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Alkhalifah RH, Alhaddad MJ, Alhashem AT, Alwesaibi H, AlKhalaf AA, Albin Saad A, Almattar M, Alkhalaf MA, Alramadhan H, Albaggal M. Prevalence of Hepatitis B Virus, Hepatitis C Virus, and HIV Infections in Hemodialysis Patients at Kano Kidney Center. Cureus 2023; 15:e41769. [PMID: 37449288 PMCID: PMC10337696 DOI: 10.7759/cureus.41769] [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] [Accepted: 07/12/2023] [Indexed: 07/18/2023] Open
Abstract
Background Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections are more prevalent in hemodialysis patients compared to the general population. The objective of this study was to evaluate the prevalence of HBV, HCV, and HIV infections in hemodialysis patients dialyzing regularly at Kano Kidney Center (KKC) in the Eastern Health Cluster of Saudi Arabia in 2022. Methods This retrospective study included all hemodialysis patients who were dialyzed regularly at KKC during 2022. Their electronic medical records were reviewed for the results of HBV, HCV, and HIV along with the patient's demographics, comorbid conditions, and dialysis history. The study was approved and monitored by the Institutional Review Board of Dammam Medical Complex. Results A total of 239 regular hemodialysis patients were included, consisting of 142 males and 97 females (59.41% and 40.59%, respectively), with a mean age of 52.71±15.83 years. Most of the patients were Saudis (156 patients, 65.27%) with the non-Saudi patients being composed mostly of Arabian patients. Nine patients (3.77%) tested positive for hepatitis B surface antigen (HBsAg), the serologic hallmark of HBV infection. Two patients (0.84%) had resolved HBV infections as evidenced by positive hepatitis B core antibody (anti-HBc) and hepatitis B surface antibody (anti-HBs). However, the majority (226 patients, 94.56%) were never tested for anti-HBc. Anti-HBs, which can imply long-term immunity against HBV from prior immunizations or infections, were positive in 165 patients (69.04%). A protective anti-HBs level of ≥ 10 IU/L was detected in 158 patients (66.11%) including 104 patients (43.51%) having ≥ 100 IU/L. Eighteen patients (7.53%) had reactive HCV antibodies. Four patients (1.67%) had chronic HCV infection as they had detectable HCV RNA. The remaining 14 patients (5.86%) cleared HCV either spontaneously (seven patients, 2.93%) or by medications (seven patients, 2.93%). HIV screening tests were negative in all 239 patients (100%). HBsAg-positive patients did not have any statistically significant differences from HBsAg-negative patients. On the other hand, the patients who were positive for HCV antibodies were older than the patients who were negative for HCV antibodies (60.66 vs 52.05 years on average, p-value <0.05). They also contained a statistically larger proportion of non-Saudi patients than the patients with no evidence of prior infections (61.11% vs 32.13%, p-value <0.05). Conclusions The study found that the prevalence of HBV and HCV infections among hemodialysis patients in KKC at 3.77% and 1.67%, respectively, is higher than that reported in the general population in Saudi Arabia, with non-Saudis having a higher prevalence rate of HCV infection than Saudis. However, the current prevalence rate is lower compared to the previous studies that were conducted in Saudi Arabia in the first decade of the 21st century, and there were no cases of HIV infections. Nevertheless, a significant proportion of patients had unprotective or negative anti-HBs antibody titers, indicating the need for strict vaccination protocols and monitoring of antibody titers to ensure optimal protection.
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Affiliation(s)
| | - Mousa J Alhaddad
- Department of Internal Medicine, Dammam Medical Complex, Dammam, SAU
| | - Ali T Alhashem
- Department of Internal Medicine, Dammam Medical Complex, Dammam, SAU
| | - Hussain Alwesaibi
- Department of Internal Medicine, Dammam Medical Complex, Dammam, SAU
| | | | | | - Mohammed Almattar
- Department of Internal Medicine, Dammam Medical Complex, Dammam, SAU
| | - Makarem A Alkhalaf
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | - Habib Alramadhan
- Nephrology, Kano Kidney Center, Dammam Medical Complex, Dammam, SAU
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Gulmez R, Ozbey D, Agbas A, Aksu B, Yildiz N, Uckardes D, Saygili S, Yilmaz EK, Yildirim ZY, Tasdemir M, Kiykim A, Cokugras H, Canpolat N, Nayir A, Kocazeybek B, Caliskan S. Humoral and cellular immune response to SARS-CoV-2 mRNA BNT162b2 vaccine in pediatric kidney transplant recipients compared with dialysis patients and healthy children. Pediatr Nephrol 2022:10.1007/s00467-022-05813-w. [PMID: 36459243 PMCID: PMC9716124 DOI: 10.1007/s00467-022-05813-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/10/2022] [Accepted: 10/31/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Compared with the general population, the immune response to COVID-19 mRNA vaccines is lower in adult kidney transplant recipients (KTRs). However, data is limited for pediatric KTRs. In this study, we aimed to assess humoral and cellular immune responses to the COVID-19 mRNA vaccine in pediatric KTRs. METHODS This multicenter, prospective, case-control study included 63 KTRs (37 male, aged 12-21 years), 19 dialysis patients, and 19 controls. Humoral (anti-SARS-CoV2 IgG, neutralizing Ab (nAb)) and cellular (interferon-gamma release assay (IGRA)) immune responses were assessed at least one month after two doses of BNT162b2 mRNA vaccine. RESULTS Among COVID-19 naïve KTRs (n = 46), 76.1% tested positive for anti-SARS-CoV-2 IgG, 54.3% for nAb, and 63% for IGRA. Serum levels of anti-SARS-CoV-2 IgG and nAb activity were significantly lower in KTRs compared to dialysis and control groups (p < 0.05 for all). Seropositivity in KTRs was independently associated with shorter transplant duration (p = 0.005), and higher eGFR (p = 0.007). IGRA titer was significantly lower than dialysis patients (p = 0.009). Twenty (43.4%) KTRs were positive for all immune parameters. Only four of 11 seronegative KTRs were IGRA-positive. COVID-19 recovered KTRs had significantly higher anti-SARS-CoV-2 IgG and nAb activity levels than COVID-19 naïve KTRs (p = 0.018 and p = 0.007, respectively). CONCLUSIONS The humoral and cellular immune responses to SARS-CoV-2 mRNA BNT162b2 vaccine are lower in pediatric KTRs compared to dialysis patients. Further prospective studies are required to demonstrate the clinical efficacy of the mRNA vaccine in KTRs. This prospective study was registered in ClinicalTrials.gov (NCT05465863, registered retrospectively at 20.07.2022). A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Ruveyda Gulmez
- grid.506076.20000 0004 1797 5496Department of Pediatric Nephrology, Cerrahpasa School of Medicine, IU-Cerrahpasa, Istanbul, Turkey
| | - Dogukan Ozbey
- grid.506076.20000 0004 1797 5496Department of Microbiology, Cerrahpasa School of Medicine, IU-Cerrahpasa, Istanbul, Turkey
| | - Ayse Agbas
- Department of Pediatric Nephrology, Cerrahpasa School of Medicine, IU-Cerrahpasa, Istanbul, Turkey.
| | - Bagdagul Aksu
- grid.9601.e0000 0001 2166 6619Department of Pediatric Nephrology, Istanbul University School of Medicine, Istanbul, Turkey ,grid.9601.e0000 0001 2166 6619Institute of Child Health, Istanbul University, Istanbul, Turkey
| | - Nurdan Yildiz
- grid.16477.330000 0001 0668 8422Department of Pediatric Nephrology, Marmara University School of Medicine, Istanbul, Turkey
| | - Diana Uckardes
- grid.411776.20000 0004 0454 921XDepartment of Pediatric Nephrology, Medeniyet University School of Medicine, Istanbul, Turkey
| | - Seha Saygili
- grid.506076.20000 0004 1797 5496Department of Pediatric Nephrology, Cerrahpasa School of Medicine, IU-Cerrahpasa, Istanbul, Turkey
| | - Esra Karabag Yilmaz
- grid.506076.20000 0004 1797 5496Department of Pediatric Nephrology, Cerrahpasa School of Medicine, IU-Cerrahpasa, Istanbul, Turkey
| | - Zeynep Yuruk Yildirim
- grid.9601.e0000 0001 2166 6619Department of Pediatric Nephrology, Istanbul University School of Medicine, Istanbul, Turkey
| | - Mehmet Tasdemir
- grid.459708.70000 0004 7553 3311Department of Pediatric Nephrology, Istinye University School of Medicine, Liv Hospital, Istanbul, Turkey
| | - Ayca Kiykim
- grid.506076.20000 0004 1797 5496Department of Pediatric Immunology and Allergy, Cerrahpasa School of Medicine, IU-Cerrahpasa, Istanbul, Turkey
| | - Haluk Cokugras
- grid.506076.20000 0004 1797 5496Department of Pediatric Immunology and Allergy, Cerrahpasa School of Medicine, IU-Cerrahpasa, Istanbul, Turkey
| | - Nur Canpolat
- grid.506076.20000 0004 1797 5496Department of Pediatric Nephrology, Cerrahpasa School of Medicine, IU-Cerrahpasa, Istanbul, Turkey
| | - Ahmet Nayir
- grid.9601.e0000 0001 2166 6619Department of Pediatric Nephrology, Istanbul University School of Medicine, Istanbul, Turkey ,Department of Pediatric Nephrology, Memorial Hospital, Istanbul, Turkey
| | - Bekir Kocazeybek
- grid.506076.20000 0004 1797 5496Department of Microbiology, Cerrahpasa School of Medicine, IU-Cerrahpasa, Istanbul, Turkey
| | - Salim Caliskan
- grid.506076.20000 0004 1797 5496Department of Pediatric Nephrology, Cerrahpasa School of Medicine, IU-Cerrahpasa, Istanbul, Turkey
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Kolland M, Riedl R, Bachler B, Ribitsch W, Niedrist T, Meissl AM, Rosenkranz AR, Kirsch AH. OUP accepted manuscript. Nephrol Dial Transplant 2022; 37:1188-1190. [PMID: 35137203 PMCID: PMC9383466 DOI: 10.1093/ndt/gfac031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Michael Kolland
- Department of Internal Medicine, Division of Nephrology, Medical University of Graz, Graz, Austria
| | - Regina Riedl
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Bernhard Bachler
- Department of Internal Medicine, Division of Nephrology, Medical University of Graz, Graz, Austria
| | - Werner Ribitsch
- Department of Internal Medicine, Division of Nephrology, Medical University of Graz, Graz, Austria
| | - Tobias Niedrist
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Anna-Maria Meissl
- Department of Internal Medicine, Division of Nephrology, Medical University of Graz, Graz, Austria
| | - Alexander R Rosenkranz
- Department of Internal Medicine, Division of Nephrology, Medical University of Graz, Graz, Austria
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Chen JJ, Lee TH, Tian YC, Lee CC, Fan PC, Chang CH. Immunogenicity Rates After SARS-CoV-2 Vaccination in People With End-stage Kidney Disease: A Systematic Review and Meta-analysis. JAMA Netw Open 2021; 4:e2131749. [PMID: 34709385 PMCID: PMC8554642 DOI: 10.1001/jamanetworkopen.2021.31749] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/27/2021] [Indexed: 01/12/2023] Open
Abstract
Importance Adults receiving dialysis treatment have a higher likelihood of death when infected with SARS-CoV-2 than adults not receiving dialysis treatment. To date, the immune response of people receiving dialysis after SARS-CoV-2 vaccination has not been systematically discussed. Objective To assess immunogenicity rates in people with end-stage kidney disease (ESKD) receiving SARS-CoV-2 vaccines, explore postvaccination potential risk factors for nonresponse, and assess whether receiving dialysis is associated with different antibody response rates compared with the nondialysis population. Data Sources This systematic review and meta-analysis used articles from PubMed, Medline, and Embase published before July 30, 2021, as well as articles in the medRxiv preprint server. Study Selection Studies that evaluated the immunogenicity rate according to the postvaccine antibody response rate in patients with ESKD receiving dialysis were selected. Data Extraction and Synthesis The meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. A random-effects model was used. Two independent reviewers conducted the literature search and extracted the data. Main Outcomes and Measures The primary outcome was the pooled antibody postvaccine response rates in individuals with ESKD. The secondary outcomes were pooled response rates in individuals receiving and not receiving dialysis. Subgroup analysis and meta-regression were conducted to identify the sources of heterogeneity. Results A total of 32 studies were included. The overall immunogenicity rate of the dialysis group was 86% (95% CI, 81%-89%). Meta-regression showed a significant difference was detected in the postvaccine response rate on the basis of prevalence of diabetes (regression coefficient, -0.06; 95% CI, -0.10 to -0.02; P = .004). Compared with nondialysis controls, patients in the dialysis group had a lower response rate after the first (relative risk [RR], 0.61; 95% CI, 0.47-0.79; I2 = 70.2%) and second (RR, 0.88; 95% CI, 0.82-0.93; I2 = 72.2%) doses, with statistically significantly increased RR between first and second doses (P = .007). Conclusions and Relevance These findings suggest that the immunogenicity rate among patients receiving dialysis was 41% after the first dose and 89% after the second dose. Diabetes might be a risk factor for nonresponse in the dialysis population. Patients receiving dialysis had a poorer antibody response rate than did individuals not receiving dialysis, particularly after the first dose.
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Affiliation(s)
- Jia-Jin Chen
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Tao Han Lee
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ya-Chung Tian
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Cheng-Chia Lee
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Pei-Chun Fan
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chih-Hsiang Chang
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan
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Yao T, Wu Y, Dong S, Gao L, Shi S, Shao Z, Wu L, Feng D, Shi J, Zhang Y, Feng Y, Liang X, Wang S. Long-term durability of immunogenicity induced by standard and triple-dose hepatitis B vaccine in patients receiving methadone maintenance treatment. Expert Rev Vaccines 2020; 19:785-794. [PMID: 32815759 DOI: 10.1080/14760584.2020.1813577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES We explored the long-term immunogenicity induced by 60 μg and 20 μg hepatitis B vaccines among patients receiving methadone maintenance treatment (MMT). METHODS In initial study, a randomized controlled trial was conducted, in which patients receiving MMT were administered 20 µg (IM20 group) or 60 µg (IM60 group) hepatitis B vaccines at months 0, 1, and 6. In this study, the responders at month 7 were followed-up at months 18, 30, and 42 to estimate long-term immunogenicity. RESULTS The response rate decreased from 78.0% (39/50) to 31.1% (14/45) in the IM20 group, and from 86.0% (43/50) to 50.0% (20/40) in the IM60 group from month 7 to 42. Vaccine-induced responses in 75% of patients were observed for 14.2 months in the IM20 group and for 20.0 months in the IM60 group, and differences between these two groups were non-significant (P > 0.05). CONCLUSION The three-dose 20 µg and 60 µg hepatitis B vaccines showed similar rapid hepatitis B surface antibody decreases. Abbreviations: HBV, hepatitis B virus; MMT, methadone maintenance treatment; HCC, hepatocellular carcinoma; HBsAg, hepatitis B surface antigen; anti-HBs, hepatitis B surface antibody; HR, hazard ratio; CI, confidence interval; IQR, interquartile range; GEE, generalized estimated equation.
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Affiliation(s)
- Tian Yao
- School of Public Health, Shanxi Medical University , Taiyuan, Shanxi, PR China
| | - Yuanting Wu
- School of Public Health, Shanxi Medical University , Taiyuan, Shanxi, PR China
| | - Shuang Dong
- School of Public Health, Shanxi Medical University , Taiyuan, Shanxi, PR China
| | - Linying Gao
- School of Public Health, Shanxi Medical University , Taiyuan, Shanxi, PR China
| | - Shan Shi
- Methadone Maintenance Treatment Clinic, Nanning Red Cross Hospital , Nanning, Guangxi, PR China
| | - Zhihong Shao
- School of Public Health, Shanxi Medical University , Taiyuan, Shanxi, PR China
| | - Lina Wu
- School of Public Health, Shanxi Medical University , Taiyuan, Shanxi, PR China
| | - Dan Feng
- School of Public Health, Shanxi Medical University , Taiyuan, Shanxi, PR China
| | - Jing Shi
- School of Public Health, Shanxi Medical University , Taiyuan, Shanxi, PR China
| | - Yawei Zhang
- Yale School of Public Health , New Haven, CT, USA
| | - Yongliang Feng
- School of Public Health, Shanxi Medical University , Taiyuan, Shanxi, PR China
| | - Xiaofeng Liang
- Chinese Preventive Medicine Association , Beijing, PR China
| | - Suping Wang
- School of Public Health, Shanxi Medical University , Taiyuan, Shanxi, PR China
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Evaluation of a hepatitis B virus protection intervention among interns at Zagazig University Hospitals, Egypt. Infect Dis Health 2019; 25:50-59. [PMID: 31767401 DOI: 10.1016/j.idh.2019.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 07/27/2019] [Accepted: 10/17/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Hepatitis B virus (HBV) infection is the most common serious liver infection. The study aimed to evaluate the effect of a HBV protection intervention on interns, as regards their knowledge, attitude and immune response to HB vaccine and to identify the factors affecting their compliance and immune response to HB vaccination at Zagazig University Hospitals. METHODS A quasi-experimental study was conducted in 3 phases over 10 months. Phase 1: assessment of knowledge, attitude and HCV/HBV immune status. Phase 2: the implementation of HBV protection campaign; vaccine administration and health education sessions. Phase 3: the assessment of the immune response to the vaccine and the change in knowledge and attitude. RESULTS Out of 120 participants, 60% were compliant to the vaccination schedule. Needle-stick injury, the seriousness of HBV infection and attendance of infection control courses are the motivating factors to vaccination (p < 0.05). After the 3rd dose, 9.7% were non-responders. BMI and diabetes were the statistically significant predictors of the immune response. The HCWs compliant with vaccination schedule had higher mean scores regarding; total knowledge (15.5 ± 2.1), p < 0.0001 and attitude (14.34 ± 3.8) p < 0.05. A significant improvement is recorded from the posttest results, p < 0.000. CONCLUSIONS A comprehensive protective program against HBV is an effective tool. A compulsory vaccination program is still needed for interns. Post vaccination monitoring program, including protective measures for vaccine non responders is urgently needed with strict follow up of at risk groups. Occult HBV cases should not be overlooked when screening for immune response to vaccine.
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Erdoğdu Hİ, Atalay E, Gürsoy G, Canbakan B, Aktürk S, Yazıcı C, Yücel O, Mersin S, Üçer S, Merhametsiz Ö, Öner C, Erat M. Factors affecting inadequate response to HBV vaccine in hemodialysis patients: northeast anatolia survey with six hemodialysis centers. Clin Exp Nephrol 2018; 23:530-536. [PMID: 30488288 DOI: 10.1007/s10157-018-1676-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 11/16/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND In hemodialysis patients Hepatitis B virus (HBV) infection is one of the problems. Because of HBV vaccine response is lower than in the general population, in this study it is aimed to determine the factors that may cause inadequate HBV vaccine response in hemodialysis patients. METHODS In study, HBsAg, anti-HBs, anti-HBc IgG data belonging to 278 patients were obtained from file and computer records. It was seen that seronegative cases had been given recombinant HBV vaccine. Anti-HBs titers were monitored 1 month after vaccination was completed. According to this, the patients are divided into two groups. Those with anti-HBs < 10 IU/mL were identified as non-responders and with anti-HBs ≥ 10 IU/mL as responders. Factors such as age, serum albumin and urea reduction rate which may affect inadequate response to HBV vaccine were evaluated. As statistical examination, Chi-square test was used for the analysis of the data determined by counting, and logistic regression was used for statistically significant independent variables in chi-square test. p value of < 0.05 was considered statistically significant (Confidence interval: 95%). RESULTS Out of 278 patients, according to exclusion criteria 81 patients were excluded. 13.2%(26/197) of HBV vaccinated patients had insufficient response. The inadequate response rate to HBV vaccination was found to be higher in patients with age ≥ 65 (p = 0.039), serum albumin < 3.5 g/dL (p = 0.024) and urea reduction rate ≤ 65 (p = 0.028). No statistically significant relationship was found between inadequate response to HBV vaccine and anti-HCV positivity, presence of diabetes mellitus, anemia status, vitamin D therapy and vascular access pathway variability. CONCLUSION We conclude that relatively high patient age, low albumin level and insufficient urea reduction rate may cause inadequate HBV vaccine response. Taking these factors into consideration may provide a useful insight for an adequate response to vaccination.
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Affiliation(s)
- Halil İbrahim Erdoğdu
- Department of Internal Medicine, Health Research Center, Kafkas University, Kars, Turkey.
| | - Eray Atalay
- Department of Internal Medicine, Health Research Center, Kafkas University, Kars, Turkey
| | - Gül Gürsoy
- Department of Internal Medicine and Endocrinology, Kafkas University, Kars, Turkey
| | - Başol Canbakan
- Department of Internal Medicine and Neprology, Kafkas University, Kars, Turkey
| | - Serkan Aktürk
- Department of Hemodialysis and Nephrology, Kars Harakani State Hospital, Kars, Turkey
| | - Canan Yazıcı
- Departement of Internal Medicine, Ardahan State Hospital, Ardahan, Turkey
| | - Orhan Yücel
- Department of Hemodialysis and Nephrology, Kars Harakani State Hospital, Kars, Turkey
| | - Sinan Mersin
- Department of Internal Medicine, Kartal Lütfi Kırdar Education and Research Hospital, Istanbul, Turkey
| | - Sengül Üçer
- Department of Clinical Microbiology and Infectious diseases, Kafkas University, Kars, Turkey
| | - Özgür Merhametsiz
- Department of Hemodialysis and Nephrology, Iğdır State Hospital, Iğdır, Turkey
| | - Can Öner
- Department of Family Medicine, Kartal Lütfi Kırdar Education and Research Hospital, Istanbul, Turkey
| | - Merve Erat
- Department of Internal Medicine, Health Research Center, Kafkas University, Kars, Turkey
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Meriki HD, Tufon KA, Anong DN, Tony NJ, Kwenti TE, Bolimo AF, Kouanou YS, Nkuo-Akenji T. Vaccine uptake and immune responses to HBV infection amongst vaccinated and non-vaccinated healthcare workers, household and sexual contacts to chronically infected HBV individuals in the South West Region of Cameroon. PLoS One 2018; 13:e0200157. [PMID: 30011286 PMCID: PMC6047772 DOI: 10.1371/journal.pone.0200157] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 06/20/2018] [Indexed: 12/18/2022] Open
Abstract
Background HBV infection affects about 257 million people globally and Sub-Saharan Africa has the highest burden. The disease still constitutes a major public health problem despite the advent of preventive measures like the HBV vaccine. This study was aimed at identifying factors that influence vaccine uptake and the efficacy of administered vaccines among people at high risk of HBV infection. Methods This was a cross-sectional study conducted between January 2016 and December 2017. A pretested semi-structured questionnaire was used to capture information on sociodemographic and vaccination status from healthcare workers, household and sexual contacts to HBV infected people. HBV serological panel as well as quantitative anti-HBs ELISA test was done for all participants. Additional information was obtained from the institutions that administered the vaccines. Results A total of 265 participants with a mean age of 32.1±8.7 were enrolled. Eighty (30.2%) of them had received at least 1 dose of the HBV vaccine while 185 (69.8%) were unvaccinated. Healthcare workers were the most vaccinated (37%). Ignorance, negligence, fear of injection and the cost of the vaccine all contributed to poor vaccine uptake in the study population. Natural immunity was seen in 9 (3.4%) of the participants. Only 64.9% of the vaccinated participants attained the desirable level of anti-HBs (≥10mIU/ml) 1–2 months after ≥ 3 doses of the vaccine. Age, gender, obesity, alcohol and smoking were not significantly associated with poor immune responses. No standardized protocol was followed by the institutions administering the vaccine. Conclusion This study revealed very poor vaccine uptake and poor immune responses to the HBV vaccine in the study population and this should urge the health sector in Cameroon to intensify their sensitization on HBV vaccine, standardize the protocol for storing and administering the vaccine, subsidize the cost of the vaccine especially amongst healthcare workers and encourage anti-HBs post vaccination testing.
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Affiliation(s)
- Henry Dilonga Meriki
- Department of Microbiology and Parasitology, University of Buea, Buea, South West Region, Cameroon
- Buea Regional Hospital, Buea, Southwest Region, Cameroon
- Department of Public health and Hygiene, Faculty of Health science, University of Buea, Buea, Southwest Region, Cameroon
| | - Kukwah Anthony Tufon
- Department of Microbiology and Parasitology, University of Buea, Buea, South West Region, Cameroon
- Buea Regional Hospital, Buea, Southwest Region, Cameroon
- * E-mail:
| | - Damian Nota Anong
- Department of Biological Science, Faculty of Science, University of Bamenda, Bamenda, North West Region, Cameroon
| | - Nyeke James Tony
- Department of Microbiology and Parasitology, University of Buea, Buea, South West Region, Cameroon
| | - Tebit Emmanuel Kwenti
- Department of Microbiology and Parasitology, University of Buea, Buea, South West Region, Cameroon
- Buea Regional Hospital, Buea, Southwest Region, Cameroon
- Department of Public health and Hygiene, Faculty of Health science, University of Buea, Buea, Southwest Region, Cameroon
- Department of Medical Laboratory Science, Faculty of Health science, University of Buea, Buea, Southwest Region, Cameroon
| | | | | | - Theresa Nkuo-Akenji
- Department of Biological Science, Faculty of Science, University of Bamenda, Bamenda, North West Region, Cameroon
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Khatami M. Cancer; an induced disease of twentieth century! Induction of tolerance, increased entropy and 'Dark Energy': loss of biorhythms (Anabolism v. Catabolism). Clin Transl Med 2018; 7:20. [PMID: 29961900 PMCID: PMC6026585 DOI: 10.1186/s40169-018-0193-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 05/29/2018] [Indexed: 12/15/2022] Open
Abstract
Maintenance of health involves a synchronized network of catabolic and anabolic signals among organs/tissues/cells that requires differential bioenergetics from mitochondria and glycolysis (biological laws or biorhythms). We defined biological circadian rhythms as Yin (tumoricidal) and Yang (tumorigenic) arms of acute inflammation (effective immunity) involving immune and non-immune systems. Role of pathogens in altering immunity and inducing diseases and cancer has been documented for over a century. However, in 1955s decision makers in cancer/medical establishment allowed public (current baby boomers) to consume million doses of virus-contaminated polio vaccines. The risk of cancer incidence and mortality sharply rose from 5% (rate of hereditary/genetic or innate disease) in 1900s, to its current scary status of 33% or 50% among women and men, respectively. Despite better hygiene, modern detection technologies and discovery of antibiotics, baby boomers and subsequent 2–3 generations are sicker than previous generations at same age. American health status ranks last among other developed nations while America invests highest amount of resources for healthcare. In this perspective we present evidence that cancer is an induced disease of twentieth century, facilitated by a great deception of cancer/medical establishment for huge corporate profits. Unlike popularized opinions that cancer is 100, 200 or 1000 diseases, we demonstrate that cancer is only one disease; the severe disturbances in biorhythms (differential bioenergetics) or loss of balance in Yin and Yang of effective immunity. Cancer projects that are promoted and funded by decision makers are reductionist approaches, wrong and unethical and resulted in loss of millions of precious lives and financial toxicity to society. Public vaccination with pathogen-specific vaccines (e.g., flu, hepatitis, HPV, meningitis, measles) weakens, not promotes, immunity. Results of irresponsible projects on cancer sciences or vaccines are increased population of drug-dependent sick society. Outcome failure rates of claimed ‘targeted’ drugs, ‘precision’ or ‘personalized’ medicine are 90% (± 5) for solid tumors. We demonstrate that aging, frequent exposures to environmental hazards, infections and pathogen-specific vaccines and ingredients are ‘antigen overload’ for immune system, skewing the Yin and Yang response profiles and leading to induction of ‘mild’, ‘moderate’ or ‘severe’ immune disorders. Induction of decoy or pattern recognition receptors (e.g., PRRs), such as IRAK-M or IL-1dRs (‘designer’ molecules) and associated genomic instability and over-expression of growth promoting factors (e.g., pyruvate kinases, mTOR and PI3Ks, histamine, PGE2, VEGF) could lead to immune tolerance, facilitating cancer cells to hijack anabolic machinery of immunity (Yang) for their increased growth requirements. Expression of constituent embryonic factors would negatively regulate differentiation of tumor cells through epithelial–mesenchymal-transition and create “dual negative feedback loop” that influence tissue metabolism under hypoxic conditions. It is further hypothesized that induction of tolerance creates ‘dark energy’ and increased entropy and temperature in cancer microenvironment allowing disorderly cancer proliferation and mitosis along with increased glucose metabolism via Crabtree and Pasteur Effects, under mitophagy and ribophagy, conditions that are toxic to host survival. Effective translational medicine into treatment requires systematic and logical studies of complex interactions of tumor cells with host environment that dictate clinical outcomes. Promoting effective immunity (biological circadian rhythms) are fundamental steps in correcting host differential bioenergetics and controlling cancer growth, preventing or delaying onset of diseases and maintaining public health. The author urges independent professionals and policy makers to take a closer look at cancer dilemma and stop the ‘scientific/medical ponzi schemes’ of a powerful group that control a drug-dependent sick society before all hopes for promoting public health evaporate.
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Affiliation(s)
- Mahin Khatami
- Inflammation, Aging and Cancer, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA.
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Kosmadakis G, Albaret J, Correia EDC, Somda F, Aguilera D. Vaccination practices in dialysis patients: A narrative review. Semin Dial 2018; 31:507-518. [PMID: 29742283 DOI: 10.1111/sdi.12709] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In a period of turmoil concerning vaccination practices, there is a serious conflict between scientifically reasonable, evidence-based guidelines and the far-fetched rumors or misconceptions concerning the vaccination practices in the general population. When a significant portion of the medical and paramedical personnel may be deliberately unvaccinated against common biological agents, achieving effective vaccination rates in the dialysis population may be complicated. Vaccination rates are unacceptably low in dialysis patients and seroconversion rates are even lower; further, serological follow-up is generally poor. The particularly anergic immune system of the advanced chronic kidney disease patients is partly a cause of both high rates of infection and low rates of seroconversions. This narrative review is an effort to summarize current knowledge concerning the vaccination practices in dialysis patients with some specific recommendations based on these facts. Of particular interest is a new vaccine, the Zoster Recombinant, Adjuvanted Vaccine (Shingrix), which we will include in our discussion.
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Affiliation(s)
- Georges Kosmadakis
- Hemodialyis Unit and Pole Metabolique, Centre Hospitalier Jacques Lacarin, Vichy, France
| | - Julie Albaret
- Hemodialyis Unit and Pole Metabolique, Centre Hospitalier Jacques Lacarin, Vichy, France
| | | | - Frederic Somda
- Hemodialyis Unit and Pole Metabolique, Centre Hospitalier Jacques Lacarin, Vichy, France
| | - Didier Aguilera
- Hemodialyis Unit and Pole Metabolique, Centre Hospitalier Jacques Lacarin, Vichy, France
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11
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Feng Y, Shi X, Shi J, Gao L, Liu G, Cheng Y, Pan M, Li C, Wang J, Guo X, Zhang Y, Liang X, Wang S. Immunogenicity, antibody persistence, and safety of the 60 μg hepatitis B vaccine in hemodialysis patients: a multicenter, randomized, double-blind, parallel-controlled trial. Expert Rev Vaccines 2017; 16:1045-1052. [PMID: 28803502 DOI: 10.1080/14760584.2017.1367667] [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] [Indexed: 02/07/2023]
Abstract
BACKGROUND To evaluate the immunogenicity, antibody persistence, and safety of the 60 µg hepatitis B vaccine in hemodialysis patients in China. METHODS We conducted a multicenter, randomized, double-blind, parallel-controlled trial including 352 hemodialysis patients who were centrally randomized in a ratio of 1:1 to receive a 20 µg (IM20 group) or 60 µg (IM60 group) recombinant hepatitis B vaccine at months 0, 1, and 6. RESULTS The vaccine-elicited antibody responses peaked at month 7, and declined at month 12. At month 7, the IM60 group had stronger GMC of anti-HBs, and a higher proportion of seroconversion and high-level response than the IM20 group did (P < 0.05). Better immune responses were observed in the IM60 group, especially for those aged or in the high-frequency hemodialysis population. CONCLUSION The high dose 60 µg recombinant hepatitis B vaccines elicited stronger immune responses than the 20 µg hepatitis B vaccine did among hemodialysis patients. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, number NCT02963714.
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Affiliation(s)
- Yongliang Feng
- a School of Public Health , Shanxi Medical University , Taiyuan , Shanxi , PR China
| | - Xiaohong Shi
- a School of Public Health , Shanxi Medical University , Taiyuan , Shanxi , PR China
| | - Jing Shi
- a School of Public Health , Shanxi Medical University , Taiyuan , Shanxi , PR China
| | - Linying Gao
- a School of Public Health , Shanxi Medical University , Taiyuan , Shanxi , PR China
| | - Guangming Liu
- b Clinical Laboratory , Heping Hospital of Changzhi Medical College , Changzhi , Shanxi , PR China
| | - Yanpeng Cheng
- a School of Public Health , Shanxi Medical University , Taiyuan , Shanxi , PR China
| | - Minghu Pan
- a School of Public Health , Shanxi Medical University , Taiyuan , Shanxi , PR China
| | - Chunxia Li
- a School of Public Health , Shanxi Medical University , Taiyuan , Shanxi , PR China
| | - Jun Wang
- a School of Public Health , Shanxi Medical University , Taiyuan , Shanxi , PR China
| | - Xuxia Guo
- b Clinical Laboratory , Heping Hospital of Changzhi Medical College , Changzhi , Shanxi , PR China
| | - Yawei Zhang
- c Department of Surgery , Yale School of Medicine , New Haven , CT , USA
| | - Xiaofeng Liang
- d National Immunization Program, Chinese Center for Disease Control and Prevention , Beijing , PR China
| | - Suping Wang
- a School of Public Health , Shanxi Medical University , Taiyuan , Shanxi , PR China
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Borgia G, Maraolo AE, Gentile I. Hepatitis B mother-to-child transmission and infants immunization: we have not come to the end of the story yet. Infect Dis (Lond) 2017; 49:584-587. [PMID: 28316268 DOI: 10.1080/23744235.2017.1303746] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Guglielmo Borgia
- a Department of Clinical Medicine and Surgery, Section of Infectious Diseases , University of Naples 'Federico II' , Naples , Italy
| | - Alberto Enrico Maraolo
- a Department of Clinical Medicine and Surgery, Section of Infectious Diseases , University of Naples 'Federico II' , Naples , Italy
| | - Ivan Gentile
- a Department of Clinical Medicine and Surgery, Section of Infectious Diseases , University of Naples 'Federico II' , Naples , Italy
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