all immunization programs implemented by nations. In Europe, the introduction of HBV vaccination has markedly reduced the incidence of acute HBV, and before the introduction of HBV vaccine, healthcare workers (HCW) were at considerable risk of infection. The present review discusses the main problems regarding three fundamental issues in hospital settings: prevention of HBV in HCW, protection induced by vaccination (problems regarding nonresponders) and risk for HCW exposed to blood-borne pathogens (occupational risk). The screening of HBV markers plays a decisive role in evaluating the degree of immune coverage in subjects exposed to biological risk and permits an increase in immune coverage through vaccine implementation.
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Affiliation(s)
- Andrea Trevisan
- Department of Cardiologic, Thoracic & Vascular Sciences, University of Padova, Via Giustiniani 2, I-35128 Padova, Italy
| | - Annamaria Nicolli
- Department of Cardiologic, Thoracic & Vascular Sciences, University of Padova, Via Giustiniani 2, I-35128 Padova, Italy
| | - Federica Chiara
- Department of Cardiologic, Thoracic & Vascular Sciences, University of Padova, Via Giustiniani 2, I-35128 Padova, Italy
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Çiftdoğan DY, Onay H, Tosun S, Özdemir TR, Özkınay F, Vardar F. IFNG and IFNGR1 gene polymorphisms in children with nonresponse to the hepatitis B vaccine. Future Virol 2014. [DOI: 10.2217/fvl.13.124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
ABSTRACT: Aim: We investigated the +874 T/A polymorphism in the first intron of the IFNG gene and intronic (CA)n polymorphic microsatellite marker of the IFNGR 1 gene in child nonresponders to hepatitis B vaccination. Materials & methods: A total of 100 children who had anti-HBs antibody levels <10 mIU/ml after vaccination against hepatitis B were included as a nonresponder group and 100 children who had anti-HBs antibody levels >10 mIU/ml after vaccination against hepatitis B were included as a responder group. Results: The frequency of the TT genotype of the IFNG (+874 T/A) gene polymorphism was higher in nonresponders (p = 0.003). The frequencies of alleles 170 and 182 for (CA)n alleles for the intronic (CA)n microsatellite of IFNGR1 were significantly higher in nonresponders (for each, p < 0.05). Conclusion: The TT genotype of the IFNG (+874 T/A) gene, and alleles 170 and 182 for (CA)n alleles for the intronic (CA)n microsatellite of the IFNGR1 gene, may be associated with nonresponse to hepatitis B vaccination.
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Affiliation(s)
- Dilek Yılmaz Çiftdoğan
- Ege University, Faculty of Medicine, Department of Pediatric Infectious Diseases, Bornova, İzmir, Turkey
| | - Hüseyin Onay
- Ege University, Department of Medical Genetics, İzmir, Turkey
| | | | | | - Ferda Özkınay
- Ege University, Department of Medical Genetics, İzmir, Turkey
| | - Fadıl Vardar
- Ege University, Faculty of Medicine, Department of Pediatric Infectious Diseases, Bornova, İzmir, Turkey
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Hepatitis B vaccination of adolescents: Significance of non-protective antibodies. Vaccine 2013; 32:62-8. [DOI: 10.1016/j.vaccine.2013.10.074] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 09/09/2013] [Accepted: 10/23/2013] [Indexed: 01/28/2023]
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24
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Riva MA, Sormani M. Anti-HBs evaluation and booster dose in vaccinated healthcare students. Vaccine 2013; 31:3777. [DOI: 10.1016/j.vaccine.2013.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Accepted: 06/03/2013] [Indexed: 11/30/2022]
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