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Lingawi HS, Afifi IK. Seroprotection of Hepatitis B Vaccine in Dental Students Two Decades after Infant Immunization and the Possible Need for Revaccination. Eur J Dent 2022; 17:143-149. [PMID: 35436788 PMCID: PMC9949927 DOI: 10.1055/s-0042-1743151] [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] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES This study aimed to assess hepatitis B surface antibody (anti-HBs) persistence among dental students two decades after infant vaccination and immune response after revaccination or booster dose in nonimmune groups. MATERIALS AND METHODS A cross-sectional study was performed using laboratory reports for anti-HBs performed to dental students at the Umm al-Qura University from 2016 to 2020. Reports were classified according to baseline antibody titer into group I (titer <10 mIU/mL), group II (titer 10 to <100 mIU/mL), and group III (titer ≥100 mIU/mL). The basal antibody titer of each group was correlated to student's gender and birth year and compared with postrevaccination or booster dose titer in groups I and II. STATISTICAL ANALYSIS Data of baseline and postrevaccination anti-HBs antibody titers were analyzed using Statistical Package for Social Science (SPSS). One-way ANOVA was used to compare between different means for antibody titers of students as well as baseline and postrevaccination antibody levels for nonimmune students with nonprotective antibody titers. Pairwise multiple comparison of the difference between baseline and postrevaccination anti-HBs antibody titers were done by post hoc Tukey's honestly significant difference (HSD) test. Chi-squared test was used for comparing between the frequencies. A p-Value of ≤0.05 was considered significant and p < 0.01 was considered highly significant. RESULTS A significant percentage (73.6%) of students had antibody titer <10 mIU/mL, while only 4.8% had antibody titer ≥100 mIU/mL with nonsignificant difference between both genders (χ 2 =3.784, p = 0.151). A statistically nonsignificant difference was also found between the three categories of anti-HBs antibody titers among students with different birth dates (χ 2 = 13.817, p = 0.182). After revaccination of nonimmune students, 100% of them showed strongly protective antibody titers with mean of 842.88 to 844.58 mIU/mL. A highly significant difference was observed between the mean baseline and postrevaccination antibody titers in both genders, with a higher mean of post revaccination (p = 0.000). CONCLUSION Two decades after infant immunization, a significant percentage of dental students failed to maintain the anti-HBs seroprotective titer. So titer measurement should be made compulsory before they begin their clinical training and revaccination or booster dose should be given to nonimmune students to maintain a high protection level.
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Affiliation(s)
- Hanadi S. Lingawi
- Preventive Dentistry Department, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia,Address for correspondence Hanadi S. Lingawi, PhD Preventive Dentistry Department, Faculty of Dentistry, Umm Al-Qura UniversityP.O. Box 14405, Makkah 22915Saudi Arabia
| | - Ibtesam K. Afifi
- Basic and Clinical Oral Sciences Department, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia,Department of Medical Microbiology and Immunology, Faculty of Medicine, Tanta University, Tanta, Egypt
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Attitudes toward Vaccinations and Vaccination Coverage Rates among Dental Students in Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052879. [PMID: 35270571 PMCID: PMC8910244 DOI: 10.3390/ijerph19052879] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/26/2022] [Accepted: 02/28/2022] [Indexed: 01/27/2023]
Abstract
Our aim was to study attitudes toward vaccinations, full vaccination rates and susceptibility rates against vaccine-preventable diseases among students attending a University Dental School. A total of 134 students were studied. Full vaccination rates were as follows: 56.5% against measles and mumps, 70.6% against rubella, 32.3% against varicella, 44.1% against hepatitis A, 45.9% against hepatitis B, and 87.7% against COVID-19. In the past decade, 63.2% of students had received a booster shot against tetanus–diphtheria, 47.8% against pertussis, and 28.1% against poliomyelitis, while 29.4% of students had been vaccinated against influenza in the past year. Susceptibility rates were 40.4% for measles, 42.4% for mumps, 28.3% for rubella, 32.3% for varicella, 55.3% for hepatitis A, 54.1% for hepatitis B, 36.8% for tetanus–diphtheria, 52.2% for pertussis, and 71.9% for poliomyelitis. Overall, 123 (91.8%) students favored mandatory vaccinations, mainly for all dentists (88.4%), while 11.6% of students favored them only for dentists who provide care to high-risk patients. In conclusion, most dental students favored mandatory vaccinations, yet we found significant vaccination gaps and susceptibility rates against vaccine-preventable diseases. Vaccinations for dental students should be intensified. A national vaccination registry for healthcare personnel including dental students is urgently needed.
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Sannathimmappa MB, Nambiar V, Arvindakshan R. Hepatitis B: Knowledge and awareness among preclinical year medical students. Avicenna J Med 2021; 9:43-47. [PMID: 31143696 PMCID: PMC6530272 DOI: 10.4103/ajm.ajm_164_18] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background and Objective Hepatitis B is an occupational health hazard to health-care workers. The complete knowledge of hepatitis B virus (HBV) transmission and prevention is indispensable for medical students. This study was conducted to assess the knowledge and awareness of hepatitis B among preclinical year medical students. Materials and Methods This is a descriptive cross-sectional study. A predesigned self-administered questionnaire concerning hepatitis B knowledge and awareness was distributed to all the preclinical year medical students. The data were collected, tabulated, and analyzed by Microsoft Excel and Statistical Package for the Social Sciences (SPSS) software, version 22. The results were expressed in numbers and percentages. Results Of 251 students, only 132 students voluntarily participated in the study. Majority of the students (84.8%) were aware of HBV infection. Many students knew that blood transfusion (81.1%) and use of contaminated needles and syringes (74.2%) are major modes of transmission. However, less than 30% of the students had knowledge about other modes of transmission. More than 50% of the students lacked in their knowledge about clinical features and complications of hepatitis B infection. Majority of students (72.7%) were aware of HBV vaccination. However, many students did not know their vaccination status, whereas only 23.5% of the students were fully immunized. Conclusion This study revealed lack of complete knowledge regarding hepatitis B among preclinical year medical students. They are at high risk of acquiring HBV infection during their clinical practice, later in life. Hence, implementation of well-structured education program in the first year itself is needed to create complete awareness among medical students about hepatitis B.
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Affiliation(s)
- Mohan B Sannathimmappa
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, National University of Science and Technology, Sohar Campus, Sultanate of Oman
| | - Vinod Nambiar
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, National University of Science and Technology, Sohar Campus, Sultanate of Oman
| | - Rajeev Arvindakshan
- Department of Community and Family Medicine, All India Institute of Medical Sciences and Research Centre, Mangalagiri, Andhra Pradesh
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Cordeiro TMSC, Ferreira Filho RP, D'Oliveira Júnior A. Factors associated with occupational and non-occupational viral hepatitis infections in Brazil between 2007-2014. Ann Hepatol 2020; 18:751-756. [PMID: 31153910 DOI: 10.1016/j.aohep.2019.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 02/17/2019] [Accepted: 02/17/2019] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES Viral hepatitis is an endemic and epidemic disease of relevance in public health. This study estimated the frequency of viral hepatitis by occupational and non-occupational infections and analyzed the factors associated with case notifications in Brazil from 2007 to 2014. MATERIAL AND METHODS This was an exploratory epidemiological study using the Notifiable Diseases Information System database. Descriptive and multivariate analyses were performed. RESULTS The frequency of viral hepatitis by occupational infections was 0.7%, of which 1.3% were due to hepatitis A virus (HAV), 45.1% hepatitis B virus (HBV), and 45.3% hepatitis C virus (HCV). There was a significant association of the disease with female sex [AOR=1.31; P=0.048], schooling [AOR=1.71; P<0.001], occupation [AOR=2.74; P<0.001], previous contact with an HBV or HCV-infected patient [AOR=5.77; P<0.001], exposure to accidents with biological materials [AOR=99.82; P<0.001], and hepatitis B vaccination [AOR=0.73; P=0.033]. CONCLUSION While there was a low frequency of viral hepatitis by occupational infections in Brazil from 2007 to 2014, these findings might be underreported and have been associated with individual and occupational characteristics. This reinforces the need for the adoption of prevention strategies in the workplace and for completeness of case notifications.
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Affiliation(s)
- Técia Maria S C Cordeiro
- School of Medicine in Bahia, Post-Graduate Program in Health Sciences, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.
| | - Raymundo P Ferreira Filho
- School of Medicine in Bahia, Post-Graduate Program in Health Sciences, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Argemiro D'Oliveira Júnior
- School of Medicine in Bahia, Post-Graduate Program in Health Sciences, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
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Knowledge, Attitudes, and Practices on Infection Control Measures in Stomatology Students in Lima, Peru. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2018; 2018:8027130. [PMID: 30298091 PMCID: PMC6157180 DOI: 10.1155/2018/8027130] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/06/2018] [Accepted: 08/19/2018] [Indexed: 11/18/2022]
Abstract
Introduction The level of knowledge, attitudes, and practices with respect to infection control measures in undergraduate stomatology students is not well understood; that is why these variables were evaluated in the students of the Universidad Privada San Juan Bautista between September and November of 2017. Methods A cross-sectional study was carried out. A total of 347 students from the Ica, Lima Norte, and Chorrillos campuses were evaluated. The sample was calculated using the statistical formula of comparison of means. The questionnaire of the CDC (Center of Contagious Diseases) was used to measure the variables described. Results It was observed that 72.05% of the students preferred to use oral rinsing before starting a treatment, 72.62% used the autoclave as the primary equipment to sterilize their instruments in the dental clinic, 95.10% considered that isolation is important in the control of the infection, 46.40% affirmed that tuberculosis is the most infectious disease, and only 26.51% considered it to be hepatitis B. On the other hand, it was found that the scores of knowledge, attitudes, and practices were 2.74 ± 2.16, 3.59 ± 0.88, and 3.59 ± 1.73, respectively. Conclusions The level of knowledge was low among the students evaluated; however, as far as the level of practices and attitudes was high, even so, this topic must be reinforced so that stomatology students reflect on the importance of the risks that exist to get infected with any disease inside the dental office, as outside of it.
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Joukar F, Mansour-Ghanaei F, Naghipour MR, Hasandokht T. Nurses' Knowledge toward Hepatitis B and Hepatitis C in Guilan, Iran. Open Nurs J 2017; 11:34-42. [PMID: 28567168 PMCID: PMC5420166 DOI: 10.2174/1874434601711010034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 02/05/2017] [Accepted: 02/13/2017] [Indexed: 12/31/2022] Open
Abstract
Background: Health care workers (HCWs) represent high risk population for viral hepatitis infection. Objectives: This study sought to assess the knowledge of HCWs regarding hepatitis B (HBV) and hepatitis C (HCV) infection. Methods: In a multi-center cross sectional study, all HCWs from eight teaching hospitals were invited to participate in the study and to fill in a self-administered questionnaire. Results: A total of 1008 eligible HCWs have responded to the study. A high proportion of the study participants (55.4% and 52.9%) had unsatisfactory knowledge about HBV and HCV. Mean knowledge score toward HBV was significantly higher among more educated staff, p <0.001 and vaccinated personnel, P=0.02. Majority of responders answered correctly to transmission questions toward HBV and HCV (90% and 80%, respectively). There was statistically significant difference in only transmission domain score between various hospitals (p<0.05). The highest scores were related to surgical hospital. Conclusion: Although more than ninety percent of our participants were educated about HBV and HCV, knowledge about nature of disease, prevention, treatment and vaccine availability was unsatisfactory. Continuous training program toward viral infection is a matter of necessity.
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Affiliation(s)
- Farahnaz Joukar
- Gastrointestinal & Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal & Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Reza Naghipour
- Gastrointestinal & Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Tolou Hasandokht
- Gastrointestinal & Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Rasht, Iran
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Vodanović M, Sović S, Galić I. Occupational Health Problems among Dentists in Croatia. Acta Stomatol Croat 2016; 50:310-320. [PMID: 28275278 DOI: 10.15644/asc50/4/4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
AIM To assess the health status among dentists in Croatia regarding the symptoms of musculoskeletal, dermatological, sight, hearing and neurological disorders. METHODS The anonymous online survey was conducted among 506 Croatian dentists. RESULTS It was found that over 78.18% of the surveyed dentists experienced work related pain in upper back, 76.97% of them in lower back. Work-related skin problems were reported by 29.29% of dentists. Vision problems were reported by 46.87% and hearing problems by 19.03% of participants. Neurological disorders were reported by 15.76% of dentists. CONCLUSION This study is the first to report on the overall health status of Croatian dentists and, unfortunately, it showed undesirable results. Numerous health hazards, increased professional requirements and limited ergonomics in the work environment of Croatian dental practitioners cause various health disorders, and the prevalence of occupational diseases is very high.
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Affiliation(s)
- Marin Vodanović
- - Department of Dental Anthropology, School of Dental Medicine, University of Zagreb; - Department of Dental Medicine, University Hospital Centre Zagreb
| | - Slavica Sović
- - Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Croatia
| | - Ivan Galić
- - University Department of Health Studies, University of Split, Croatia
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Cárdenas-Perea ME, Gómez-Conde E, Santos-López G, Pérez-Contreras I, Díaz-Orea MA, Gándara-Ramírez JL, Cruz Y López OR, Márquez-Domínguez L, Sosa-Jurado F. Hepatitis B surface antibodies in medical students from a public university in Puebla, Mexico. Hum Vaccin Immunother 2016; 12:1857-62. [PMID: 27171749 DOI: 10.1080/21645515.2016.1151587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Although preventable with vaccination, Hepatitis B virus (HBV) infection is a major health concern, with ∼400 million people at risk of developing the chronic form of the disease worldwide. The anti-HBV vaccine consists of a recombinant HBV surface antigen (HBsAg), which induces specific anti-HBs antibodies and confers 95% protection for >20 y. The aim of the present study was to analyze the response to HBV vaccination by measuring anti-HBs antibodies in serum samples from medical students of a public university in Puebla, Mexico. HBV infection markers HBsAg and anti-HBs, were also determined. A total of 201 students were included and vaccination coverage was found at 54%. Overall seropositivity for HBsAg, anti-HBc and anti-HBs determined by ELISA was 0.5%, 1.0% and 47%, respectively. Protective levels of anti-HBs >10 mIU/mL were found in 93.2% of subjects vaccinated with 2 or 3 doses and in 40% of those vaccinated with a single dose; while only 4.8% of unvaccinated subjects were anti-HBs positive. The response to the HBV vaccine was different in each participant, despite similar vaccination scheme. A history of blood transfusion/organ transplant or more than 2 sexual partners was significantly associated with anti-HBc positivity, OR = 399 (p = 0.010) and OR = 19.9 (p = 0.044), respectively. HBV immunization coverage was low in our sample compared with reports from countries with similar HBV prevalence, but anti-HBs in vaccinated individuals were in the expected range. It is important to promote HBV vaccination and awareness among medical students, due to their exposure risk.
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Affiliation(s)
- María Elena Cárdenas-Perea
- a Departamento de Agentes Biológicos , Facultad de Medicina, Benemérita Universidad Autónoma de Puebla (BUAP) , Puebla , México
| | - Eduardo Gómez-Conde
- a Departamento de Agentes Biológicos , Facultad de Medicina, Benemérita Universidad Autónoma de Puebla (BUAP) , Puebla , México
| | - Gerardo Santos-López
- b Laboratorio de Biología Molecular y Virología, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social , Metepec, Atlixco , Puebla , México
| | - Irma Pérez-Contreras
- a Departamento de Agentes Biológicos , Facultad de Medicina, Benemérita Universidad Autónoma de Puebla (BUAP) , Puebla , México
| | - María Alicia Díaz-Orea
- c Departamento de Inmunología , Facultad de Medicina, Benemérita Universidad Autónoma de Puebla (BUAP) , Puebla, Puebla , México
| | - José Luís Gándara-Ramírez
- a Departamento de Agentes Biológicos , Facultad de Medicina, Benemérita Universidad Autónoma de Puebla (BUAP) , Puebla , México
| | - Othón Rafael Cruz Y López
- a Departamento de Agentes Biológicos , Facultad de Medicina, Benemérita Universidad Autónoma de Puebla (BUAP) , Puebla , México
| | - Luis Márquez-Domínguez
- b Laboratorio de Biología Molecular y Virología, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social , Metepec, Atlixco , Puebla , México
| | - Francisca Sosa-Jurado
- b Laboratorio de Biología Molecular y Virología, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social , Metepec, Atlixco , Puebla , México
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Li R, Dong W, He W, Liu Y. Chinese dental students' knowledge and attitudes toward HIV/AIDS. J Dent Sci 2015; 11:72-78. [PMID: 30894949 PMCID: PMC6395151 DOI: 10.1016/j.jds.2015.09.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 08/25/2015] [Indexed: 11/28/2022] Open
Abstract
Background/purpose Oral care is vital to human immunodeficiency virus (HIV)-positive individuals. As future dentists, it is pertinent that dental students have sufficient knowledge and a positive approach toward this disease. The purpose of this study was to assess HIV/AIDS-related knowledge and attitudes among clinical dental students in central China. Materials and methods This survey was conducted on 103 dental students in the final year of a 5-year program. A structured questionnaire with 50 questions examining their knowledge under various categories and 17 questions examining their attitudes toward the disease was employed. Results The survey was completed by 92.2% (95/103) of the students. The results revealed that more than half of the respondents demonstrated a good level of knowledge, although few exhibited an excellent level. The mean scores on knowledge was 79.41 ± 6.3 out of a maximum possible score of 100, and there was no significant difference regarding sex. Despite their good level of knowledge, the majority (93.68%) displayed a negative attitude (nonprofessional attitude) toward HIV/AIDS. Conclusion These findings might help to define strategies to improve the quality of education among Chinese dental students and suggests that there is a need to address student misconceptions and attitudes toward the disease.
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Affiliation(s)
- Rui Li
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, PR China
| | - Wenhang Dong
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, PR China
| | - Wei He
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, PR China
| | - Yiming Liu
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, PR China
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Levels of anti-HBs antibody in HBV-vaccinated students enrolled in the faculty of medicine, dentistry and health professions of a large Italian University. BIOMED RESEARCH INTERNATIONAL 2015; 2015:712020. [PMID: 25629052 PMCID: PMC4299313 DOI: 10.1155/2015/712020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 05/28/2014] [Accepted: 06/16/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Prophylaxis against hepatitis B virus (HBV) addressed to students of the faculties of health professions has received great attention. Objectives. The present study aims to assess vaccination coverage against hepatitis B in healthcare professionals in training. MATERIALS AND METHODS A retrospective study was carried out using data from the students of medicine, dentistry, and health professions. RESULTS 4180 vaccination certifications were examined through the internal database. Significant differences (<0.0001) emerge between the number of doses applied and the antibody level. 50.4% of the students have nonprotective antibody levels (<10 IU). The age of the first dose significantly influences the level of coverage, resulting in more coverage in those vaccinated with earlier onset (1-10 years). Antibody levels are not significantly different by type of course; the levels of noncoverage are present in 44.4% of the students of medicine and dentistry and in 50.6% among those belonging to the health professions. CONCLUSIONS This study represents one of the first experiences in Italy on vaccination against HBV and the relationship between doses of vaccination and antibody titer in the biomedical students that can configure a step forward in the real-time monitoring in order to establish a register of vaccination.
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Chen EQ, Bai L, Chen LL, Zhou TY, Du LY, Tang H. Prolonged Combination Therapy is More Effective than Monotherapy in Management of Chronic Hepatitis B Patients With Sustained Virological Response: An Experience From a 'Real-World' Clinical Setting. IRANIAN RED CRESCENT MEDICAL JOURNAL 2013; 15:e7788. [PMID: 24693412 PMCID: PMC3955527 DOI: 10.5812/ircmj.7788] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 09/25/2013] [Accepted: 10/29/2013] [Indexed: 02/05/2023]
Abstract
BACKGROUND Little is known about the duration of combination therapy for patients with chronic hepatitis B (CHB) and suboptimal response to nucleos(t)ide analogues(NAs) monotherapy. OBJECTIVES This study aimed to assess whether monotherapy could be used for treatment of CHB patients, who poorly responded to Adefovir Dipivoxil (ADV) but obtained good responses after at least 12-month lamivudine (LAM) or telbivudine (LdT) add-on therapy. PATIENTS AND METHODS Forty-five patients were enrolled, and the baseline time-point was determined according to enrollment data. Twenty-six patients chose to continue combination therapy (LAM+ADV or LdT+ADV, Group A) and 19 patients switched to single-drug maintenance therapy (LAM or LdT or ADV, Group B). RESULTS There were no significant differences between two groups in baseline characteristics (P > 0.05). At 12th month, sustained virological response rate was greater in group A compared to group B (96.2% vs. 47.4%, P < 0.001), and the rates of NAs-associated resistance were 0% in group A and 15.8% in group B. Alanine aminotransferase normalization rate was also significantly higher in group A compared with group B (92.3% vs. 36.8%, P < 0.001). Among hepatitis positive patients with Be antigen (HBeAg)-, 40% (4/10) in group A and 9.1% (1/11) in group B achieved HBeAg seroconversion at the 12th month. Of patients in group B with positive-HBeAg before the previous combination therapy and detectable HBV DNA at 6 months of previous combination therapy were associated with high risks of viral relapse after switching to single-drug maintenance therapy. CONCLUSIONS Prematurely switching to single-drug maintenance therapy would be resulted in viral relapse, and prolonged combination therapy was effective to maintain sustained responses for patients with initial suboptimal response to ADV.
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Affiliation(s)
- En Qiang Chen
- Center of Infectious Diseases, West China Hospital, Sichuan University, China
- Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University, China
| | - Lang Bai
- Center of Infectious Diseases, West China Hospital, Sichuan University, China
- Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University, China
| | - Lan Lan Chen
- Center of Infectious Diseases, West China Hospital, Sichuan University, China
- Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University, China
| | - Tao You Zhou
- Center of Infectious Diseases, West China Hospital, Sichuan University, China
- Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University, China
| | - Ling Yao Du
- Center of Infectious Diseases, West China Hospital, Sichuan University, China
- Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University, China
| | - Hong Tang
- Center of Infectious Diseases, West China Hospital, Sichuan University, China
- Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University, China
- Corresponding Author: Hong Tang, Center of Infectious Diseases, West China Hospital, Sichuan University, China. Tel: + 86-2885422650, E-mail:
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