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Omersel J, Karas Kuželički N. Vaccinomics and Adversomics in the Era of Precision Medicine: A Review Based on HBV, MMR, HPV, and COVID-19 Vaccines. J Clin Med 2020; 9:E3561. [PMID: 33167413 PMCID: PMC7694388 DOI: 10.3390/jcm9113561] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/31/2020] [Accepted: 11/02/2020] [Indexed: 02/06/2023] Open
Abstract
Precision medicine approaches based on pharmacogenomics are now being successfully implemented to enable physicians to predict more efficient treatments and prevention strategies for a given disease based on the genetic background of the patient. This approach has already been proposed for vaccines, but research is lagging behind the needs of society, and precision medicine is far from being implemented here. While vaccinomics concerns the effectiveness of vaccines, adversomics concerns their side effects. This area has great potential to address public concerns about vaccine safety and to promote increased public confidence, higher vaccination rates, and fewer serious adverse events in genetically predisposed individuals. The aim here is to explore the contemporary scientific literature related to the vaccinomic and adversomic aspects of the three most-controversial vaccines: those against hepatitis B, against measles, mumps, and rubella, and against human Papilloma virus. We provide detailed information on the genes that encode human leukocyte antigen, cytokines and their receptors, and transcription factors and regulators associated with the efficacy and safety of the Hepatitis B and Measles, Mumps and Rubella virus vaccines. We also investigate the future prospects of vaccinomics and adversomics of a COVID-19 vaccine, which might represent the fastest development of a vaccine ever.
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Affiliation(s)
| | - Nataša Karas Kuželički
- Faculty of Pharmacy, University of Ljubljana, Aškerčeva cesta 7, 1000 Ljubljana, Slovenia;
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Weitzel T, Rodríguez F, Noriega LM, Marcotti A, Duran L, Palavecino C, Porte L, Aguilera X, Wolff M, Cortes CP. Hepatitis B and C virus infection among HIV patients within the public and private healthcare systems in Chile: A cross-sectional serosurvey. PLoS One 2020; 15:e0227776. [PMID: 31917810 PMCID: PMC6952094 DOI: 10.1371/journal.pone.0227776] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 12/27/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Coinfections of HIV patients with hepatitis B virus (HBV) and hepatitis C virus (HCV) are mayor public health problems, contributing to the emerging burden of HIV-associated hepatic mortality. Coinfection rates vary geographically, depending on various factors such as predominant transmission modes, HBV vaccination rates, and prevalence of HBV and HCV in the general population. In South America, the epidemiology of coinfections is uncertain, since systematic studies are scarce. Our study aimed to analyze rates of HBV and HCV infection in people living with HIV attending centers of the public and private health system in Chile. METHODS We performed a cross-sectional study including a public university hospital and a private health center in Santiago, Metropolitan Region in Chile. Serum samples were used to determine serological markers of hepatitis B (HBsAg, anti-HBs, anti-HBc total, HBeAg, anti-HBe) and anti-HCV. Demographic, clinical and laboratory data were obtained from medical records. RESULTS 399 patients were included (353 from public, 46 from private health center). Most (92.8%) were male, with a median age of 38.3 years; 99.4% acquired HIV through sexual contact (75.0% MSM); 25.7% had AIDS and 90.4% were on ART. In 78.9%, viral loads were <40 cps/mL; the median CD4 cell count was 468 cells/mm3. According to their serological status, 37.6% of patients were HBV naïve (susceptible), 6.5% were vaccinated, 43.6% had resolved HBV infection, and 5.8% were chronically infected. The rate of vaccination was 4.5% in the public and 21.7% in the private system. HCV coinfection was found in 1.0% of all patients. CONCLUSION HBV coinfection rate was within the range of other South American countries, but lower than in non-industrialized regions in Asia and Africa. A low percentage of patients were HBV vaccinated, especially within the public system. HCV coinfection rate was very low, most probably due to the rareness of injecting drug use.
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Affiliation(s)
- Thomas Weitzel
- Laboratorio Clínico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
- Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | | | - Luis Miguel Noriega
- Departamento de Medicina Interna, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Alejandra Marcotti
- Departamento de Medicina Interna, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Luisa Duran
- Departamento de Medicina Interna, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Carla Palavecino
- Departamento de Medicina, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Lorena Porte
- Laboratorio Clínico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Ximena Aguilera
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Marcelo Wolff
- Fundación Arriarán, Santiago, Chile
- Departamento de Medicina, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Claudia P. Cortes
- Fundación Arriarán, Santiago, Chile
- Departamento de Medicina, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Amorim LT, Schlemper Junior BR. HIV/AIDS in small cities in Midwest Santa Catarina, south of Brazil: Clinical and epidemiological aspects, opportunistic infections. Rev Soc Bras Med Trop 2019; 52:e20180430. [PMID: 31188912 DOI: 10.1590/0037-8682-0430-2018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 03/27/2019] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION We avaluated the clinical features, epidemiology, opportunistic infections and coinfections of HIV/AIDS patients. METHODS We analyzed the records of 143 patients receiving antiretroviral therapy at a public center in the Midwest of Santa Catarina, south of Brazil, from December 2014 to September 2015. RESULTS Most were male, Caucasian, married, with low education level, and aged 31-50 years. Heterosexual transmission was the most common infection route. Regarding coinfection, 3.5% had hepatitis C, 2.1% hepatitis B, 4.2% syphilis, and 4.9% tuberculosis; 38.5% had opportunistic infections. CONCLUSIONS HIV infection follows the national trend, but hepatitis B and C coinfection rates were higher, while tuberculosis rate was lower.
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Flanagan KL, Fink AL, Plebanski M, Klein SL. Sex and Gender Differences in the Outcomes of Vaccination over the Life Course. Annu Rev Cell Dev Biol 2018; 33:577-599. [PMID: 28992436 DOI: 10.1146/annurev-cellbio-100616-060718] [Citation(s) in RCA: 331] [Impact Index Per Article: 55.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Both sex (i.e., biological differences) and gender (i.e., social or cultural influences) impact vaccine acceptance, responses, and outcomes. Clinical data illustrate that among children, young adults, and aged individuals, males and females differ in vaccine-induced immune responses, adverse events, and protection. Although males are more likely to receive vaccines, following vaccination, females typically develop higher antibody responses and report more adverse effects of vaccination than do males. Human, nonhuman animal, and in vitro studies reveal numerous immunological, genetic, hormonal, and environmental factors that differ between males and females and contribute to sex- and gender-specific vaccine responses and outcomes. Herein, we address the impact of sex and gender variables that should be considered in preclinical and clinical studies of vaccines.
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Affiliation(s)
- Katie L Flanagan
- Department of Immunology and Pathology, Monash University, Melbourne, Victoria, Australia, 3800; ,
| | - Ashley L Fink
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205; ,
| | - Magdalena Plebanski
- Department of Immunology and Pathology, Monash University, Melbourne, Victoria, Australia, 3800; ,
| | - Sabra L Klein
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205; ,
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Comparison of Hepatitis B Virus Infection in HIV-Infected and HIV-Uninfected Participants Enrolled in a Multinational Clinical Trial: HPTN 052. J Acquir Immune Defic Syndr 2018; 76:388-393. [PMID: 28749822 DOI: 10.1097/qai.0000000000001511] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Data comparing hepatitis B virus (HBV) infection in HIV-infected [HIV(+)], and HIV-uninfected [HIV(-)] individuals recruited into the same study are limited. HBV infection status and chronic hepatitis B (cHB) were characterized in a multinational clinical trial: HIV Prevention Trials Network (HPTN 052). METHOD HBV infection status at enrollment was compared between HIV(+) (N = 1241) and HIV(-) (N = 1232) from 7 HBV-endemic countries. Hepatitis B e antigen and plasma HBV DNA were determined in cHB. Median CD4, median plasma HIV RNA, and prevalence of transaminase elevation were compared in HIV(+) with and without cHB. Significance was assessed with χ, Fisher exact, and median tests. RESULTS Among all participants, 33.6% had HBV exposure without cHB (8.9% isolated HBV core antibody, "HBcAb"; 24.7% HBcAb and anti-HB surface antibody positive, "recovered"), 4.3% had cHB, 8.9% were vaccinated, and 53.5% were uninfected. Data were similar among HIV(+) and HIV(-) except for isolated HBcAb, which was more prevalent in HIV(+) than HIV(-) [10.1% vs. 7.7%, P = 0.046]. Median HBV DNA trended higher in HIV(+) than in HIV(-). In HIV(+) with cHB versus those without cHB, transaminase elevations were more prevalent (alanine aminotransferase ≤ grade 2, 12% vs. 5.2%, P = 0.037; aspartate aminotransferase ≤ grade 2, 26% vs. 6.0%, P < 0.001), CD4 trended lower, and HIV RNA was similar. CONCLUSIONS HBV infection status did not differ by HIV infection status. HIV co-infection was associated with isolated HBcAb and a trend of increased HBV DNA. In HIV, cHB was associated with mild transaminase elevations and a trend toward lower CD4.
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Tengan FM, Abdala E, Nascimento M, Bernardo WM, Barone AA. Prevalence of hepatitis B in people living with HIV/AIDS in Latin America and the Caribbean: a systematic review and meta-analysis. BMC Infect Dis 2017; 17:587. [PMID: 28836955 PMCID: PMC5571507 DOI: 10.1186/s12879-017-2695-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 08/20/2017] [Indexed: 12/17/2022] Open
Abstract
Background Hepatitis B virus (HBV) infection is a major cause of chronic liver disease worldwide. In immunocompromised patients, the chronicity rates of HBV infection are higher, but the rates of hepatitis Be antigen (HBeAg) and HBsAg loss and seroconversion to anti-HBe and anti-HBs are lower than those in immunocompetent subjects. This study aimed to evaluate articles on the prevalence of HBsAg in people living with human immunodeficiency virus (HIV) /AIDS (PLWHA) in Latin America and the Caribbean (LAC). Methods We searched the PubMed, Latin American and Caribbean Health Sciences, and Embase databases for studies up to November 2016 on infection with HIV and HBV in LAC without period or language restrictions. We did not include case reports, case series, review articles, comments, or studies with a sample size smaller than 100. We also evaluated the quality of the articles using a list of criteria totaling 21 items. Results Of the 28 selected articles (n = 18,457) published from 1999 to 2016, 18 studies (64.3%) were from Brazil, 3 (10.7%) were from Argentina, 2 (7.1%) were from Chile, 2 (7.1%) were from Cuba, 1 (3.6%) was from Colombia, 1 (3.6%) was from Venezuela, and 1 (3.6%) was from Jamaica. The mean score for the assessment of the study quality was 11.6 (range: 8–16). The estimated pooled prevalence of HBsAg among PLWHA in the selected studies was 7.0% (95% CI 7.0–7.0%). The pooled prevalence of HBsAg was 8.0% (95% CI 8.0–9.0%) in the studies published from 1999 to 2006 and 6.0% (95% CI 5.0–6.0%) in the studies published during the later timeframe. Conclusions The results of this review indicate the need to increase the investment in preventive measures against hepatitis B, particularly when the impact of adequate vaccination in this population is considered. Future studies with larger sample sizes are needed in LAC to determine the true prevalence of hepatitis B throughout the region and to clarify and address the risk factors associated with the acquisition of infection. Electronic supplementary material The online version of this article (10.1186/s12879-017-2695-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fatima Mitiko Tengan
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo (Universidade de São Paulo - USP), São Paulo, Brazil. .,Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinical Hospital, School of Medicine, USP, São Paulo, Brazil.
| | - Edson Abdala
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo (Universidade de São Paulo - USP), São Paulo, Brazil.,Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinical Hospital, School of Medicine, USP, São Paulo, Brazil
| | - Marisa Nascimento
- Nursing Division, Clinics Hospital, School of Medicine, USP, São Paulo, SP, Brazil
| | | | - Antonio Alci Barone
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo (Universidade de São Paulo - USP), São Paulo, Brazil.,Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinical Hospital, School of Medicine, USP, São Paulo, Brazil
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Lima K, de Souza Leal É, Cavalcanti AMS, Salustiano DM, de Medeiros LB, da Silva SP, Lacerda HR. Epidemiological, Clinical and Antiretroviral Susceptibility Characterization of Human Immunodeficiency Virus Subtypes B and Non-B in Pernambuco, Northeast Brazil. PLoS One 2016; 11:e0155854. [PMID: 27218259 PMCID: PMC4878750 DOI: 10.1371/journal.pone.0155854] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 05/05/2016] [Indexed: 01/15/2023] Open
Abstract
Background HIV-1 diversity causes important differences in the virus’ biological properties and their interactions with hosts, such as cell tropism, responses to antiretroviral therapy, drug-resistance, and disease progression. Objectives We evaluated the interrelationship of phylogenetic inference with epidemiological and laboratory data for HIV-1 isolates circulating in Pernambuco, Northeast Region—Brazil. Study design A total of 168 HIV-1 pol sequences were analysed, 64 were obtained from 2002–2003, and 104, from 2007–2009. Socio-demographic, clinical, and behavioural data were obtained from medical records. Laboratory testing enabled the determination of recent HIV-1 infections and co-infections with HBV, HCV, HTLV, or syphilis. Surveillance drug-resistance mutation analysis and antiretroviral susceptibility profiling were performed using HIV Drug-Resistance Database. Results HIV-1 non-B was associated with female, lower education, lower viral loads, and higher T cell counts mean. Frequencies of co-infection HIV-HBV, HIV-HCV, and HIV-syphilis were 27.8% (95% CI: 19.8–37.7), 1.04% (95% CI: 0.05–5.00) and 14.7% (95% CI: 8.6–23.0), respectively. Drug-resistant mutations rate was 2.98% (95% CI: 1.10–6.47). HIV-HBV subtype B co-infection was associated with men who have sex with men (MSM), higher education, higher viral loads and males. HIV-syphilis subtype non-B co-infection was associated with MSM status, lower T cell counts and males. Conclusions Data showed the importance of molecular characterisations of the HIV-1 epidemic and its relation with epidemiological and clinical characteristics of the population, as well as its association with other infectious diseases, so they can effort to improve preventive measures for health services and more information about the progress and effects of the epidemic in Northeastern–Brazil.
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Affiliation(s)
- Kledoaldo Lima
- Postgraduate at Department of Tropical Medicine, Federal University of Pernambuco, Recife, Pernambuco, Brazil
- * E-mail:
| | | | | | | | | | | | - Heloísa Ramos Lacerda
- Postgraduate at Department of Tropical Medicine, Federal University of Pernambuco, Recife, Pernambuco, Brazil
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Oliveira MP, Lemes PS, Matos MAD, Del-Rios NHA, Santos Carneiro MA, Costa Silva ÁM, Lopes CLR, Teles SA, Aires RS, Lago BV, Araujo NM, Martins RMB. Overt and occult hepatitis B virus infection among treatment-naïve HIV-infected patients in Brazil. J Med Virol 2016; 88:1222-9. [DOI: 10.1002/jmv.24462] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2015] [Indexed: 12/18/2022]
Affiliation(s)
- Marina Pedroso Oliveira
- Institute of Tropical Pathology and Public Health; Federal University of Goiás (UFG); Goiás Brazil
| | - Pollyanne Sousa Lemes
- Institute of Tropical Pathology and Public Health; Federal University of Goiás (UFG); Goiás Brazil
| | - Márcia Alves Dias Matos
- Institute of Tropical Pathology and Public Health; Federal University of Goiás (UFG); Goiás Brazil
| | | | | | - Ágabo Macedo Costa Silva
- Institute of Tropical Pathology and Public Health; Federal University of Goiás (UFG); Goiás Brazil
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Araújo-Mariz C, Lopes EP, Ximenes RAA, Lacerda HR, Miranda-Filho DB, Montarroyos UR, Barreto S, Salustiano DM, Albuquerque MFPM. Serological markers of hepatitis B and C in patients with HIV/AIDS and active tuberculosis. J Med Virol 2015; 88:996-1002. [PMID: 26580855 DOI: 10.1002/jmv.24432] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2015] [Indexed: 12/16/2022]
Abstract
Infection with hepatitis B virus (HBV) and C virus (HCV) are common in patients with HIV/AIDS and tuberculosis (TB). This is a cross-sectional study with patients infected with HIV/AIDS and active TB in Recife, Brazil, aiming to verify the prevalence of markers for HBV: antibody to hepatitis B core antigen (anti-HBc); and HCV: antibody to hepatitis C virus (anti-HCV) by chemiluminescence, and to identify the frequency of associated factors. Data were collected through questionnaires, and blood was drawn from patients for analysis. We used the chi-square test and the Fisher exact test when necessary. We conducted a bivariate logistic regression analysis and the magnitude of the associations was expressed as odds ratio (OR) with a confidence interval of 95%. Among 166 patients studied with HIV/AIDS and active TB, anti-HBc was positive in 61 patients [36.7%; 95%CI (29.4-44.6%)] and anti-HCV in 11[6.6%; 95%CI (3.4-11.5%)]. In the logistic regression analysis, male sex, and age ≥40 years were independent factors associated with the occurrence of anti-HBc. In conclusion, we verified a high frequency of HBV contact marker and a low frequency of HCV markers in patients with HIV/AIDS and TB in Recife.
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Affiliation(s)
| | - Edmundo Pessoa Lopes
- Departamento de Medicina Tropical, Universidade Federal de Pernambuco, Recife, Brazil
| | - Ricardo A A Ximenes
- Departamento de Medicina Tropical, Universidade Federal de Pernambuco, Recife, Brazil.,Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, Brazil
| | - Heloísa R Lacerda
- Departamento de Medicina Tropical, Universidade Federal de Pernambuco, Recife, Brazil
| | | | | | - Silvana Barreto
- Hospital das Clínicas de Pernambuco, Universidade Federal de Pernambuco, Recife, Brazil
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