1
|
Kang X, Zhao C, Chen S, Zhang X, Xue B, Li C, Wang S, Yang X, Xia Z, Xu Y, Huang Y, Qiu Z, Li C, Wang J, Pang J, Shen Z. Development of a cell-free toehold switch for hepatitis A virus type I on-site detection. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2023; 15:5813-5822. [PMID: 37870419 DOI: 10.1039/d3ay01408h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
Picornavirus hepatitis A virus (HAV) is a common cause of hepatitis worldwide. It is spread primarily through contaminated food and water or person-to-person contact. HAV I has been identified as the most common type of human HAV infection. Here, we have developed a cell-free toehold switch sensor for HAV I detection. We screened 10 suitable toehold switch sequences using NUPACK software, and the VP1 gene was used as the target gene. The optimal toehold switch sequence was selected by in vivo expression. The best toehold switch concentration was further found to be 20 nM in a cell-free system. 5 nM trigger RNA activated the toehold switch to generate visible green fluorescence. The minimum detection concentration decreased to 1 pM once combined with NASBA. HAV I trigger RNA could be detected accurately with excellent specificity. In addition, the cell-free toehold switch sensor was verified in HAV I entities. The successful construction of the cell-free toehold switch sensor provided a convenient, rapid, and accurate method for HAV I on-site detection, especially in developing countries, without the involvement of expensive facilities and additional professional operators.
Collapse
Affiliation(s)
- Xiaodan Kang
- College of Food Science and Technology, Shanghai Ocean University, Shanghai, 201306, China.
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Chen Zhao
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Shuting Chen
- College of Food Science and Technology, Shanghai Ocean University, Shanghai, 201306, China.
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Xi Zhang
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Bin Xue
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Chenyu Li
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Shang Wang
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Xiaobo Yang
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Zhiqiang Xia
- The 908th Hospital of Chinese People's Liberation Army Joint Logistic Support Force, Nanchang, 330000, China
| | - Yongchun Xu
- The 908th Hospital of Chinese People's Liberation Army Joint Logistic Support Force, Nanchang, 330000, China
| | - Yongliang Huang
- The 908th Hospital of Chinese People's Liberation Army Joint Logistic Support Force, Nanchang, 330000, China
| | - Zhigang Qiu
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Chao Li
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Jingfeng Wang
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Jian Pang
- The Air Force Hospital of Northern Theater People's Liberation Army, Shenyang 110042, China.
| | - Zhiqiang Shen
- College of Food Science and Technology, Shanghai Ocean University, Shanghai, 201306, China.
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| |
Collapse
|
2
|
Van Damme P, Pintó RM, Feng Z, Cui F, Gentile A, Shouval D. Hepatitis A virus infection. Nat Rev Dis Primers 2023; 9:51. [PMID: 37770459 DOI: 10.1038/s41572-023-00461-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/23/2023] [Indexed: 09/30/2023]
Abstract
Hepatitis A is a vaccine-preventable infection caused by the hepatitis A virus (HAV). Over 150 million new infections of hepatitis A occur annually. HAV causes an acute inflammatory reaction in the liver that usually resolves spontaneously without chronic sequelae. However, up to 20% of patients experience a prolonged or relapsed course and <1% experience acute liver failure. Host factors, such as immunological status, age, pregnancy and underlying hepatic diseases, can affect the severity of disease. Anti-HAV IgG antibodies produced in response to HAV infection persist for life and protect against re-infection; vaccine-induced antibodies against hepatitis A confer long-term protection. The WHO recommends vaccination for individuals at higher risk of infection and/or severe disease in countries with very low and low hepatitis A virus endemicity, and universal childhood vaccination in intermediate endemicity countries. To date, >25 countries worldwide have implemented such programmes, resulting in a reduction in the incidence of HAV infection. Improving hygiene and sanitation, rapid identification of outbreaks and fast and accurate intervention in outbreak control are essential to reducing HAV transmission.
Collapse
Affiliation(s)
- Pierre Van Damme
- Centre for the Evaluation of Vaccination, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
| | - Rosa M Pintó
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Zongdi Feng
- Centre for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Angela Gentile
- Department of Epidemiology, Hospital de Niños Ricardo Gutierrez, University of Buenos Aires, Buenos Aires, Argentina
| | - Daniel Shouval
- Institute of Hepatology, Hadassah-Hebrew University Hospital, Jerusalem, Israel
| |
Collapse
|
3
|
Maki Y, Edo N, Mizuguchi M, Ikeda M, Kitano M, Kitagami E, Osa M, Yamamoto S, Ogawa T, Nakamura T, Kawana A, Kimizuka Y. Impact of frequency and duration of freeze-dried inactivated tissue culture hepatitis A vaccine (Aimmugen®) vaccination on antibody titers; a japanese cross-sectional study. Vaccine 2023; 41:5974-5978. [PMID: 37620202 DOI: 10.1016/j.vaccine.2023.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 07/26/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND The effect of the timing of additional doses and the long-term persistence of lyophilized inactivated tissue culture hepatitis A (HA) vaccine (Aimmugen®) on antibodies is unknown. METHODS A single-center, cross-sectional, observational study was conducted in collaboration with the Japan Air Self-Defense Force, whose personnel were immunized with Aimmugen® when deployed to endemic areas. Patients who consented to this study after a medical examination with blood sampling between June 2022 and February 2023 were included; HA-IgG level in the residual serum was measured using the chemiluminescent immunoassay method. The exact vaccination history was investigated based on immunization records maintained by the Ministry of Defense, and a questionnaire was used to collect confounding factors. RESULTS Of the 181 participants observed, 49 were in the unvaccinated group, and 132 were in the vaccinated group. Out of the vaccinated group, 6.8 % received either one or two doses, 40.9 % received three doses, and 52.3 % received more than four doses. IgG antibody titers (S/CO value) in each group (0, 1 or 2, 3, and over 4) increased in a frequency-dependent manner, with those vaccinated over four times showing significantly higher IgG antibody titers than all other groups (0.19 ± 0.10 vs 3.66 ± 3.00 vs 7.63 ± 3.57 vs 10.57 ± 1.86, respectively). When the number of months elapsed from the last vaccination to the date of blood collection in each group was plotted against IgG antibody titer, the slope of the regression line flattened out from a decreasing trend in the order 1 or 2, 3, over 4. CONCLUSIONS Three doses of Aimmugen® are efficacious, but four or more doses induce more robust and sustained antibody production. Additionally, four or more doses may be effective when there is a need to ensure long-term immunity or risk of prolonged exposure.
Collapse
Affiliation(s)
- Yohei Maki
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Naoki Edo
- Division of Behavioral Science, National Defense Medical College Research Institute, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Makoto Mizuguchi
- Department of Healthcare, Japan Self-Defense Force Iruma Hospital, 2-1-4 Koyodai, Iruma, Saitama 358-0001, Japan
| | - Mikihito Ikeda
- Department of Dental, Japan Self-Defense Force Iruma Hospital, 2-1-4 Koyodai, Iruma, Saitama 358-0001, Japan
| | - Masato Kitano
- Division of Behavioral Science, National Defense Medical College Research Institute, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Etsuko Kitagami
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Morichika Osa
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Shotaro Yamamoto
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Takunori Ogawa
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Takahiro Nakamura
- Department of Mathematics, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Akihiko Kawana
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Yoshifumi Kimizuka
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
| |
Collapse
|
4
|
Garcia-Fogeda I, Besbassi H, Larivière Y, Ogunjimi B, Abrams S, Hens N. Within-host modeling to measure dynamics of antibody responses after natural infection or vaccination: A systematic review. Vaccine 2023:S0264-410X(23)00422-X. [PMID: 37198016 DOI: 10.1016/j.vaccine.2023.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 04/08/2023] [Accepted: 04/10/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Within-host models describe the dynamics of immune cells when encountering a pathogen, and how these dynamics can lead to an individual-specific immune response. This systematic review aims to summarize which within-host methodology has been used to study and quantify antibody kinetics after infection or vaccination. In particular, we focus on data-driven and theory-driven mechanistic models. MATERIALS PubMed and Web of Science databases were used to identify eligible papers published until May 2022. Eligible publications included those studying mathematical models that measure antibody kinetics as the primary outcome (ranging from phenomenological to mechanistic models). RESULTS We identified 78 eligible publications, of which 8 relied on an Ordinary Differential Equations (ODEs)-based modelling approach to describe antibody kinetics after vaccination, and 12 studies used such models in the context of humoral immunity induced by natural infection. Mechanistic modeling studies were summarized in terms of type of study, sample size, measurements collected, antibody half-life, compartments and parameters included, inferential or analytical method, and model selection. CONCLUSIONS Despite the importance of investigating antibody kinetics and underlying mechanisms of (waning of) the humoral immunity, few publications explicitly account for this in a mathematical model. In particular, most research focuses on phenomenological rather than mechanistic models. The limited information on the age groups or other risk factors that might impact antibody kinetics, as well as a lack of experimental or observational data remain important concerns regarding the interpretation of mathematical modeling results. We reviewed the similarities between the kinetics following vaccination and infection, emphasising that it may be worth translating some features from one setting to another. However, we also stress that some biological mechanisms need to be distinguished. We found that data-driven mechanistic models tend to be more simplistic, and theory-driven approaches lack representative data to validate model results.
Collapse
Affiliation(s)
- Irene Garcia-Fogeda
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium.
| | - Hajar Besbassi
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Ynke Larivière
- Global Health Institute (GHI), Family Medicine and Population Health (FAMPOP), University of Antwerp, Antwerp, Belgium; Centre for the Evaluation of Vaccination, Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Benson Ogunjimi
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Antwerp Unit for Data Analysis and Computation in Immunology and Sequencing (AUDACIS), Antwerp, Belgium; Antwerp Center for Translational Immunology and Virology (ACTIV), Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Department of Paediatrics, University Hospital Antwerp, Antwerp, Belgium
| | - Steven Abrams
- Global Health Institute (GHI), Family Medicine and Population Health (FAMPOP), University of Antwerp, Antwerp, Belgium; Data Science Institute (DSI), Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), UHasselt, Hasselt, Belgium
| | - Niel Hens
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Data Science Institute (DSI), Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), UHasselt, Hasselt, Belgium
| |
Collapse
|
5
|
Analysis of Antibodies Induced after SARS-CoV-2 Vaccination Using Antigen Coded Bead Array Luminex Technology. Vaccines (Basel) 2023; 11:vaccines11020442. [PMID: 36851319 PMCID: PMC9964277 DOI: 10.3390/vaccines11020442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/02/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023] Open
Abstract
Objectives. Since the outbreak of SARS-CoV-2 in late 2019, nearly 12.2 billion doses of the COVID-19 vaccine have been administered worldwide; however, the humoral immune responses induced by different types of vaccines are yet to be fully validated. Methods. We analyzed antibody levels in 100 serum samples after vaccination with different types of COVID-19 vaccines and their reactivity against the RBD antigen of Delta and Omicron variants using a bead-based microarray. Results. Elevated levels of anti-wild-type (WT)-RBD IgG and anti-WT-NP IgG were detected in participants who received two doses of the inactivated vaccines (CoronaVac or BBIBP-CorV) and three doses of the recombinant spike protein vaccine (ZF2001), indicating that antibody responses to SARS-CoV-2 were generated regardless of the vaccine administered. We found highly correlated levels of serum anti-RBD IgG and anti-NP IgG (r = 0.432, p < 0.001). We observed that the antibodies produced in vivo after COVID-19 vaccination still reacted with variants of SARS-CoV-2 (p < 0.0001). Conclusions. Our results show that high levels of specific antibodies can be produced after completion of COVID-19 vaccination (two doses of the inactivated vaccines or three doses of ZF2001), with some degree of cross-reactivity to the RBD antigen of Delta and Omicron variants, and provide an accessible and practical experimental method for post-vaccination antibody detection.
Collapse
|
6
|
Qiu Y, Wu ZK, Wu J, Yao J, Liu Y, Ren W, Sun YJ, Shen LZ, Ren JJ. Modeling long-term persistence after 8 years of hepatitis B booster vaccination in 5- to 15-year-old children. Hum Vaccin Immunother 2022; 18:2061247. [PMID: 35507912 PMCID: PMC9897632 DOI: 10.1080/21645515.2022.2061247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Vaccination remains the most effective and cost-saving measure to protect against hepatitis B, a global health problem. It is crucial to characterize the persistence of the immune response after booster vaccination. This study aimed to quantify the persistence through mathematical modeling. Booster vaccination against hepatitis B was conducted in children 5-15 years in 2009-10 in Zhejiang Province. There were four dosage formulations of hepatitis B vaccines [Shenzhenkangtai Biotechnology Co. Ltd. Dalianhanxin Biotechnology Co. Ltd. NCPC GeneTech Biotechnology Pharmaceutical Co. Ltd. Sinovac Biotech Co. LTD. China]: 5, 10, and 20 μg hepatitis B vaccines or 5 μg hepatitis A and B (HAB) combination vaccine with a 0-1-6-month schedule. These were randomly administered to children negative for all hepatitis B markers, named as the schedule 2 group. Anti-HBs positive subjects were given one dose of booster, named as the schedule 1 group. Anti-HBs antibody was measured 1, 7, 18, 66, and 102 months after the first booster dose. A linear mixed-effects model was proposed to predict long-term persistence. One hundred two months after the booster dose, the mean anti-HBs levels were 33.8 mIU/mL, with 73.7 mIU/mL for the schedule 1 group and 20.2 mIU/mL for the schedule 2 group. The model predicted that 99.5% of subjects would remain seropositive (≥10mIU/mL) at year 20 post booster vaccination, with 100.0% and 98.8% for the schedule 1 group and the schedule 2 group, respectively, whereas at year 30, the seropositivity rates would decrease to 76.8%, with 99.4% for the schedule 1 group and 62.5% for the schedule 2 group. The immunogenicity of the booster vaccination could persist for at least 8 years. Mathematical modeling may predict even longer, up to 30 years of protection.
Collapse
Affiliation(s)
- Yan Qiu
- Department of General Practice, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zi-Kang Wu
- Department of Scientific Research, Women’s Hospital, School of Medicine Zhejiang University, Hangzhou, China
| | - Jie Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jun Yao
- Department of Immunization Program Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Ying Liu
- Department of General Practice, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wen Ren
- Department of General Practice, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yu-Jing Sun
- Department of General Practice, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ling-Zhi Shen
- Department of Immunization Program Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China,CONTACT Jing-Jing Ren Department of General Practice, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou310003, China
| | - Jing-Jing Ren
- Department of General Practice, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China,Ling-Zhi Shen Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou310051, China
| |
Collapse
|
7
|
Lin N, Fu H, Pu D, Quan Y, Li Y, Yin X, Wei Y, Wang H, Ma X, Wei X. Criteria for judging the immune markers of COVID-19 disease vaccines. MedComm (Beijing) 2022; 3:1-12. [PMID: 35005708 PMCID: PMC8719528 DOI: 10.1002/mco2.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 11/27/2021] [Accepted: 11/28/2021] [Indexed: 02/05/2023] Open
Abstract
As severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) sweeping the world, effective and affordable vaccines are in urgent need. A reliable system for the assessment of SARS‐CoV‐2 vaccines would boost the development of vaccines and reduce the research cost. We constructed a logistic regression model and analyzed the relationship between antibody (Ab) level and efficacy of different vaccine types. The relationship between assessment dates and Ab levels was depicted by plotting the mean of Ab levels evolved over time and a fitted cubic polynomial model. Anti‐spike immunoglobulin G (IgG) could best estimate the vaccine efficacy (VE) (adjusted R2 = 0.731) and neutralizing Ab to live SARS‐CoV‐2 also explained a fine relationship (adjusted R2 = 0.577). Neutralizing Abs to live SARS‐CoV‐2 in inactivated virus vaccines reached a peak during days 40–60, and their receptor‐binding domain (RBD)‐IgG peaked during days 40–50. For messenger RNA (mRNA) and viral vector vaccines, their neutralizing Ab to live SARS‐CoV‐2 peaked later than day 40, and for RBD‐IgG during days 30–50. For mRNA and viral vector vaccines, their peak time of Abs was later than that in inactivated virus vaccines. RBD‐IgG peaked earlier than Ab to live SARS‐CoV‐2. Anti‐spike IgG and Ab to live SARS‐CoV‐2 may be good immune markers for VE assessment.
Collapse
Affiliation(s)
- Nan Lin
- West China School of Medicine West China Hospital Sichuan University Chengdu China
| | - Haoxuan Fu
- Department of Statistics University of Illinois at Urbana Champaign Urbana Illinois USA
| | - Dan Pu
- Department of Radiation Oncology Cancer Center, West China Hospital, Sichuan University Chengdu China
| | - Yuxin Quan
- West China School of Medicine West China Hospital Sichuan University Chengdu China
| | - Yueyi Li
- Department of Biotherapy Cancer Center, West China Hospital, Sichuan University Chengdu China
| | - Xiaomeng Yin
- Department of Biotherapy Cancer Center, West China Hospital, Sichuan University Chengdu China
| | - Yuhao Wei
- West China School of Medicine West China Hospital Sichuan University Chengdu China
| | - Hang Wang
- West China School of Medicine West China Hospital Sichuan University Chengdu China
| | - Xuelei Ma
- Department of Biotherapy Cancer Center, West China Hospital, Sichuan University Chengdu China
| | - Xiawei Wei
- Laboratory of Aging Research and Nanotoxicology, State Key Laboratory of Biotherapy National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University Chengdu China
| |
Collapse
|
8
|
Silva AMODAD, Santos RCS, Araujo MGS, Silva LHL, Santos DFD. Intramuscular injection safety without aspiration in the ventro-gluteal region during vaccination: randomized clinical trial. Rev Bras Enferm 2021; 75:e20201119. [PMID: 34431926 DOI: 10.1590/0034-7167-2020-1119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 03/29/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to compare adverse events after administrating hepatitis A vaccine intramuscularly in the ventro-gluteal region between techniques with and without aspiration. METHODS randomized double-blind clinical trial, using hepatitis A vaccine (inactivated) in the ventro-gluteal region, with a sample of 74 participants in the intervention group, vaccinated with the slow injection technique without aspiration, and 74 participants in the control group undergoing slow injection with aspiration. Daily assessment of participants was carried out in the 72 hours after vaccination, in order to ascertain local, systemic adverse events, local and contralateral temperatures. RESULTS the occurrence of local and systemic adverse events was homogeneous between the groups in the three days after vaccination (p>0.05). There was no influence of sex, race, pre-existing disease and use of medication. CONCLUSIONS the intramuscular vaccination technique without aspiration in the ventro-gluteal region is safe for adverse events following immunization compared to the conventional technique with aspiration.
Collapse
|
9
|
Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021; 70:1-187. [PMID: 34292926 PMCID: PMC8344968 DOI: 10.15585/mmwr.rr7004a1] [Citation(s) in RCA: 772] [Impact Index Per Article: 257.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
These guidelines for the treatment of persons who have or are at risk for
sexually transmitted infections (STIs) were updated by CDC after consultation
with professionals knowledgeable in the field of STIs who met in Atlanta,
Georgia, June 11–14, 2019. The information in this report updates the
2015 guidelines. These guidelines discuss 1) updated recommendations for
treatment of Neisseria gonorrhoeae, Chlamydia trachomatis,
and Trichomonas vaginalis; 2) addition of
metronidazole to the recommended treatment regimen for pelvic inflammatory
disease; 3) alternative treatment options for bacterial vaginosis; 4) management
of Mycoplasma genitalium; 5) human papillomavirus vaccine
recommendations and counseling messages; 6) expanded risk factors for syphilis
testing among pregnant women; 7) one-time testing for hepatitis C infection; 8)
evaluation of men who have sex with men after sexual assault; and 9) two-step
testing for serologic diagnosis of genital herpes simplex virus. Physicians and
other health care providers can use these guidelines to assist in prevention and
treatment of STIs.
Collapse
|
10
|
Micheli L, Fasoli A, Attar A, Donia DT, Divizia M, Amine A, Palleschi G, Salazar Carballo PA, Moscone D. An ELIME assay for hepatitis A virus detection. Talanta 2021; 234:122672. [PMID: 34364473 DOI: 10.1016/j.talanta.2021.122672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/24/2021] [Accepted: 06/26/2021] [Indexed: 10/20/2022]
Abstract
An Enzyme Linked ImmunoMagnetic Electrochemical assay (ELIME) was developed for the detection of the hepatitis A virus (HAV). This system is based on the use of new polydopamine-modified magnetic nanobeads as solid support for the immunochemical chain, and an array of 8 screen-printed electrodes as a sensing platform. Enzymatic-by-product is quickly measured by differential pulse voltammetry. For this purpose, all analytical parameters were optimized; in particular, different blocking reagents were evaluated in order to minimize the nonspecific interaction of bioreagents. Using the ELIME assays, a quantitative determination of HAV can be achieved with a detection limit of 1·10-11 IU mL-1 and a working range between 10-10 - 5 × 10-7 IU mL-1. The cross-reactivity of the commercial monoclonal antibodies against HAV used in ELIME assays was tested for Coxsackie B4, resulting very low. The sensitivity was also investigated and compared with spectrophotometric sandwich ELISA. The average relative standard deviation (RSD) of the ELIME method was less than 5% for the assays performed on the same day, and 7% for the measurements made on different days. The proposed system was applied to the cell culture of HAV, which title was quantified by Real-Time Quantitative Reverse Transcription PCR (RT¬qPCR). To compare the results, a correlation between the units used in ELIME (IU mL-1) and those used in RT¬qPCR (genome mL-1) was established using a HAV-positive sample, resulting in 1 IU mL-1-10-4 gen mL-1 (R2 = 0.978). The ELIME tool exhibits good stability and high biological selectivity for HAV antigen detection and was successfully applied for the determination of HAV in tap water.
Collapse
Affiliation(s)
- Laura Micheli
- Department of Chemical Sciences and Technologies, University of Rome "Tor Vergata", Via della Ricerca Scientifica, 00133, Rome, Italy; Consorzio Interuniversitario Biostrutture e Biosistemi "INBB", Viale Medaglie d'Oro 305, 00136, Rome, Italy.
| | - Andrea Fasoli
- Department of Chemical Sciences and Technologies, University of Rome "Tor Vergata", Via della Ricerca Scientifica, 00133, Rome, Italy
| | - Aisha Attar
- Faculty of Sciences and Techniques, Hassan II University of Casablanca, BP 146, Mohammedia, 20650, Morocco; Department of Pharmacology, College of Medicine, The University of Illinois at Chicago, 835 S Wolcott Ave E403 (MC868), Chicago, IL, 60612, USA
| | - Domenica T Donia
- Department of Experimental Medicine and Surgery, University of Roma "Tor Vergata", Via Montpellier, 1, 00133, Roma, Italy
| | - Maurizio Divizia
- Department of Experimental Medicine and Surgery, University of Roma "Tor Vergata", Via Montpellier, 1, 00133, Roma, Italy
| | - Aziz Amine
- Faculty of Sciences and Techniques, Hassan II University of Casablanca, BP 146, Mohammedia, 20650, Morocco
| | - Giuseppe Palleschi
- Department of Chemical Sciences and Technologies, University of Rome "Tor Vergata", Via della Ricerca Scientifica, 00133, Rome, Italy; Consorzio Interuniversitario Biostrutture e Biosistemi "INBB", Viale Medaglie d'Oro 305, 00136, Rome, Italy
| | - Pedro A Salazar Carballo
- Neurochemistry and Neuroimaging Group, (Laboratory of Sensors, Biosensors and Materials) Faculty of Medical Sciences, University of La Laguna, Campus de Ofra s/n, 38071, La Laguna, Tenerife, Spain
| | - Danila Moscone
- Department of Chemical Sciences and Technologies, University of Rome "Tor Vergata", Via della Ricerca Scientifica, 00133, Rome, Italy; Consorzio Interuniversitario Biostrutture e Biosistemi "INBB", Viale Medaglie d'Oro 305, 00136, Rome, Italy
| |
Collapse
|
11
|
Agrawal A, Kolhapure S, Andani A, Ota MOC, Badur S, Karkada N, Mitra M. Long-Term Persistence of Antibody Response with Two Doses of Inactivated Hepatitis A Vaccine in Children. Infect Dis Ther 2020; 9:785-796. [PMID: 32710245 PMCID: PMC7680478 DOI: 10.1007/s40121-020-00311-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Hepatitis A virus infection is more severe in adults than children. Although vaccination can protect adults, current childhood programs cover a large population more successfully. Childhood vaccination is, therefore, a solution to protecting adults if it induces lasting immunity. Fifteen-year protection has been demonstrated in children, but longer-term data are only available for adults. We aimed to predict long term persistence of antibody in children beyond 15 years and assess if immunological mechanisms triggered by vaccination support longer-term protection. METHODS Long-term clinical studies using hepatitis A (HAV) or A/B vaccines (HAB) containing 720 or 1440 Enzyme-linked immunosorbent assay Units (EU) of hepatitis A virus antigen were identified. Duration of persistence of antibodies and possible protection was determined by descriptively comparing antibody geometric mean concentration (GMC) kinetics, as well as GMC (95% confidence interval) at 15 years post-vaccination across studies. Immunological mechanism studies describing hepatitis A vaccination were identified. RESULTS One study in children 12-15 years (2-dose HAB 720) and four in adults (2-dose HAV 1440 and 3-dose HAB 720) showed comparable GMC kinetics and per year rates of change up to 15 years. At 15 years, the GMC in children [414.7 mEU/ml (336.9; 510.5)] was in the same range as in adults [range 282.6 (217.6; 367.0) to 550.1 (416.0; 727.4)]. Based on these data, mathematical model predictions from adult studies (showing > 85% protected at 50 years) were deemed likely to also apply to children. Studies identified, both humoral and cell-mediated responses are induced following vaccination. CONCLUSION Based on comparable antibody data in adults and children up to 15 years, similar longer-term antibody persistence is expected in children with 2-dose inactivated hepatitis A 720 containing vaccine at least up to 50 years. Accordingly, improving routine childhood hepatitis A vaccination coverage could protect against more severe disease in adulthood. Fig. 1 Plain language summary TRIAL REGISTRATION: ClinicalTrials.gov identifiers, NCT00875485, NCT01000324, NCT01037114, NCT00289757, NCT00291876.
Collapse
Affiliation(s)
| | | | | | - Martin O C Ota
- Vaccines Scientific Affairs and Public Health, GSK, Wavre, Belgium
| | - Selim Badur
- Vaccines Scientific Affairs and Public Health, GSK, Istanbul, Turkey
| | | | | |
Collapse
|
12
|
Juliao P, Abadia I, Welby S, Wéry S, Wong D, De Léon T, DeAntonio R, Naranjo L, Guignard A, Marano C. Hepatitis A antibody persistence 8 and 10 years after 1-dose and 2-dose vaccination in children from Panama. Vaccine 2020; 39:26-34. [PMID: 33239226 DOI: 10.1016/j.vaccine.2020.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 08/14/2020] [Accepted: 11/10/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Hepatitis A virus (HAV) remains a global public health concern, which is potentially growing in Latin America, due to an expected shift from high to intermediate endemicity levels. The use of HAV vaccines in pediatric national immunization programs (NIPs), either as a 2-dose or a 1-dose schedule, has been explored in Latin American countries; however, evidence demonstrating long-term protection in this population is limited in the region. We evaluated long-term antibody persistence following a 1-dose partial series and the recommended 2-dose schedule used in Panama's pediatric NIP. METHODS Two independent cross-sectional serological surveys were conducted at year 8 (Y8) and Y10 following vaccination under the NIP with 1 or 2 doses of an inactivated HAV vaccine (Havrix, GSK). Seropositivity (anti-HAV antibody concentration ≥ 15 mIU/mL) rates and antibody geometric mean concentrations (GMCs) were assessed at each serosurvey. Non-inferiority of 1 dose versus 2 doses was also explored. RESULTS This study (NCT02712359) included 600 and 599 children at Y8 and Y10 post-vaccination, respectively. Seropositivity rates were 74.3% (95% confidence interval [CI]: 69.0; 79.2) and 97.7% (95% CI: 95.3; 99.1) at Y8 and 71.9% (95% CI: 66.4; 76.9) and 96.3% (95% CI: 93.5; 98.2) at Y10, in the 1-dose and 2-dose groups, respectively. Antibody GMCs were lower in the 1-dose versus the 2-dose group in both surveys. Non-inferiority was not demonstrated since the lower limit of the 2-sided 95% CI for the between-group difference in seropositivity rates (1-dose minus 2-dose) was < -10%. CONCLUSION Anti-HAV antibody persistence was observed in lower percentages of children receiving 1 dose versus 2 doses of Havrix, at 8 and 10 years post-vaccination in Panama. Further investigations are needed to confirm antibody persistence and conclude on the protection afforded beyond 10 years in the pediatric population in Latin America.
Collapse
Affiliation(s)
| | - Ivonne Abadia
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología de Panama, Panama City, Panama.
| | | | | | - Digna Wong
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología de Panama, Panama City, Panama.
| | - Tirza De Léon
- Unidad Materno-Infantil José Domingo de Obaldia, Chiriqui, Panama.
| | | | | | | | | |
Collapse
|
13
|
Wang Y, Qi Y, Xu W, Hu Y, Wang L, Yu Y, Jiang Z, Xia J, Zeng G, Wang Y. Immunogenicity persistence in children of hepatitis A vaccines Healive® and Havrix®: 11 years follow-up and long-term prediction. Hum Vaccin Immunother 2020; 16:2559-2564. [PMID: 32040376 PMCID: PMC7644183 DOI: 10.1080/21645515.2020.1715687] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/19/2019] [Accepted: 01/07/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Hepatitis A vaccine has been used in mass and routine public vaccination programs in China. Long-term follow-up studies are required to determine the duration of protection and the need for booster vaccinations. Methods: A prospective, randomized, open-label clinical trial was performed to compare the geometric mean concentration (GMC) and seroprotection rates of anti-Hepatitis A virus (HAV) antibodies elicited by the inactivated vaccines Healive and Havrix. 400 healthy children were randomly assigned 3:1 ratio to receive two doses of Healive or Havrix at 0 and 6 months. Persistence of anti-HAV antibodies for 5 years post immunization has been reported The current study reports new data at 11 years post immunization for the purpose of showing antibody persistence. Sensitivity analyzes were performed to assess the results. In addition, predictions for long-term antibody persistence were performed using a statistical model. Two different serological assays were used that were shown to be 98.3% concordant for detecting anit-HAV antibody. Results: GMCs were significantly higher following Healive compared to Havrix at 1, 6, 7, 66, 112 and 138 months post-vaccination. In addition, the GMCs obtained using sensitivity analysis were very similar to those obtained using the original models. Prediction analysis indicated that the duration of protection for both vaccines was at least 30 years after immunization, with a lower limit of the 95% confidence interval for GMC of greater than 20mIU/mL. Conclusions: Healive is more immunogenic than Havrix in children at 11 years post full immunization. Prediction analysis indicated at least 30 years of antibody persistence for both vaccines.
Collapse
Affiliation(s)
- Yongji Wang
- Department of Health Statistics, School of Preventive Medicine, Air Force Military Medical University, Xi’an, Shaanxi, China
| | - Yangyang Qi
- Department of Statistics, Beijing Key Tech Statistical Consulting Co., Ltd, Beijing, China
| | - Wenguo Xu
- Department of Immunization Planning, Center for Disease Control and Prevention of Changzhou City, Changzhou, Jiangsu, China
| | - Yuansheng Hu
- Department of Clinical Research, Sinovac Biotech, Beijing, China
| | - Ling Wang
- Department of Health Statistics, School of Preventive Medicine, Air Force Military Medical University, Xi’an, Shaanxi, China
| | - Yongpei Yu
- Department of Statistics, Peking University Clinical Research Institute, Peking University Health Science Center, Beijing, China
| | - Zhiwei Jiang
- Department of Statistics, Beijing Key Tech Statistical Consulting Co., Ltd, Beijing, China
| | - Jielai Xia
- Department of Health Statistics, School of Preventive Medicine, Air Force Military Medical University, Xi’an, Shaanxi, China
| | - Gang Zeng
- Department of Clinical Research, Sinovac Biotech, Beijing, China
| | - Yalong Wang
- Department of Immunization Planning, Center for Disease Control and Prevention of Changzhou City, Changzhou, Jiangsu, China
| |
Collapse
|
14
|
Nelson NP, Weng MK, Hofmeister MG, Moore KL, Doshani M, Kamili S, Koneru A, Haber P, Hagan L, Romero JR, Schillie S, Harris AM. Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020. MMWR Recomm Rep 2020; 69:1-38. [PMID: 32614811 PMCID: PMC8631741 DOI: 10.15585/mmwr.rr6905a1] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
HEPATITIS A IS A VACCINE-PREVENTABLE, COMMUNICABLE DISEASE OF THE LIVER CAUSED BY THE HEPATITIS A VIRUS (HAV). THE INFECTION IS TRANSMITTED VIA THE FECAL-ORAL ROUTE, USUALLY FROM DIRECT PERSON-TO-PERSON CONTACT OR CONSUMPTION OF CONTAMINATED FOOD OR WATER. HEPATITIS A IS AN ACUTE, SELF-LIMITED DISEASE THAT DOES NOT RESULT IN CHRONIC INFECTION. HAV ANTIBODIES (IMMUNOGLOBULIN G [IGG] ANTI-HAV) PRODUCED IN RESPONSE TO HAV INFECTION PERSIST FOR LIFE AND PROTECT AGAINST REINFECTION; IGG ANTI-HAV PRODUCED AFTER VACCINATION CONFER LONG-TERM IMMUNITY. THIS REPORT SUPPLANTS AND SUMMARIZES PREVIOUSLY PUBLISHED RECOMMENDATIONS FROM THE ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES (ACIP) REGARDING THE PREVENTION OF HAV INFECTION IN THE UNITED STATES. ACIP RECOMMENDS ROUTINE VACCINATION OF CHILDREN AGED 12-23 MONTHS AND CATCH-UP VACCINATION FOR CHILDREN AND ADOLESCENTS AGED 2-18 YEARS WHO HAVE NOT PREVIOUSLY RECEIVED HEPATITIS A (HEPA) VACCINE AT ANY AGE. ACIP RECOMMENDS HEPA VACCINATION FOR ADULTS AT RISK FOR HAV INFECTION OR SEVERE DISEASE FROM HAV INFECTION AND FOR ADULTS REQUESTING PROTECTION AGAINST HAV WITHOUT ACKNOWLEDGMENT OF A RISK FACTOR. THESE RECOMMENDATIONS ALSO PROVIDE GUIDANCE FOR VACCINATION BEFORE TRAVEL, FOR POSTEXPOSURE PROPHYLAXIS, IN SETTINGS PROVIDING SERVICES TO ADULTS, AND DURING OUTBREAKS.
Collapse
|
15
|
Lin JJ, Lee YT, Yang HJ. Factors associated with hepatitis A virus infection among HIV-positive patients before and after implementation of a hepatitis A virus vaccination program at a medical centre in central Taiwan. Sex Health 2020; 17:239-246. [PMID: 32571474 DOI: 10.1071/sh19029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 02/04/2020] [Indexed: 11/23/2022]
Abstract
Background Taiwan government has promoted the administration of a hepatitis A vaccine at public expense for high-risk groups as a preventive measure after the outbreak of hepatitis A virus (HAV) infections in 2015. The aim of this study was to evaluate the efficacy of such vaccination policy in patients with human immunodeficiency virus (HIV). METHODS From January 2016 to July 2017, we enrolled 658 HIV-positive male participants. Participants were stratified into anti-HAV-positive (n = 165) and anti-HAV-negative (n = 493) groups. A total of 364 anti-HAV-negative patients received vaccination against HAV and were followed up for 1.5 years. A Cox regression model was used to estimate the effects of factors predicting positive anti-HAV detection after vaccination. RESULTS Patients with HIV had an anti-HAV-positive prevalence of 25.1% before vaccination. Of the 364 patients inoculated with the first dose of vaccine, 58.0% received the second dose. Seroresponse rates were 50.0% and 80.6%, respectively. Antibody production was 30.0% lower in patients with a CD4 T-cell count <200 cells/µL (adjusted relative risk (ARR) = 0.7; 95% confidence interval (CI) = 0.5-0.9) compared with those with 500 cells/µL. Hepatitis C co-infection reduced the production of antibodies by 50.0% (ARR = 0.5; 95% CI = 0.2-0.8). CONCLUSION This study suggests that vaccination against hepatitis A be administered when the immunity of an HIV-positive patient is strong. The promotion of the current vaccination policy against hepatitis A in Taiwan has improved the vaccination rate; the response rate for receiving one dose of the vaccine doubled.
Collapse
Affiliation(s)
- Jia-Juen Lin
- Department of Public Health, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Road, Taichung 40201, Taiwan; and Department of Infection Diseases, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Road, Taichung 40201, Taiwan
| | - Yuan-Ti Lee
- Department of Infection Diseases, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Road, Taichung 40201, Taiwan; and School of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Road, Taichung 40201, Taiwan
| | - Hao-Jan Yang
- Department of Public Health, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Road, Taichung 40201, Taiwan; and Department of Family and Community Medicine, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Road, Taichung 40201, Taiwan; and Corresponding author.
| |
Collapse
|
16
|
Affiliation(s)
- Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Viviana Simon
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
17
|
Espul C, Cuello H, Lo Castro I, Bravo C, Thollot Y, Voznica J, Vigne C, Coudeville L. Statistical modeling alongside observational data predicts long-term immunogenicity of one dose and two doses of pediatric hepatitis A vaccine in the Mendoza province of Argentina. Vaccine 2020; 38:1715-1722. [PMID: 31928855 DOI: 10.1016/j.vaccine.2019.12.049] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Follow-up for anti-hepatitis A (HA) antibody persistence up to 10 years was conducted after implementation of universal vaccination against HA virus (HAV) in Mendoza, Argentina. Based on these data, statistical modeling was used to predict the antibody persistence to 30 years. METHODS A non-interventional study evaluated long-term immunogenicity (geometric mean concentrations [GMCs] and seroprotection rate) following routine vaccination with 1 dose (Group 1: N = 436) or 2 doses (Group 2: N = 108) of HA vaccine. Associated statistical modeling based on a Bayesian approach of mixed effects models on log transformed titers evaluated three models (linear, piecewise linear, and exponential decay, with and without a natural boosting effect). RESULTS From the initial cohort, 9 participants (Group 1) and 1 participant (Group 2) showed antibody titers below the seroprotective threshold and received a booster. At Year 10, 190 (Group 1) and 51 (Group 2) participants remained in the study without a booster dose and all were seroprotected. Regarding statistical modeling, the piecewise linear model showed the best fit and demonstrated high and similar seroprotection for each schedule up to 30 years (89% [1-dose schedule], 85% [2-dose schedule]). The 2-dose schedule showed higher GMC (95% CI) than the 1-dose schedule (Year 10: 352 [271-456] versus 78 [69.8-87.6] mIU/mL) and Year 30 (predicted) (37 [13-97] versus 19 [11-34] mIU/mL). Natural boosting had little impact on predicted seroprotection rates at 30 years for the 1-dose schedule (89% [0.8-0.96] and 84% [0.73-0.94] with and without a natural booster, respectively). CONCLUSIONS Long-term persistence of anti-HAV antibodies was observed up to 10 years with 1-dose and 2-dose vaccine schedules, supporting booster flexibility. Statistical modeling predicted good persistence of seroprotection for each schedule up to 30 years. Natural boosting had a limited impact on seroprotection rate predictions, enabling extrapolation of these results to non-endemic settings for traveler vaccination.
Collapse
Affiliation(s)
- C Espul
- Ministerio de Salud/Hospital Central de Mendoza, Mendoza, Argentina.
| | - H Cuello
- Seccíon Virología, Hospital Central de Mendoza, Mendoza, Argentina
| | - I Lo Castro
- Seccíon Virología, Hospital Central de Mendoza, Mendoza, Argentina
| | - C Bravo
- Sanofi Pasteur, Lyon, France.
| | | | - J Voznica
- Sanofi Pasteur, Lyon, France; Department of Biology, École Normale Supérieure Paris-Saclay, Cachan, France.
| | - C Vigne
- Sanofi Pasteur, Lyon, France.
| | | |
Collapse
|
18
|
Warrier R, Bhalla G, Shukla R, Bandyopadhyay K. Antibody response among nucleic acid amplification test confirmed COVID-19-positive patients: A cross-sectional study. JOURNAL OF MARINE MEDICAL SOCIETY 2020. [DOI: 10.4103/jmms.jmms_107_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
19
|
Freedman DO, Chen LH. Vaccines for International Travel. Mayo Clin Proc 2019; 94:2314-2339. [PMID: 31685156 DOI: 10.1016/j.mayocp.2019.02.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 01/16/2019] [Accepted: 02/14/2019] [Indexed: 01/02/2023]
Abstract
The pretravel management of the international traveler should be based on risk management principles. Prevention strategies and medical interventions should be based on the itinerary, preexisting health factors, and behaviors that are unique to the traveler. A structured approach to the patient interaction provides a general framework for an efficient consultation. Vaccine-preventable diseases play an important role in travel-related illnesses, and their impact is not restricted to exotic diseases in developing countries. Therefore, an immunization encounter before travel is an ideal time to update all age-appropriate immunizations as well as providing protection against diseases that pose additional risk to travelers that may be delineated by their destinations or activities. This review focuses on indications for each travel-related vaccine together with a structured synthesis and graphics that show the geographic distribution of major travel-related diseases and highlight particularly high-risk destinations and behaviors. Dosing, route of administration, need for boosters, and possible accelerated regimens for vaccines administered prior to travel are presented. Different underlying illnesses and medications produce different levels of immunocompromise, and there is much unknown in this discipline. Recommendations regarding vaccination of immunocompromised travelers have less of an evidence base than for other categories of travelers. The review presents a structured synthesis of issues pertinent to considerations for 5 special populations of traveler: child traveler, pregnant traveler, severely immunocompromised traveler, HIV-infected traveler, and traveler with other chronic underlying disease including asplenia, diabetes, and chronic liver disease.
Collapse
Affiliation(s)
- David O Freedman
- Division of Infectious Diseases, William C. Gorgas Center for Geographic Medicine, University of Alabama at Birmingham.
| | - Lin H Chen
- Division of Infectious Diseases and Travel Medicine, Mount Auburn Hospital, Cambridge, MA; Department of Medicine, Harvard Medical School, Boston, MA
| |
Collapse
|
20
|
Garcia Garrido HM, Veurink AM, Leeflang M, Spijker R, Goorhuis A, Grobusch MP. Hepatitis A vaccine immunogenicity in patients using immunosuppressive drugs: A systematic review and meta-analysis. Travel Med Infect Dis 2019; 32:101479. [PMID: 31521804 DOI: 10.1016/j.tmaid.2019.101479] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/02/2019] [Accepted: 09/09/2019] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Inactivated hepatitis A (HepA) vaccines are very immunogenic in healthy individuals; however, it remains unclear how different immunosuppressive regimens affect HepA vaccine immunogenicity. Our objective was to summarise the current evidence on immunogenicity of HepA vaccination in patients using immunosuppressive drugs. METHODS We systematically searched the literature for studies on immunogenicity of inactivated HepA vaccines in adults using immunosuppressive drugs. Studies reporting seroconversion rates (SCR) 4-8 weeks after 1 and 2 doses of HepA vaccine in organ transplant recipients and patients with chronic inflammatory conditions were included in a meta-analysis. RESULTS We included 17 studies, comprising 1,332 individuals. In healthy controls (2 studies), SCRs were 90-94% after the first dose and 100% after the second dose. In organ transplant recipients, SCRs ranged from 0 to 67% after the first dose of vaccine and 0-97% after the second dose. In patients with chronic inflammatory conditions, SCRs ranged from 6% to 100% after the first dose and from 48 to 100% after the second dose of vaccine. Patients using a TNF-alpha inhibitor versus conventional immune-modulators (e.g. methotrexate, azathioprine, corticosteroids) were more likely to seroconvert after the first dose of vaccine (OR12.1 [2.14-68.2]) but not after the second dose of vaccine (OR 0.78 [0.21-2.92]) in a meta-analysis. CONCLUSION Studies evaluating HepA vaccine immunogenicity in immunosuppressive agents are heterogeneous. Overall, there is an impaired immune response following HepA vaccination in patients using immunosuppressive drugs, especially after only one dose of vaccine and in organ transplant recipients. HepA vaccination should therefore be considered before immunosuppressive therapy. Future research should focus on alternative vaccination regimens and long-term immunogenicity. PROSPERO ID CRD42018102607.
Collapse
Affiliation(s)
- Hannah M Garcia Garrido
- Amsterdam UMC, University of Amsterdam, Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Meibergdreef 9, Amsterdam, the Netherlands.
| | - Ati M Veurink
- Amsterdam UMC, University of Amsterdam, Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Meibergdreef 9, Amsterdam, the Netherlands
| | - Mariska Leeflang
- Amsterdam UMC, University of Amsterdam, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health, Meibergdreef 9, Amsterdam, the Netherlands
| | - René Spijker
- Amsterdam UMC, University of Amsterdam, Medical Library, Amsterdam Public Health, Meibergdreef 9, Amsterdam, the Netherlands; Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Abraham Goorhuis
- Amsterdam UMC, University of Amsterdam, Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Meibergdreef 9, Amsterdam, the Netherlands
| | - Martin P Grobusch
- Amsterdam UMC, University of Amsterdam, Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Meibergdreef 9, Amsterdam, the Netherlands
| |
Collapse
|
21
|
Slifka MK, Amanna IJ. Role of Multivalency and Antigenic Threshold in Generating Protective Antibody Responses. Front Immunol 2019; 10:956. [PMID: 31118935 PMCID: PMC6504826 DOI: 10.3389/fimmu.2019.00956] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 04/15/2019] [Indexed: 12/03/2022] Open
Abstract
Vaccines play a vital role in protecting our communities against infectious disease. Unfortunately, some vaccines provide only partial protection or in some cases vaccine-mediated immunity may wane rapidly, resulting in either increased susceptibility to that disease or a requirement for more booster vaccinations in order to maintain immunity above a protective level. The durability of antibody responses after infection or vaccination appears to be intrinsically determined by the structural biology of the antigen, with multivalent protein antigens often providing more long-lived immunity than monovalent antigens. This forms the basis for the Imprinted Lifespan model describing the differential survival of long-lived plasma cell populations. There are, however, exceptions to this rule with examples of highly attenuated live virus vaccines that are rapidly cleared and elicit only short-lived immunity despite the expression of multivalent surface epitopes. These exceptions have led to the concept that multivalency alone may not reliably determine the duration of protective humoral immune responses unless a minimum number of long-lived plasma cells are generated by reaching an appropriate antigenic threshold of B cell stimulation. Examples of long-term and in some cases, potentially lifelong antibody responses following immunization against human papilloma virus (HPV), Japanese encephalitis virus (JEV), Hepatitis B virus (HBV), and Hepatitis A virus (HAV) provide several lessons in understanding durable serological memory in human subjects. Moreover, studies involving influenza vaccination provide the unique opportunity to compare the durability of hemagglutinin (HA)-specific antibody titers mounted in response to antigenically repetitive whole virus (i.e., multivalent HA), or detergent-disrupted “split” virus, in comparison to the long-term immune responses induced by natural influenza infection. Here, we discuss the underlying mechanisms that may be associated with the induction of protective immunity by long-lived plasma cells and their importance in future vaccine design.
Collapse
Affiliation(s)
- Mark K Slifka
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR, United States
| | - Ian J Amanna
- Najít Technologies, Inc., Beaverton, OR, United States
| |
Collapse
|
22
|
Keersmaekers N, Ogunjimi B, Van Damme P, Beutels P, Hens N. An ODE-based mixed modelling approach for B- and T-cell dynamics induced by Varicella-Zoster Virus vaccines in adults shows higher T-cell proliferation with Shingrix than with Varilrix. Vaccine 2019; 37:2537-2553. [PMID: 30975567 DOI: 10.1016/j.vaccine.2019.03.075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 03/23/2019] [Accepted: 03/29/2019] [Indexed: 11/19/2022]
Abstract
Clinical trials covering the immunogenicity of a vaccine aim to study the longitudinal dynamics of certain immune cells after vaccination. The corresponding immunogenicity datasets are mainly analyzed by the use of statistical (mixed effects) models. This paper proposes the use of mathematical ordinary differential equation (ODE) models, combined with a mixed effects approach. ODE models are capable of translating underlying immunological post vaccination processes into mathematical formulas thereby enabling a testable data analysis. Mixed models include both population-averaged parameters (fixed effects) and individual-specific parameters (random effects) for dealing with inter- and intra-individual variability, respectively. This paper models B-cell and T-cell datasets of a phase I/II, open-label, randomized, parallel-group study (NCT00492648) in which the immunogenicity of a new Herpes Zoster vaccine (Shingrix) is compared with the original Varicella Zoster Virus vaccine (Varilrix). Since few significant correlations were found between the B-cell and T-cell datasets, each dataset was modeled separately. By following a general approach to both the formulation of several different models and the procedure of selecting the most suitable model, we were able to propose a mathematical ODE mixed-effects model for each dataset. As such, the use of ODE-based mixed effects models offers a suitable framework for handling longitudinal vaccine immunogenicity data. Moreover, this approach allows testing for differences in immunological processes between vaccines or schedules. We found that the Shingrix vaccination schedule led to a more pronounced proliferation of T-cells, without a difference in T-cell decay rate compared to the Varilrix vaccination schedule.
Collapse
Affiliation(s)
- Nina Keersmaekers
- Centre for Health Economics Research & Modeling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Antwerp Unit for Data Analysis and Computation in Immunology and Sequencing (AUDACIS), University of Antwerp, Antwerp, Belgium.
| | - Benson Ogunjimi
- Centre for Health Economics Research & Modeling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Antwerp Unit for Data Analysis and Computation in Immunology and Sequencing (AUDACIS), University of Antwerp, Antwerp, Belgium; Antwerp Center for Translational Immunology and Virology (ACTIV), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Department of Paediatrics, Antwerp University Hospital, Edegem, Belgium
| | - Pierre Van Damme
- Antwerp Unit for Data Analysis and Computation in Immunology and Sequencing (AUDACIS), University of Antwerp, Antwerp, Belgium; Centre for the Evaluation of Vaccination (CEV), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Philippe Beutels
- Centre for Health Economics Research & Modeling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Antwerp Unit for Data Analysis and Computation in Immunology and Sequencing (AUDACIS), University of Antwerp, Antwerp, Belgium
| | - Niel Hens
- Centre for Health Economics Research & Modeling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Antwerp Unit for Data Analysis and Computation in Immunology and Sequencing (AUDACIS), University of Antwerp, Antwerp, Belgium; Interuniversity Institute for Biostatistics and statistical Bioinformatics, Hasselt University, Diepenbeek, Belgium
| |
Collapse
|
23
|
Ramsay LC, Anyiwe K, Li M, Macdonald L, Coyte PC, Sander B. Economic evaluation of a publicly funded hepatitis A travel vaccination program in Ontario, Canada. Vaccine 2019; 37:1467-1475. [PMID: 30770225 DOI: 10.1016/j.vaccine.2019.01.070] [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: 09/12/2018] [Revised: 01/11/2019] [Accepted: 01/23/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND Hepatitis A virus (HAV) causes acute liver infection and is spread through the fecal-oral route. Travel to countries in HAV-endemic regions (e.g., Asia and Latin America) is a well-described risk factor for infection. Currently, Ontario publicly funds hepatitis A vaccination for some populations at high risk of HAV infection but not for all travellers to endemic countries. The objective of this study was to determine the cost-effectiveness of expanding publicly funded HAV vaccination to people planning travel to HAV-endemic regions, from the Ontario healthcare payer perspective. METHODS We conducted a cost-utility analysis comparing an expanded high-risk publicly-funded hepatitis A vaccination program including funded vaccine for travellers to endemic regions to the current high risk program in Ontario. A Markov state transition model was developed, including six possible health states. Model parameters were informed through targeted literature searches and included hepatitis A disease probabilities, utilities associated with health states, health system expenditures, and vaccine costs. Future costs and health outcomes were discounted at 1.5%. Primary outcomes included cost, incremental cost-effectiveness ratio (ICER) and quality adjusted life years (QALYs) over a lifetime time horizon. We conducted one-way, two-way, and probabilistic sensitivity analysis. RESULTS The expanded high risk HAV vaccine program provided few incremental health gains in the travel population (mean 0.000037 QALYs/person), at an incremental cost of $124.31. The ICER of the expanded program compared to status quo is $3,391,504/QALY gained. The conclusion of the model was robust to changes in key parameters across reasonable ranges. CONCLUSIONS The expanded vaccination program substantially exceeds commonly accepted cost-effectiveness thresholds. Further research concerning possible cost-effective implementation of high-risk travel hepatitis A vaccination should focus on a more integrated understanding of the risk of acquiring hepatitis A during travel to endemic regions (e.g., purpose, length of stay).
Collapse
Affiliation(s)
- L C Ramsay
- School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada.
| | - K Anyiwe
- School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada
| | - M Li
- East China Normal University, Zhongshan N Rd, Shanghai 3663, China
| | - L Macdonald
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada; Public Health Ontario, 480 University Avenue, Toronto, Ontario M5G 1V2, Canada
| | - P C Coyte
- School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada; Canadian Centre for Health Economics, 155 College Street, Toronto, Ontario M5T 1P8, Canada
| | - B Sander
- School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada; Public Health Ontario, 480 University Avenue, Toronto, Ontario M5G 1V2, Canada; Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| |
Collapse
|
24
|
Jayasundara D, Hui BB, Regan DG, Heywood AE, MacIntyre CR, Wood JG. Modelling the decline and future of hepatitis A transmission in Australia. J Viral Hepat 2019; 26:199-207. [PMID: 30315680 DOI: 10.1111/jvh.13018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 07/23/2018] [Accepted: 09/17/2018] [Indexed: 12/13/2022]
Abstract
Hepatitis A incidence has declined in most countries through a combination of prevention measures, augmented through the use of a highly effective vaccine. In Australia, the proportion of the population susceptible to hepatitis A infection has declined over time due to high rates of opportunistic vaccination as well as the sustained inflow of seropositive immigrants from high-endemicity countries. These factors have contributed to a rapid decline in incidence. An age-structured hepatitis A transmission model incorporating demographic changes was fitted to seroprevalence and disease notification data and used to project incidence trends and transmission potential for hepatitis A in the general population. Robustness of findings was assessed through worst-case scenarios regarding vaccine uptake, migration and the duration of immunity. The decline in age-specific seroprevalence until the introduction of hepatitis A vaccine in 1994 was well explained through a declining basic reproduction number (R0 ) that remained >1. Accounting for existing immunity, we estimated that the effective reproduction number (Reff ) <1 in the general population of Australia since the early 1990s, declining more rapidly after the introduction of the hepatitis A vaccine. Future projections under a variety of scenarios support Reff remaining <1 with continued low incidence in the general population. In conclusion, our results suggest that sustained endemic transmission in the general Australian population is no longer possible although risks of sporadic outbreaks remain. This suggests potential for local elimination of hepatitis A infection in Australia, provided that elimination criteria can be defined and satisfied in risk groups. The methodology used here to investigate elimination potential can easily be replicated in settings such as in the USA where sequential seroprevalence studies are supported by routine notification data.
Collapse
Affiliation(s)
- Duleepa Jayasundara
- Faculty of Medicine, School of Public Health and Community Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Ben B Hui
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - David G Regan
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Anita E Heywood
- Faculty of Medicine, School of Public Health and Community Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - C Raina MacIntyre
- Faculty of Medicine, School of Public Health and Community Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - James G Wood
- Faculty of Medicine, School of Public Health and Community Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
25
|
Bouckenooghe A, Bailleux F, Feroldi E. Modeling the long-term persistence of neutralizing antibody in children and toddlers after vaccination with live attenuated Japanese encephalitis chimeric virus vaccine. Hum Vaccin Immunother 2018; 15:72-79. [PMID: 30230947 PMCID: PMC6363153 DOI: 10.1080/21645515.2018.1515455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The live-attenuated Japanese encephalitis chimeric virus vaccine JE-CV (IMOJEV®, Sanofi Pasteur) elicits a robust antibody response in children, which wanes over time. Clinical efficacy is based on a correlate of protection against JE infection defined as neutralizing antibody levels equal to or greater than the threshold of 10 (1/dil). Information on the duration of persistence of the JE antibody response above this threshold is needed. We constructed statistical models using 5-year persistence data from a randomised clinical trial (NCT00621764) in children (2–5 years old) primed with inactivated JE vaccine who received a booster dose of JE-CV, and in JE-naïve toddlers (12–24 months) who received a JE-CV single dose primary vaccination. Models were constructed using a Bayesian Monte-Carlo Markov Chain approach and implemented with OpenBugs V3.2.1. Antibody persistence was predicted for up to 10 years following JE-CV vaccination. Findings from a piecewise model with 2 phases (children) and a classic linear model (toddlers) are presented. For children, predicted median antibody titers (77 [2.5th–97.5th percentile range 41–144] 1/dil) remained above the threshold for seroprotection over the 10 years following booster JE-CV vaccination; the predicted median duration of protection was 19.5 years. For toddlers, 10 years after JE-CV primary vaccination median antibody titers were predicted to wane to around the level required for seroprotection (10.8 [5.8–20.1] 1/dil). A booster dose of JE-CV in children is predicted to provide long-term protection against JE. Such data are useful to facilitate decisions on implementation of and recommendations for future vaccination strategies.
Collapse
Affiliation(s)
- Alain Bouckenooghe
- a Clinical Sciences and Medical Affairs , Sanofi Pasteur , Singapore , Singapore
| | - Fabrice Bailleux
- b Clinical Program and Operations , Sanofi Pasteur , Marcy l'Etoile , France
| | - Emmanuel Feroldi
- c Global Clinical Sciences , Sanofi Pasteur , Marcy l'Etoile , France
| |
Collapse
|
26
|
Tarazona B, Díaz-Menéndez M, Mato Chaín G. International travelers receiving pharmacological immunosuppression: Challenges and opportunities. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.medcle.2018.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
27
|
Tarazona B, Díaz-Menéndez M, Mato Chaín G. International travelers receiving pharmacological immunosuppression: Challenges and opportunities. Med Clin (Barc) 2017; 150:233-239. [PMID: 29096964 DOI: 10.1016/j.medcli.2017.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 08/04/2017] [Indexed: 02/07/2023]
Abstract
There is an increasing number of international travelers receiving immunosuppressive therapy due to the better life expectation and quality offered by this kind of treatment. The complexity of pre-travel counseling in these patients lies in their greater susceptibility to certain travel-related infections and the potential severity of these, as well as in the contraindications and interactions that may occur between certain vaccines and/or prophylaxis and their base therapy. Counseling the traveler represents a challenge for clinicians who have to tailor vaccinations and other recommended preventive measures to the immunosuppressed patients. Thus, pre-travel assessment of patients receiving immunosuppressive therapy should be performed in a specialized Traveler's Medical Unit, working closely with the specialist doctor in charge of treating the patient's underlying medical condition. The purpose of this article is to review available evidence on the health recommendations indicated in the pre-travel administration of vaccines, antimalarial chemoprophylaxis and other measures to prevent communicable diseases in travelers receiving immunosuppressive therapy.
Collapse
Affiliation(s)
- Belisa Tarazona
- Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, España
| | - Marta Díaz-Menéndez
- Unidad de Medicina Tropical y del Viajero, Hospital Universitario La Paz-Carlos III, Madrid, España.
| | - Gloria Mato Chaín
- Unidad de Vacunación del Adulto, Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, España
| |
Collapse
|
28
|
Mandli J, Attar A, Ennaji MM, Amine A. Indirect competitive electrochemical immunosensor for hepatitis A virus antigen detection. J Electroanal Chem (Lausanne) 2017. [DOI: 10.1016/j.jelechem.2017.05.047] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
29
|
Van Damme P, Leroux-Roels G, Suryakiran P, Folschweiller N, Van Der Meeren O. Persistence of antibodies 20 y after vaccination with a combined hepatitis A and B vaccine. Hum Vaccin Immunother 2017; 13:972-980. [PMID: 28281907 PMCID: PMC5443376 DOI: 10.1080/21645515.2016.1274473] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Vaccination is the most effective and well-tolerated method of conferring long-term protection against hepatitis A and B viruses (HAV; HBV). Long-term studies are required to characterize the duration of protection and need for boosters. Following primary immunization of 150 and 157 healthy adults with 3-doses of combined hepatitis A/hepatitis B vaccine (HAB; Twinrix™, GSK Vaccines, Belgium) at 0-1-6 months in 2 separate studies, we measured vaccine-induced antibody persistence against HAV and HBV annually for 20 y (Study A: NCT01000324; Study B: NCT01037114). Subjects with circulating anti-HAV antibodies < 15 mIU/mL or with anti-hepatitis B surface antigen < 10 mIU/mL were offered an additional monovalent hepatitis A and/or B vaccine dose (Havrix™/Engerix™-B, GSK Vaccines, Belgium). Applying the immunogenicity results from these studies, mathematical modeling predicted long-term persistence. After 20 y, 18 and 25 subjects in studies A and B, respectively, comprised the long-term according-to-protocol cohort for immunogenicity; 100% and 96.0% retained anti-HAV antibodies ≥ 15 mIU/mL, respectively; 94.4% and 92.0% had anti-HBs antibodies ≥ 10 mIU/mL, respectively. Between Years 16–20, 4 subjects who received a challenge dose of monovalent hepatitis A vaccine (N = 2) or hepatitis B vaccine (N = 2), all mounted a strong anamnestic response suggestive of immune memory despite low antibody levels. Mathematical modeling predicts that 40 y after vaccination ≥ 97% vaccinees will maintain anti-HAV ≥ 15 mIU/mL and ≥ 50% vaccinees will retain anti-HBs ≥ 10 mIU/mL. Immunogenicity data confirm that primary immunization with 3-doses of HAB induces persisting anti-HAV and anti-HBs specific antibodies in most adults for up to 20 y; mathematical modeling predicts even longer-term protection.
Collapse
Affiliation(s)
- Pierre Van Damme
- a Centre for the Evaluation of Vaccination , Vaccine and Infectious Disease Institute, University of Antwerp , Antwerp , Belgium
| | | | | | | | | |
Collapse
|
30
|
Zhang Z, Zhu X, Hu Y, Liang M, Sun J, Song Y, Yang Q, Ji H, Zeng G, Song L, Chen J. Five-year antibody persistence in children after one dose of inactivated or live attenuated hepatitis A vaccine. Hum Vaccin Immunother 2017; 13:1-6. [PMID: 28319454 DOI: 10.1080/21645515.2016.1278329] [Citation(s) in RCA: 9] [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
In China, both inactivated hepatitis A (HA) vaccine and live attenuated HA vaccine are available. We conducted a trial to evaluate 5-year immune persistence induced by one dose of inactivated or live attenuated HA vaccines in children. Subjects with no HA vaccination history had randomly received one dose of inactivated or live attenuated HA vaccine at 18-60 months of age. Anti-HAV antibody concentrations were measured before vaccination and at the first, second, and fifth year after vaccination. Suspected cases of hepatitis A were monitored during the study period. A total of 332 subjects were enrolled and 182 provided evaluable serum samples at all planned time points. seropositive rate at 5 y was 85.9% in the inactivated HA vaccine group and 90.7% in the live attenuated HA vaccine group. GMCs were 76.3% mIU/ml (95% CI: 61.7 - 94.4) and 66.8mIU/ml (95% CI: 57.8 - 77.3), respectively. No significant difference in antibody persistence between 2 groups was found. No clinical hepatitis A case was reported. A single dose of an inactivated or live attenuated HA vaccine at 18-60 months of age resulted in high HAV seropositive rate and anti-HAV antibody concentrations that lasted for at least 5 y.
Collapse
Affiliation(s)
- Zhilun Zhang
- a Tianjin Center for Disease Control and Prevention , Tianjin , China
| | - Xiangjun Zhu
- a Tianjin Center for Disease Control and Prevention , Tianjin , China
| | | | - Miao Liang
- a Tianjin Center for Disease Control and Prevention , Tianjin , China
| | - Jin Sun
- a Tianjin Center for Disease Control and Prevention , Tianjin , China
| | - Yufei Song
- b Sinovac Biotech Co., LTD. , Beijing , China
| | - Qi Yang
- c Jixian county Center for Disease Control and Prevention , Jixian, Tianjin , China
| | - Haiquan Ji
- c Jixian county Center for Disease Control and Prevention , Jixian, Tianjin , China
| | - Gang Zeng
- b Sinovac Biotech Co., LTD. , Beijing , China
| | - Lifei Song
- b Sinovac Biotech Co., LTD. , Beijing , China
| | | |
Collapse
|
31
|
Immunogenicity and estimation of antibody persistence following vaccination with an inactivated virosomal hepatitis A vaccine in adults: A 20-year follow-up study. Vaccine 2017; 35:1448-1454. [PMID: 28190741 DOI: 10.1016/j.vaccine.2017.01.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 01/16/2017] [Accepted: 01/17/2017] [Indexed: 11/21/2022]
Abstract
PURPOSE This was a 20-year follow-up study to assess long-term persistence of protective antibody levels against the hepatitis A virus (HAV) in healthy participants vaccinated with 2 doses of inactivated hepatitis A vaccine (Epaxal®) between 1992 and 1995. METHODS Blood samples for anti-HAV antibody concentrations were obtained during a follow-up visit 20years after vaccination and were analyzed in parallel with samples still available from previous visits using AxSYM® HAVAB 2.0 assay. RESULTS Mean (SD) age of the participants was 44.71 (3.905) years at year 20 follow-up (N=95). Participants completing 0/12-month Epaxal® immunization regimen (N=94) had seroprotection rate of 100% (95% CI: 96.2, 100.0) with ⩾10mIU/mL seropositivity cut-off and 98.9% (95% CI: 94.2, 100.0) with ⩾20mIU/mL cut-off. With ⩾10mIU/mL cut-off, the estimated median duration of protection was 77.3years (95% CI: 71.8, 83.5) with 95% of the vaccinated participants predicted to be protected for at least 41.5years. At ⩾20mIU/mL cut-off, the estimated median duration of protection was 64.8years (95% CI: 60.1, 68.4) with 95% of the vaccinated participants predicted to be protected for at least 33years. Anti-HAV antibody geometric mean concentrations were higher in women (277.9; 95% CI: 217.7, 354.7) than in men (167.7; 95% CI: 125.2, 224.6). CONCLUSION The data from this 20-year follow-up study confirm previous observations that two doses of Epaxal® provide protection against hepatitis A infection for at least 30years in over 95% of healthy participants.
Collapse
|
32
|
Parrón I, Planas C, Godoy P, Manzanares-Laya S, Martínez A, Sala MR, Minguell S, Torner N, Jané M, Domínguez A. Effectiveness of hepatitis A vaccination as post-exposure prophylaxis. Hum Vaccin Immunother 2017; 13:423-427. [PMID: 27925847 PMCID: PMC5328215 DOI: 10.1080/21645515.2017.1264798] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Hepatitis A (HA) has been a vaccine-preventable disease since 1995. In Catalonia, a universal combined hepatitis A+B vaccination program of preadolescents was initiated at the end of 1998. However, outbreaks are reported each year and post-exposure prophylaxis (PEP) with hepatitis A virus (HAV) vaccine or immunoglobulin (IG) is recommended to avoid cases. The aim of this study was to assess the effectiveness of HAV vaccine and IG in preventing hepatitis A cases in susceptible exposed people. A retrospective cohort study of contacts of HA cases involved in outbreaks reported in Catalonia between January 2006 and December 2012 was made. The rate ratios and 95% confidence intervals (CI) of HA in susceptible contacts receiving HAV or IG versus those without PEP were calculated. There were 3550 exposed persons in the outbreaks studied: 2381 received one dose of HAV vaccine (Hepatitis A or hepatitis A+B), 190 received IG, and 611 received no PEP. 368 exposed subjects received one dose of HAV vaccine and IG simultaneously and were excluded from the study. The effectiveness of PEP was 97.6% (95% CI 96.2-98.6) for HAV vaccine and 98.3% (95% CI 91.3-99.9) for IG; the differences were not statistically significant (p = 0.36). The elevated effectiveness of HAV vaccination for PEP in HA outbreaks, similar to that of IG, and the long-term protection of active immunization, supports the preferential use of vaccination to avoid secondary cases.
Collapse
Affiliation(s)
- Ignasi Parrón
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - Caritat Planas
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - Pere Godoy
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
- CIBER Epidemiología y Salud pública (CIBERESP), Madrid, Spain
| | - Sandra Manzanares-Laya
- CIBER Epidemiología y Salud pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Ana Martínez
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
- CIBER Epidemiología y Salud pública (CIBERESP), Madrid, Spain
| | - Maria Rosa Sala
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - Sofia Minguell
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - Nuria Torner
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
- CIBER Epidemiología y Salud pública (CIBERESP), Madrid, Spain
- Departament de Medicina. Universitat de Barcelona, Barcelona, Spain
| | - Mireia Jané
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
- CIBER Epidemiología y Salud pública (CIBERESP), Madrid, Spain
| | - Angela Domínguez
- CIBER Epidemiología y Salud pública (CIBERESP), Madrid, Spain
- Departament de Medicina. Universitat de Barcelona, Barcelona, Spain
| | - the Working Group for the Study of Hepatitis A in Catalonia
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
- CIBER Epidemiología y Salud pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona, Barcelona, Spain
- Departament de Medicina. Universitat de Barcelona, Barcelona, Spain
| |
Collapse
|
33
|
Huang Y, Zhang L, Janes H, Frahm N, Isaacs A, Kim JH, Montefiori D, McElrath MJ, Tomaras GD, Gilbert PB. Predictors of durable immune responses six months after the last vaccination in preventive HIV vaccine trials. Vaccine 2017; 35:1184-1193. [PMID: 28131393 DOI: 10.1016/j.vaccine.2016.09.053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 08/04/2016] [Accepted: 09/21/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND The evaluation of durable immune responses is important in HIV vaccine research and development. The efficiency of such evaluation could be increased by incorporating predictors of the responses in the statistical analysis. In this paper, we investigated whether and how baseline demographic variables and immune responses measured two weeks after vaccination predicted durable immune responses measured six months later. METHODS We included data from seven preventive HIV vaccine regimens evaluated in three clinical trials: a Phase 1 study of four DNA, NYVAC and/or AIDSVAX vaccine regimens (HVTN096), a Phase 2 study of two DNA and/or MVA vaccine regimens (HVTN205), and a Phase 3 study of a single ALVAC/AIDSVAX regimen (RV144). Regularized random forests and linear regression models were used to identify and evaluate predictors of the positivity and magnitude of durable immune responses. RESULTS We analyzed 201 vaccine recipients with data from 10 to 127 immune response biomarkers, and 3-5 demographic variables. The best prediction of participants' durable response positivity based on two-week responses rendered up to close-to-perfect accuracy; the best prediction of participants' durable response magnitude rendered correlation coefficients between the observed and predicted responses ranging up to 0.91. Though prediction performances differed among biomarkers, durable immune responses were best predicted by the two-week response level of the same biomarker. Adding demographic information and two-week response levels of different biomarkers provided little or no improvement in the predictions. CONCLUSIONS For some biomarkers and for the vaccines we studied, two-week post-vaccination responses can well predict durable responses six months later. Therefore, if immune response durability is only assessed in a sub-sample of vaccine recipients, statistical analyses of durable responses will have increased efficiency by incorporating two-week response data. Further research is needed to generalize the findings to other vaccine regimens and biomarkers. Clinicaltrials.gov identifiers: NCT01799954, NCT00820846, NCT00223080.
Collapse
Affiliation(s)
- Yunda Huang
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., Seattle, WA 98109, USA; Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., Seattle, WA 98109, USA; Department of Global Health, University of Washington, 1510 San Juan Rd., Seattle, WA 98195, USA.
| | - Lily Zhang
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., Seattle, WA 98109, USA; Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., Seattle, WA 98109, USA.
| | - Holly Janes
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., Seattle, WA 98109, USA; Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., Seattle, WA 98109, USA; Department of Biostatistics, University of Washington, 1705 NE Pacific St., Seattle, WA 98195, USA.
| | - Nicole Frahm
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., Seattle, WA 98109, USA; Department of Global Health, University of Washington, 1510 San Juan Rd., Seattle, WA 98195, USA.
| | - Abby Isaacs
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., Seattle, WA 98109, USA; Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., Seattle, WA 98109, USA.
| | - Jerome H Kim
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, 503 Robert Grant Ave., Silver Spring, MD 20910, USA; International Vaccine Institute, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea.
| | - David Montefiori
- Duke Human Vaccine Institute, Genome Court, MSRB II, Durham, NC 27710, USA.
| | - M Julie McElrath
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., Seattle, WA 98109, USA; Department of Global Health, University of Washington, 1510 San Juan Rd., Seattle, WA 98195, USA; Department of Laboratory Medicine, University of Washington, 1959 NE Pacific St., Seattle, WA 98195, USA; Department of Medicine, University of Washington, 1959 NE Pacific St., Seattle, WA 98195, USA.
| | - Georgia D Tomaras
- Duke Human Vaccine Institute, Genome Court, MSRB II, Durham, NC 27710, USA.
| | - Peter B Gilbert
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., Seattle, WA 98109, USA; Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., Seattle, WA 98109, USA; Department of Biostatistics, University of Washington, 1705 NE Pacific St., Seattle, WA 98195, USA.
| |
Collapse
|
34
|
Curran D, de Ridder M, Van Effelterre T. The impact of assumptions regarding vaccine-induced immunity on the public health and cost-effectiveness of hepatitis A vaccination: Is one dose sufficient? Hum Vaccin Immunother 2016; 12:2765-2771. [PMID: 27428611 PMCID: PMC5137541 DOI: 10.1080/21645515.2016.1203495] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 06/01/2016] [Accepted: 06/15/2016] [Indexed: 11/26/2022] Open
Abstract
Hepatitis A vaccination stimulates memory cells to produce an anamnestic response. In this study, we used a mathematical model to examine how long-term immune memory might convey additional protection against clinical/icteric infections. Dynamic and decision models were used to estimate the expected number of cases, and the costs and quality-adjusted life-years (QALYs), respectively. Several scenarios were explored by assuming: (1) varying duration of vaccine-induced immune memory, (2) and/or varying levels of vaccine-induced immune memory protection (IMP), (3) and/or varying levels of infectiousness in vaccinated individuals with IMP. The base case analysis assumed a time horizon of 25 y (2012 - 2036), with additional analyses over 50 and 75 y. The analyses were conducted in the Mexican public health system perspective. In the base case that assumed no vaccine-induced IMP, the 2-dose hepatitis A vaccination strategy was cost-effective compared with the 1-dose strategy over the 3 time horizons. However, it was not cost-effective if we assumed additional IMP durations of at least 10 y in the 25-y horizon. In the 50- and 75-y horizons, the 2-dose strategy was always cost-effective, except when 100% reduction in the probability of icteric Infections, 75% reduction in infectiousness, and mean durations of IMP of at least 50 y were assumed. This analysis indicates that routine vaccination of toddlers against hepatitis A virus would be cost-effective in Mexico using a single-dose vaccination strategy. However, the cost-effectiveness of a second dose depends on the assumptions of additional protection by IMP and the time horizon over which the analysis is performed.
Collapse
|
35
|
Stuurman AL, Marano C, Bunge EM, De Moerlooze L, Shouval D. Impact of universal mass vaccination with monovalent inactivated hepatitis A vaccines - A systematic review. Hum Vaccin Immunother 2016; 13:724-736. [PMID: 27786671 PMCID: PMC5360128 DOI: 10.1080/21645515.2016.1242539] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The WHO recommends integration of universal mass vaccination (UMV) against hepatitis A virus (HAV) in national immunization schedules for children aged ≥1 year, if justified on the basis of acute HAV incidence, declining endemicity from high to intermediate and cost-effectiveness. This recommendation has been implemented in several countries. Our aim was to assess the impact of UMV using monovalent inactivated hepatitis A vaccines on incidence and persistence of anti-HAV (IgG) antibodies in pediatric populations. We conducted a systematic review of literature published between 2000 and 2015 in PubMed, Cochrane Library, LILACS, IBECS identifying a total of 27 studies (Argentina, Belgium, China, Greece, Israel, Panama, the United States and Uruguay). All except one study showed a marked decline in the incidence of hepatitis A post introduction of UMV. The incidence in non-vaccinated age groups decreased as well, suggesting herd immunity but also rising susceptibility. Long-term anti-HAV antibody persistence was documented up to 17 y after a 2-dose primary vaccination. In conclusion, introduction of UMV in countries with intermediate endemicity for HAV infection led to a considerable decrease in the incidence of hepatitis A in vaccinated and in non-vaccinated age groups alike.
Collapse
Affiliation(s)
- Anke L Stuurman
- a Pallas, Health Research and Consultancy BV , Rotterdam , The Netherlands
| | | | - Eveline M Bunge
- a Pallas, Health Research and Consultancy BV , Rotterdam , The Netherlands
| | | | - Daniel Shouval
- c Hadassah Hebrew University Hospital , Liver Unit , Jerusalem , Israel
| |
Collapse
|
36
|
Yu C, Song Y, Qi Y, Li C, Jiang Z, Li C, Zhang W, Wang L, Xia J. Comparison of immunogenicity and persistence between inactivated hepatitis A vaccine Healive® and Havrix® among children: A 5-year follow-up study. Hum Vaccin Immunother 2016; 12:2595-2602. [PMID: 27385349 DOI: 10.1080/21645515.2016.1197450] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Inactivated vaccines for hepatitis A virus (HAV) infection are widely used in China. Mass vaccination programs drive the need for data on long-term persistence of vaccine-induced protection. METHODS A prospective, randomized, open-label clinical trial was conducted to compare geometric mean concentrations (GMCs) and seroconversion rates (SRs) of anti-HAV antibody elicited by the inactivated vaccines Healive and Havrix for 5 y post immunization, in which 400 healthy children were randomly assigned in a 3:1 ratio to receive 2 doses of Healive or Havrix at 0 and 6 month. Anti-HAV antibody concentration was detected by microparticle enzyme immunoassay (MEIA) during the study. Furthermore, an attempt was made to predict persistence of protective immunogenicity by using a suitable statistical model. RESULTS The GMCs were significantly higher after vaccination with Healive than after Havrix as comparator vaccine at 1, 6, 7, 18, 30, 42, 54 and 66 month (P < 0.01) with the peak point at 7 month (3427.2 mIU/ml for Healive and 1441.9 mIU/ml for Comparator). Similarly significant differences of SRs were found between the 2 groups at 1 and 6 month (P < 0.01). Afterwards, the SRs of both groups reached 100% at 7 month and did not decline until 66 month(99.1% for Healive and 97.5% for Comparator). A linear mixed model with a change point at 18 month(Model 3) was found to be suitable to predict persistence of protective immunogenicity induced by vaccines. It was estimated that the duration of protection for Healive was at least 20 y with a lower limit of GMC 95% confidence interval (CI) no less than 20 mIU/mL. CONCLUSIONS Compared with Havrix, the new preservative-free inactivated hepatitis A vaccine (Healive) in 2 doses showed better persistence of antibody concentrations for 5 y after full-course immunization among children and the persistence of protective immunogenicity was estimated for at least 20 y.
Collapse
Affiliation(s)
- Chengkai Yu
- a Department of Health Statistics , School of Preventive Medicine, Fourth Military Medical University , Xi'an , Shaanxi , China
| | | | - Yangyang Qi
- a Department of Health Statistics , School of Preventive Medicine, Fourth Military Medical University , Xi'an , Shaanxi , China
| | - Chanjuan Li
- a Department of Health Statistics , School of Preventive Medicine, Fourth Military Medical University , Xi'an , Shaanxi , China
| | - Zhiwei Jiang
- a Department of Health Statistics , School of Preventive Medicine, Fourth Military Medical University , Xi'an , Shaanxi , China
| | - Chen Li
- a Department of Health Statistics , School of Preventive Medicine, Fourth Military Medical University , Xi'an , Shaanxi , China
| | - Wei Zhang
- a Department of Health Statistics , School of Preventive Medicine, Fourth Military Medical University , Xi'an , Shaanxi , China
| | - Ling Wang
- a Department of Health Statistics , School of Preventive Medicine, Fourth Military Medical University , Xi'an , Shaanxi , China
| | - Jielai Xia
- a Department of Health Statistics , School of Preventive Medicine, Fourth Military Medical University , Xi'an , Shaanxi , China
| |
Collapse
|
37
|
Spradling PR, Bulkow LR, Negus SE, Homan C, Bruce MG, McMahon BJ. Persistence of seropositivity among persons vaccinated for hepatitis A during infancy by maternal antibody status: 15-year follow-up. Hepatology 2016; 63:703-11. [PMID: 26637987 PMCID: PMC6459008 DOI: 10.1002/hep.28375] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 10/26/2015] [Accepted: 11/24/2015] [Indexed: 01/09/2023]
Abstract
UNLABELLED The effect of passively transferred maternal antibody to hepatitis A virus (anti-HAV) on the duration of seropositivity after hepatitis A vaccination during infancy and early childhood is unclear. We obtained levels of anti-HAV at intervals through age 15-16 years among three groups of Alaskan Native children who initiated a two-dose inactivated hepatitis A vaccination series at ages 6 months (group 1), 12 months (group 2), and 15 months (group 3), each group randomized according to maternal anti-HAV status. Seropositivity (anti-HAV ≥20 mIU/mL) 30 years after the second vaccine dose among the three groups was predicted using a random effects model. One hundred eighty-three children participated in the study; follow-up did not differ significantly by vaccine group or maternal anti-HAV status. Although the frequency of seropositivity among all participants through age 10 years was high (100% among groups 2 and 3 and >90% among group 1), there was a decrease thereafter through age 15-16 years among group 1 children, who initiated vaccination at age 6 months (50%-75%), and among maternal anti-HAV-positive children in groups 2 and 3 (67%-87%), who initiated vaccination at ages 12 months and 15 months, respectively. Nonetheless, the model indicated that anti-HAV seropositivity should persist for ≥30 years after vaccination in 64% of all participants; among those seropositive at age 15-16 years, 84% were predicted to remain so for ≥30 years. CONCLUSION Most children vaccinated during early childhood available for sampling maintained seropositivity through age 15-16 years; however, seropositivity was less frequent among those starting vaccination at age 6 months and among maternal antibody-positive participants who started vaccination at age 12 months or 15 months; overall, our findings support current vaccine recommendations and continued follow-up of this cohort.
Collapse
Affiliation(s)
- Philip R. Spradling
- Division of Viral Hepatitis, Centers for Disease Control
and Prevention, Atlanta, GA
| | - Lisa R. Bulkow
- Arctic Investigations Program, Division of Preparedness and
Emerging Infectious Diseases, National Center for Emerging and Zoonotic Infectious
Diseases, Centers for Disease Control and Prevention, Anchorage, AK
| | - Susan E. Negus
- Liver Disease and Hepatitis Program, Alaska Native Tribal
Health Consortium, Anchorage, AK
| | - Chriss Homan
- Liver Disease and Hepatitis Program, Alaska Native Tribal
Health Consortium, Anchorage, AK
| | - Michael G. Bruce
- Arctic Investigations Program, Division of Preparedness and
Emerging Infectious Diseases, National Center for Emerging and Zoonotic Infectious
Diseases, Centers for Disease Control and Prevention, Anchorage, AK
| | - Brian J. McMahon
- Arctic Investigations Program, Division of Preparedness and
Emerging Infectious Diseases, National Center for Emerging and Zoonotic Infectious
Diseases, Centers for Disease Control and Prevention, Anchorage, AK
- Liver Disease and Hepatitis Program, Alaska Native Tribal
Health Consortium, Anchorage, AK
| |
Collapse
|
38
|
Klevens RM, Denniston MM, Jiles-Chapman RB, Murphy TV. Decreasing immunity to hepatitis A virus infection among US adults: Findings from the National Health and Nutrition Examination Survey (NHANES), 1999-2012. Vaccine 2015; 33:6192-8. [PMID: 26476364 DOI: 10.1016/j.vaccine.2015.10.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 10/01/2015] [Accepted: 10/03/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND The clinical course of hepatitis A virus (HAV) infection is more severe with increased age. In the United States, surveillance data reported to CDC since 2011 indicate increases in both the absolute number of cases and the mean age of cases. Total antibody to HAV (anti-HAV) is a marker of immunity. METHODS We analyzed National Health and Nutrition Examination Survey (NHANES) data for anti-HAV from respondents aged ≥ 2 years collected from 2007 to 2012 and compared with data collected 10 years earlier (1999-2006). For US-born adults aged ≥ 20 years, we estimated age-adjusted anti-HAV prevalence by demographic and other characteristics, evaluated factors associated with anti-HAV positivity and examined anti-HAV prevalence by decade of birth. RESULTS The prevalence of anti-HAV among adults aged ≥ 20 years was 24.2% (95% CI 22.5-25.9) during 2007-2012, a significant decline from 29.5% (95% CI 28.0-31.1) during 1999-2006. Prevalence of anti-HAV was consistently lower in 2007-2012 compared to 1999-2006 by all characteristics examined. In 2007-2012, the lowest age-specific prevalence was among adults aged 30-49 years (16.1-17.6%). Factors significantly associated with anti-HAV positivity among adults were older age, Mexican American ethnicity, living below poverty, less education, and not having insurance. By decade of birth, the prevalence of anti-HAV was slightly lower in 2009-2012 than in 1999-2002, except among persons born from 1980 to 1989. CONCLUSIONS NHANES data document very low prevalence of hepatitis A immunity among U.S. adults aged 30-49 years; waning of anti-HAV over time may be minimal. Improving vaccination coverage among susceptible adults should be considered.
Collapse
Affiliation(s)
- R Monina Klevens
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, NE, Mailstop G-37, Atlanta, GA 30329, United States.
| | - Maxine M Denniston
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, NE, Mailstop G-37, Atlanta, GA 30329, United States
| | - Ruth B Jiles-Chapman
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, NE, Mailstop G-37, Atlanta, GA 30329, United States
| | - Trudy V Murphy
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, NE, Mailstop G-37, Atlanta, GA 30329, United States
| |
Collapse
|
39
|
Denniston MM, Monina Klevens R, Jiles RB, Murphy TV. Self-reported hepatitis A vaccination as a predictor of hepatitis A virus antibody protection in U.S. adults: National Health and Nutrition Examination Survey 2007-2012. Vaccine 2015; 33:3887-93. [PMID: 26116252 PMCID: PMC4568740 DOI: 10.1016/j.vaccine.2015.06.063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 06/11/2015] [Accepted: 06/12/2015] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To estimate the predictive value of self-reported hepatitis A vaccine (HepA) receipt for the presence of hepatitis A virus (HAV) antibody (anti-HAV) from either past infection or vaccination, as an indicator of HAV protection. METHODS Using 2007-2012 National Health and Nutrition Examination Survey data, we assigned participants to 4 groups based on self-reported HepA receipt and anti-HAV results. We compared characteristics across groups and calculated three measures of agreement between self-report and serologic status (anti-HAV): percentage concordance, and positive (PPV) and negative (NPV) predictive values. Using logistic regression we investigated factors associated with agreement between self-reported vaccination status and serological results. RESULTS Demographic and other characteristics varied significantly across the 4 groups. Overall agreement between self-reported HepA receipt and serological results was 63.6% (95% confidence interval [CI] 61.9-65.2); PPV and NPV of self-reported vaccination status for serological result were 47.0% (95% CI 44.2-49.8) and 69.4% (95% CI 67.0-71.8), respectively. Mexican American and foreign-born adults had the highest PPVs (71.5% [95% CI 65.9-76.5], and 75.8% [95% CI 71.4-79.7]) and the lowest NPVs (21.8% [95% CI 18.5-25.4], and 20.0% [95% CI 17.2-23.1]), respectively. Young (ages 20-29 years), US-born, and non-Hispanic White adults had the lowest PPVs (37.9% [95% CI 34.5-41.5], 39.1% [95% CI, 36.0-42.3], and 39.8% [36.1-43.7]), and the highest NPVs (76.9% [95% CI 72.2-81.0, 78.5% [95% CI 76.5-80.4)], and 80.6% [95% CI 78.2-82.8), respectively. Multivariate logistic analyses found age, race/ethnicity, education, place of birth and income to be significantly associated with agreement between self-reported vaccination status and serological results. CONCLUSIONS When assessing hepatitis A protection, self-report of not having received HepA was most likely to identify persons at risk for hepatitis A infection (no anti-HAV) among young, US-born and non-Hispanic White adults, and self-report of HepA receipt was least likely to be reliable among adults with the same characteristics.
Collapse
Affiliation(s)
- Maxine M Denniston
- Epidemiology and Surveillance Branch, Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - R Monina Klevens
- Epidemiology and Surveillance Branch, Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Ruth B Jiles
- Epidemiology and Surveillance Branch, Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Trudy V Murphy
- Vaccine Research and Policy, Office of the Director, Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| |
Collapse
|
40
|
Rodrigues AF, Soares HR, Guerreiro MR, Alves PM, Coroadinha AS. Viral vaccines and their manufacturing cell substrates: New trends and designs in modern vaccinology. Biotechnol J 2015. [PMID: 26212697 PMCID: PMC7161866 DOI: 10.1002/biot.201400387] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Vaccination is one of the most effective interventions in global health. The worldwide vaccination programs significantly reduced the number of deaths caused by infectious agents. A successful example was the eradication of smallpox in 1979 after two centuries of vaccination campaigns. Since the first variolation administrations until today, the knowledge on immunology has increased substantially. This knowledge combined with the introduction of cell culture and DNA recombinant technologies revolutionized vaccine design. This review will focus on vaccines against human viral pathogens, recent developments on vaccine design and cell substrates used for their manufacture. While the production of attenuated and inactivated vaccines requires the use of the respective permissible cell substrates, the production of recombinant antigens, virus‐like particles, vectored vaccines and chimeric vaccines requires the use – and often the development – of specific cell lines. Indeed, the development of novel modern viral vaccine designs combined with, the stringent safety requirements for manufacture, and the better understanding on animal cell metabolism and physiology are increasing the awareness on the importance of cell line development and engineering areas. A new era of modern vaccinology is arriving, offering an extensive toolbox to materialize novel and creative ideas in vaccine design and its manufacture.
Collapse
Affiliation(s)
- Ana F Rodrigues
- iBET, Instituto de Biologia Experimental e Tecnológica, Oeiras, Portugal
| | - Hugo R Soares
- iBET, Instituto de Biologia Experimental e Tecnológica, Oeiras, Portugal.,Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, Oeiras, Portugal
| | - Miguel R Guerreiro
- iBET, Instituto de Biologia Experimental e Tecnológica, Oeiras, Portugal.,Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, Oeiras, Portugal
| | - Paula M Alves
- iBET, Instituto de Biologia Experimental e Tecnológica, Oeiras, Portugal.,Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, Oeiras, Portugal
| | - Ana S Coroadinha
- iBET, Instituto de Biologia Experimental e Tecnológica, Oeiras, Portugal. .,Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, Oeiras, Portugal.
| |
Collapse
|
41
|
Theeten H, Van Herck K, Van Der Meeren O, Crasta P, Van Damme P, Hens N. Long-term antibody persistence after vaccination with a 2-dose Havrix (inactivated hepatitis A vaccine): 20 years of observed data, and long-term model-based predictions. Vaccine 2015; 33:5723-5727. [PMID: 26190091 DOI: 10.1016/j.vaccine.2015.07.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 06/11/2015] [Accepted: 07/06/2015] [Indexed: 01/13/2023]
Abstract
Antibody persistence in two cohorts of adults, who received inactivated hepatitis A (HAV) vaccine (1440El.U; Havrix; GSK Vaccines) according to a 0-6 or 0-12 month schedule in 1992-1993, has been measured annually. After 20 years, >97% of the subjects in both studies were seropositive for anti-HAV antibodies. Geometric mean concentrations in the according-to-protocol cohorts were 312 mIU/ml in 34/36 subjects vaccinated initially at 0-6 months (NCT00289757) and 317 mIU/ml in 85/86 subjects vaccinated at 0-12 months (NCT00291876). Over the whole follow-up period, seven subjects (2+5, respectively) lost circulating anti-HAV antibodies but mounted a strong response after HAV booster administration (1440El.U). Mathematical modelling, which was applied to assess true persistence at Year 20 (accounting for drop-outs and missing data), and to predict longer-term persistence confirmed previous estimates that seropositive anti-HAV levels would persist in ≥95% vaccinees at Year 30 and ≥90% at Year 40. ClinicalTrials.Gov number: NCT00289757/NCT00291876.
Collapse
Affiliation(s)
- Heidi Theeten
- Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Koen Van Herck
- Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium; Department of Public Health, Ghent University, Ghent, Belgium
| | | | - Priya Crasta
- GlaxoSmithKline Wavre, Belgium and Mumbai, India
| | - Pierre Van Damme
- Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.
| | - Niel Hens
- Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium; Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, Diepenbeek, Belgium
| |
Collapse
|
42
|
A single dose of inactivated hepatitis A vaccine promotes HAV-specific memory cellular response similar to that induced by a natural infection. Vaccine 2015; 33:3813-20. [DOI: 10.1016/j.vaccine.2015.06.099] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 06/23/2015] [Accepted: 06/24/2015] [Indexed: 11/22/2022]
|
43
|
Estripeaut D, Contreras R, Tinajeros O, Castrejón MM, Shafi F, Ortega-Barria E, DeAntonio R. Impact of Hepatitis A vaccination with a two-dose schedule in Panama: Results of epidemiological surveillance and time trend analysis. Vaccine 2015; 33:3200-7. [PMID: 25981490 DOI: 10.1016/j.vaccine.2015.04.100] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 04/25/2015] [Accepted: 04/30/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE In April 2007, Panama introduced Hepatitis A universal vaccination using a two-dose schedule (Havrix(®)junior; GSK Vaccines, Belgium). We assessed the impact of this hepatitis A vaccine three years after it was recommended for universal mass vaccination in Panama. MATERIALS AND METHODS Hepatitis A vaccination impact was assessed using two different approaches. The first approach used retrospective data (incidence and number of cases for all age groups), collected from the passive surveillance of the Epidemiologic Surveillance System of the Ministry of Health of hepatitis A and unspecified hepatitis before (2000-2006) and after (2008-2010) introduction of hepatitis A vaccine. The second approach was a prospective hospital-based active surveillance for hepatitis cases conducted in subjects (0-14 years) during 2009-2011 at three sentinel hospitals in Panama. RESULTS Overall, the annual incidence of hepatitis A and unspecified hepatitis in 2008, 2009 and 2010 were 13.1, 7.9 and 3.7 per 100,000 subjects, lower than the baseline incidence of 51.1 per 100,000 subjects. In comparison to the mean baseline period (2000-2006), there was an 82% mean reduction in the overall hepatitis-related outcomes (hepatitis A and unspecified hepatitis) after vaccine introduction (2008-2010) in all age groups. In the hospital-based surveillance (2009-2011), of the 42 probable viral hepatitis A cases, nine cases were confirmed as acute hepatitis A (8 in 2009, 1 in 2010). Of these confirmed cases, two belonged to the targeted vaccine group (1-4 years) but were not vaccinated. CONCLUSIONS Our study suggests that the introduction of two-dose hepatitis A vaccines in Panama has contributed to the reduction in the incidence of overall hepatitis-related outcomes for all age groups, suggesting herd protection. Additional monitoring is required to document a sustained long-term effect.
Collapse
Affiliation(s)
| | - Rodolfo Contreras
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
| | - Olga Tinajeros
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT), Panama City, Panama
| | | | | | | | | |
Collapse
|
44
|
Liu XE, Chen HY, Liao Z, Zhou Y, Wen H, Peng S, Liu Y, Li R, Li J, Zhuang H. Comparison of Immunogenicity Between Inactivated and Live Attenuated Hepatitis A Vaccines Among Young Adults: A 3-Year Follow-up Study. J Infect Dis 2015; 212:1232-6. [PMID: 25969561 DOI: 10.1093/infdis/jiv213] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 03/30/2015] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED A randomized clinical trial of hepatitis A vaccines (1 or 2 doses of inactivated vaccine [Healive] or 1 dose of live attenuated vaccine [Biovac]) was conducted among adults to evaluate seroprotection rates and geometric mean concentrations of antibody against hepatitis A virus for 36 months. High rates of seroprotection persisted for at least 36 months among adults who received 1 or 2 doses of inactivated hepatitis A vaccine but not among adults who received 1 dose of live attenuated hepatitis A vaccine. The long-term serial monitoring of immunogenicity induced by 1 dose of inactivated hepatitis A vaccine is needed to determine an effective alternative to a 2-dose schedule. CLINICAL TRIALS REGISTRATION NCT01865968.
Collapse
Affiliation(s)
- Xue-en Liu
- Department of Microbiology and Center of Infectious Disease, School of Basic Medical Sciences, Peking University Health Science Center, Beijing
| | - Hai-ying Chen
- Nanchang Center for Disease Control and Prevention, Jiangxi
| | - Zheng Liao
- Nanchang Center for Disease Control and Prevention, Jiangxi
| | - Yisheng Zhou
- Nanchang Center for Disease Control and Prevention, Jiangxi
| | - Hairong Wen
- Nanchang Center for Disease Control and Prevention, Jiangxi
| | - Shihui Peng
- Nanchang Center for Disease Control and Prevention, Jiangxi
| | - Yan Liu
- Sinovac Biotech, Beijing, China
| | - Rui Li
- Department of Microbiology and Center of Infectious Disease, School of Basic Medical Sciences, Peking University Health Science Center, Beijing
| | - Jie Li
- Department of Microbiology and Center of Infectious Disease, School of Basic Medical Sciences, Peking University Health Science Center, Beijing
| | - Hui Zhuang
- Department of Microbiology and Center of Infectious Disease, School of Basic Medical Sciences, Peking University Health Science Center, Beijing
| |
Collapse
|
45
|
Long-term antibody persistence in children after vaccination with the pediatric formulation of an aluminum-free virosomal hepatitis A vaccine. Pediatr Infect Dis J 2015; 34:e85-91. [PMID: 25389920 DOI: 10.1097/inf.0000000000000616] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The pediatric dose of the virosomal hepatitis A vaccine Epaxal, Epaxal Junior, is safe and immunogenic in children from 1 to 17 years of age. The present study investigated the long-term immunogenicity of Epaxal Junior. The standard doses of Epaxal and aluminum-adsorbed hepatitis A vaccine (Havrix Junior) were used as comparators. METHODS A total of 271 children who had completed a 0/6-month immunization schedule (priming and booster dose) participated in this follow-up study. Anti-hepatitis A virus (HAV) antibody levels were measured using a microparticle enzyme immunoassay (HAVAB 2.0 Quantitative; Abbott Diagnostics, Wiesbaden, Germany) starting at 18 months following the second dose, and then yearly until 66 months (ie, 5.5 years) after the second dose. RESULTS All subjects tested at Month 66 still had protective anti-HAV antibodies (≥10 mIU/mL). Antibody titers were generally lower in subjects 1-7 years old than in subjects 8-17 years old and higher in females 11-17 years old than in males 11-17 years old. In addition, an age-dependent decay was observed, that is, antibody decreased more rapidly in younger than in older children. CONCLUSIONS Vaccination of children with two doses of Epaxal Junior confers a real-time protection of at least 5.5 years. This protection is estimated to last approximately 25 years. Younger children showed lower antibody titers and a faster antibody decline than older children. Additional follow-up studies are needed beyond 5.5 years to further assess the long-term immunogenicity of Epaxal Junior.
Collapse
|
46
|
Garcia Garrido HM, Wieten RW, Grobusch MP, Goorhuis A. Response to Hepatitis A Vaccination in Immunocompromised Travelers. J Infect Dis 2015; 212:378-85. [PMID: 25649170 DOI: 10.1093/infdis/jiv060] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 01/26/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Hepatitis A vaccines are highly immunogenic in healthy patients, but there is uncertainty about their immunogenicity in immunocompromised patients. METHODS Our study included immunocompromised patients who received 1 or 2 hepatitis A vaccinations between January 2011 and June 2013. We assessed factors that influenced the serologic response to vaccination. We performed a literature review of previous studies on hepatitis A vaccination in immunocompromised patients. RESULTS Of 85 immunocompromised patients, 65 used immunosuppressive drugs, 13 had received stem cell transplants, and 7 were infected with human immunodeficiency virus. After vaccination, 65 of 85 (76.5%) developed antibodies. Tumor necrosis factor α blocker use was associated with better serologic responses than other immunosuppressive drugs. Female patients were more compliant than male patients with postvaccination antibody titer measurements. In 11 relevant studies, antibody responses after the first and second vaccination averaged 37% and 82%, respectively. Factors that negatively influenced serologic response rates were high doses of immunosuppressive drugs, fewer hepatitis A vaccinations, and a short interval between vaccination and antibody measurement. CONCLUSIONS Immunocompromised patients showed moderate to good serologic responses to hepatitis A vaccination, but may need more time to develop immunity. Tumor necrosis factor α blocker use was associated with better antibody responses than other drugs. Specifically, male patients should be motivated to return for antibody titer measurements.
Collapse
Affiliation(s)
- Hannah M Garcia Garrido
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Rosanne W Wieten
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Martin P Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Abraham Goorhuis
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| |
Collapse
|
47
|
Antibody persistence and T-cell balance: two key factors confronting HIV vaccine development. Proc Natl Acad Sci U S A 2014; 111:15614-21. [PMID: 25349379 DOI: 10.1073/pnas.1413550111] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The quest for a prophylactic AIDS vaccine is ongoing, but it is now clear that the successful vaccine must elicit protective antibody responses. Accordingly, intense efforts are underway to identify immunogens that elicit these responses. Regardless of the mechanism of antibody-mediated protection, be it neutralization, Fc-mediated effector function, or both, antibody persistence and appropriate T-cell help are significant problems confronting the development of a successful AIDS vaccine. Here, we discuss the evidence illustrating the poor persistence of antibody responses to Env, the envelope glycoprotein of HIV-1, and the related problem of CD4(+) T-cell responses that compromise vaccine efficacy by creating excess cellular targets of HIV-1 infection. Finally, we propose solutions to both problems that are applicable to all Env-based AIDS vaccines regardless of the mechanism of antibody-mediated protection.
Collapse
|