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Sharma, Aditya. "Cost-effectiveness of Hepatitis A and Hepatitis B Vaccination for Jail Inmates." Yale University, 2008. http://ymtdl.med.yale.edu/theses/available/etd-08272007-114829/.
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Despite evidence that viral hepatitis poses a significant risk to public health, universal vaccination has not yet been implemented. The risk for viral hepatitis infection is particularly high among injection drug users and other individuals who do not attend regular health care visits. Jails provide a structural opportunity to vaccinate these high risk individuals. HAV and HBV vaccines administered on an accelerated three week schedule could dramatically decrease the lifetime risk for contracting viral hepatitis among jail detainees. Assuming that 75% of detainees would accept vaccination, 33% have previous exposure to HAV, 25% have previous exposure to HBV, and independent future healthcare costs were US $317,000, the US health care system would save $12 per individual with a vaccinate upon entry program in comparison to no intervention. This savings translates into an economic benefit amounting to about US$ 5,000,000 saved if all new jail inmates in a given year were immunized. A vaccination upon entry program for HAV/HBV in jails should be widely implemented with coordination between the corrections system and public health agencies to reduce the growing cost of viral hepatitis infection.
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Dannetun, Eva. "Reasons for non-vaccination /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-739-1/.
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Zhu, Sheng, and 朱晟. "Effect of the health belief model in explaining HBV screening and vaccination health behaviour : a systematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193831.
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Objectives
To systematically review all studies HBV screening and vaccination health behaviour according to the Health Belief Model theoretical framework including perceived susceptibility, severity, barriers and benefits, cues to action and self-efficacy.
Methodology
The literature search used PUBMED, MEDLINE, CINAHL plus, Wan Fang database, and Chinese Journal Net with English and Chinese language. About 73 studies (PUBMED: 33 MEDLINE: 10, CINAHL plus: 3, Wan Fang database: 16, Chinese journal net: 11) in total were identified; after applying the inclusion and exclusion criteria, 11 studies met the criteria and in the final analysis. The target group included high infection rate groups (pregnant women, unprotected sexual behaviour, and immigrant group) and illness groups (chronic Hepatitis B and Hepatitis B virus carriers).
Results and Discussion
HBV screening and vaccination behaviour were determined by perceived the susceptibility, perceived severity, perceived barriers and benefits, and cues to action. The self-efficacy was seldom designed in the questionnaire of the reviewed articles. The Health belief model was a useful model for explaining HBV screening and vaccination behaviour. Screening- and vaccination-related beliefs of the screening and vaccination vary by high risk groups. From the review more attention to self-efficacy and perceived control may improve vaccination uptake. There were contrast results with the social economic characteristics, such as age, gender, income, in determining the HBV screening and vaccination behaviour.
Conclusion and Implication
As the policy maker, health care providers need to develop specific interventions paying attention to the different aspects of the Health Belief Model to improve the perceived of Hepatitis B virus.published_or_final_version
Public Health
Master
Master of Public Health
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Karthigesu, Vassandra Devi. "A study of hepatitis B virus variation and antigenic variants." Thesis, Royal Veterinary College (University of London), 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.309416.
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Radix, Jane. "Hepatitis B vaccination as a component of routine adult care." Thesis, Teachers College, Columbia University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3621790.
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Though hepatitis B virus infection is vaccine preventable, it remains a leading cause of serious liver disease including cirrhosis and hepatocellular carcinoma. With more than 2 million individuals living in the United States chronically infected, increasing the adult vaccination rate, currently estimated at only 26.3% based on large patient self-report surveys, is a public health imperative. Primary care visits represent an opportunity to assess hepatitis B risk and vaccination status, and to administer vaccine.
The purpose of the study was to determine the factors that affect primary care physician recommendation and delivery of hepatitis B vaccine as part of routine adult care, and measure vaccination rate in the primary care setting. A survey was developed, validated and completed online by a random sample of 319 physicians who provide routine primary care for >100 adult patients each month. Adult hepatitis B vaccination rate was calculated based on physician-reported caseload and number of vaccinations administered over a 6 month period. In addition to practice descriptors, 24 survey items assessed physician knowledge, attitudes and practices related to vaccination rate.
Statistical analyses were conducted using SPSS software. The median and mean vaccination rates were 3.3% and 9.4%, respectively. Vaccination rates were highest among physicians practicing medicine for <10 years, in private hospital settings located in urban areas. Vaccination significantly correlated (p<.05) with routine assessment of hepatitis B risk, guidelines-based vaccination, and distribution of patient education materials. Focusing on history of intravenous drug use as the key indication for vaccination and concerns regarding related liability were found to be barriers to vaccination. Forward multiple linear regression analysis generated a model that predicted 26% of variance in vaccination rate, which suggested that physicians who have integrated risk assessment, discussion of vaccination rationale with patients, and vaccine delivery into their routine primary care practices exhibit higher vaccination rates.
The results suggest that adult hepatitis B vaccination rates may be increased through physician education that reinforces identification of CHB risk factors other than intravenous drug use and clarifies the limited nature of vaccine injury liability, as well as health policies that incentivize vaccination in the primary care setting.
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Baars, J. E. "Hard to reach? Hepatitis B vaccination among high-risk groups." [S.l.] : [The Author], 2009. http://hdl.handle.net/1765/14434.
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Ohlson, Emilia, and Frida Bladh. "Knowledge about hepatitis B and attitudes towards hepatitis B vaccination among university students in Thailand : A quantitative study." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-272494.
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Introduction: Hepatitis B is a highly contagious infection. Basic knowledge about hepatitis B is necessary; with more knowledge people take preventive actions against hepatitis B, such as using stick proof cannulas. In Thailand an expected number of 8-20% of the population are currently carriers of the HBV infection. Aim: The aim of the study was to investigate the knowledge about hepatitis B and the attitudes towards the vaccination among Thai university students. Method: A cross-sectional study with a quantitative method was used. 280 students participated in the study, and the response rate was 93.9 %. The data was analysed using SPSS Statistics 20. Result: Both genders had poor knowledge about hepatitis B, however 91.1 % of the students had heard about hepatitis B. About half of the students (55.4 %) knew correctly that hepatitis B is sexually transmitted and 40.0 % of the students knew that hepatitis B could cause liver cancer. There was no significant difference in knowledge between the genders. The attitudes towards the vaccine were satisfactory between both genders, 89.3 % of the students knew that healthy people need the vaccination and 81.1 % believed that they would receive the vaccination. However, only 43.6 % knew that the vaccination could be free or low cost through certain programs. There was a significant difference (p-value = 0.042) between the genders; the male students had a more positive attitude towards the vaccine than the female students. Conclusion: The results from the Thai students showed that more information about the Hepatitis infection is needed to raise awareness among this certain group of people. Information about how it is transmitted is essential to improve the public health. It is also important to improve the individual's self-care, to encourage them to receive the vaccination. From a nursing point of view improving the knowledge about HBV and a positive attitude towards the vaccine in the prolonging contribute to improve the public health by getting a lower rate of cases with HBV.
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Siriyasatien, Padet. "An assessment of hepatitis B vaccine delivery by transgenic Aedes aegypti mosquitoes." Thesis, University of Liverpool, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367187.
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Lu, Qiuying Sandy, and 呂秋瑩. "Health economic evaluation of universal infant hepatitis B vaccination programmes in China." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/207183.
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Introduction: China has about 120 million hepatitis B virus (HBV) carriers and a 7.2% hepatitis B surface antigen (HBsAg) prevalence in 2006.This creates a huge disease burden and also leads to significant economic losses. Since 2002, a free universal infant hepatitis B vaccination programme has provideda 3-dose primary vaccination for all infants. Although some economic evaluations of this programme have been conducted, a comprehensive cost-effectiveness analysis (CEA) to estimate long-term benefit using mathematical modeling would aid understanding of population strategies for hepatitis B control in large populations. Moreover, the most common mode of infection is perinataltransmission at birth. However the more effective immunization programme involving screening women during pregnancy for HBV-carrier status and providing passive-active vaccination for newborns has not been implemented in China.
Aims: To identify the most cost-effective universal infant hepatitis B vaccination strategy for China.
Method: A hospital-based survey was conducted during 2010-2011 in a general hospital in Shenzhen, China, in order to obtain costing data to estimate the economic burden of chronic hepatitis B patients. Annual direct and indirect costs from this study were used as cost parameters in the CEA models. Mathematical models were developed to simulate perinatal transmission, vaccination programmes and disease progression using Markov modeling and decision trees. Quality-adjusted life year (QALYs) as well as health and monetary outcomes were also assessed. Univariate sensitivity analysis and probabilistic sensitivity analysis using Monte Carlo simulation were performed to test parameter uncertainty. Two programmes of screening of pregnant women for both HBsAg and/or HBeAg and the infant passive-active vaccination were compared with the current vaccine-only programme in one CEA, while the other CEA estimated the effect of the current infant programme compared with no vaccination.
Findings: The estimated total economic burden including annual direct and indirect cost among hepatitis B patients of RMB 43104.5 (US$6340.8). The economic burdens of associated disease states of hepatitis B infection were highest for hepatocellular carcinoma (HCC) (RMB 77297.1), decompensated cirrhosis (RMB 50725.7), chronic active hepatitis B (CAH) (RMB 37449.5) and finally compensated cirrhosis (RMB 37276.9). The average total economic burden per hepatitis B patient amounted to 46% of Shenzhen GDP per capitain 2010, and 5.4% of the city’s annual per capita income. The current vaccine-only infant vaccination programme was justified by costsavings, from both a societal and health care payer’s perspective, reducing new HBV infections by about 76%. This has produced a gain of 743,000 life-years and 620,000 QALYs given current numbers and savings of US$2~3billion saved over the lifetime of a national cohortof 10,000,000 newborns. A universal control programme involving the screening of pregnant women for HBsAg and passive-active vaccination, would reduce new infections by 13%, saving 436,000 life years and gaining 121,000 QALYs for a saving of about US$546 million compared with current vaccine-only programme.
Implications: The universal infant hepatitis B vaccination programme is currently a cost-effective strategy for hepatitis B control in China.A beneficial amendment to the current strategy wouldinclude screening of all pregnant women for HBsAg and vaccinating newborns in a passive-active way.published_or_final_version
Public Health
Doctoral
Doctor of Philosophy
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Mureithi, John Gachagua. "Hepatitis B vaccination policies and coverage for nurse working at public and private hospitals in Tshwane, South Africa." Thesis, University of Limpopo (Medunsa Campus), 2009. http://hdl.handle.net/10386/248.
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Thesis (MPH)--University of Limpopo, 2009.BACKGROUND AND AIM: Hepatitis B virus (HBV) is the major cause of hepatitis in South Africa (SA), with an estimated 4 million carriers. It is transmitted by infected blood and other body fluids, placing health care workers (HCWs) at high risk of infection. The SA Department of Health strongly recommends that all HCWs be vaccinated against HBV, but studies have shown that uptake of the vaccine is sub-optimal. This study aimed to estimate HB vaccination coverage levels among nurses, and describe the demographics and characteristics of the HB vaccination policies associated with different levels of coverage, at private and public hospitals in Tshwane. METHODS: This was a questionnaire-based cross-sectional study on 300 randomly selected nurses and 12 chief infection control officers (CICOs) from 13 hospitals (6 public and 7 private) in Tshwane performing high risk procedures. CICOs were asked questions about HB vaccination policies and coverage, while nurses were asked about demographics, HB vaccination status, and the HB vaccination policies of their institutions. RESULTS: The response rate was 84.3% (253/300) for nurses, and 75% (9/12) for CICOs. Of the nurses, 68.0% (172/253) were vaccinated, and logistic regression analysis found that those statistically significantly most likely to be vaccinated were: 30 years and younger (odds ratio [OR]=2.9; 95% CI: 1.11–7.59); employed in private hospitals (OR=3.0; 95% CI: 1.24–7.32); and graduated after 1990 (OR=2.6; 95% CI: 1.10–6.19). Also, logistic regression analysis found two statistically significant policy-related predictor for vaccination uptake, which was the presence of HB vaccination program (OR=4.6; 95% CI: 2.11-10.06); and compulsory HB vaccination (OR=2.8; 95% CI: 1.37-5.70. CONCLUSION: There is a need for a national policy on HB vaccination of HCWs which should include compulsory vaccination, to increase the vaccination coverage level amongst nurses.
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Cardell, Kristina. "Studies on Hepatitis B Vaccination and Factors Associated withthe Vaccine Response." Doctoral thesis, Linköpings universitet, Infektionsmedicin, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-20800.
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Hepatitis B virus causes liver disease and up to 2 billion people have been in contact with the virus world wide. It can cause both acute and chronic disease. The routes for transmission are through blood, mother to infant at time of delivery and sexually. Chronic hepatitis B infection is a risk factor for development of liver cirrhosis and hepatocellular carcinoma. Prevention of hepatitis B virus infection is highly desirable. Since the early1980s hepatitis B vaccine has been available. It can effectively prevent the disease and has been found to be safe. The World Health Organisation, WHO, has recommended all countries to implement the vaccine in their children’s vaccination programmes and many countries have followed this recommendation. In Sweden so far the recommendation is vaccination of identified risk groups for hepatitis B. Health care workers who are at risk of having blood contact in their work is one such risk group. In a large study on health care workers who were intradermally vaccinated with the hepatitis B vaccine, 960/1406 (68.3%) developed protective levels of antibodies to HBsAg (anti-HBs; defined as >10 mIU/mL) after three doses. After administering of an additional fourth dose to non-responders the response rate was 1187/1335 (88.9%). Risk factors for non-response were smoking and age above 40 years. Also, the vaccine response rates improved during the study and a risk of giving a too small dose with intradermal administration was also identified. This suggests that intradermal administration is dependent on well trained personnel. A genetic factor which has been proposed to be associated with a non-responder status to HBV vaccination is the HLA haplotype of the host. In a study in on 69 responders and 53 non-responders the haplotypes were therefore determined. It was found that [DQB1*0602; DQA1*0102; DR15] and [DQB1*0603; DQA1*0103; DRB1*1301] were more likely to be found in responders (p<0.025 and p<0.05 respectively). In non-responders the haplotype [DQB1*0604; DQA1*0102; DRB1*1302] was found more frequently (p<0.005). This study supports that the HLA class II of the host is involved in the ability to respond to the HBV vaccination. To further test the genetic link between the HLA of the host and a non-responder status, relatives to known intradermal non-responders with known haplotypes for DQA1, DQB1 and DRB1 were vaccinated in the same way, intradermally. The response rate in the relatives was 15/26 (58%) which is lower than expected suggesting a genetic influence on the vaccine response. In this study 5/6 with the haplotype [DQB1*0604; DQA1*0102; DRB1*1302] were non-responders which is in line with the previous data that this haplotype is correlated to hepatitis B vaccine non-response. Finally, to test a strategy by which we could induce an effective anti-HBs seroconversion in non-responders we revaccinated these with the combined hepatitis A and B vaccine intramuscularly at a double dose. Already after the first revaccination dose 26/44 (60%) responded with protective antibodies compared to 2/20 (10%) in a vaccine naïve reference group, suggesting an anamnestic response. After three doses 42/44 (95%) responded in the non-responder group and 20/20 (100%) in the reference group. All participants in the study responded to the hepatitis A antigen. In conclusion these studies show that intradermal vaccine administration can be used and is effective, and that the ability to respond is influenced by several, including genetic, factors. Importantly a non-responder status to hepatitis B vaccination is not absolute, a double dose of the combined HAV and HBV vaccine effectively overcomes this non-response in most individuals.
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Smith, Jennifer. "Viral diversity and dynamics of hepatitis C virus." Thesis, University of Oxford, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.559853.
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Complex patterns of HCV infection are increasingly reported, particularly in highly exposed individuals, with multiple and variable subtype profiles seen in many chronic patients. This study aims to address some of the questions arising from this increasingly diverse and dynamic picture, both within hosts and at a population level. In Chapter 2 I find evidence for a highly dynamic infection profile in acute HCV, both in terms of viral load and the dominant subtype. I extrapolate these observations from individual patients to formulate a model of HCV transmission across a high-risk population in order to predict the impact of current and anticipated interventions in Chapters 3 and 4. I show that antiviral therapy and a putative vaccination can still have a significant impact on HCV prevalence at the population level, even when the latter offers only partial protection and in the epidemiological background of ongoing exposure. Thus, in an epidemic with more than one circulating strain it will be crucial for any individual or combination of interventions to target all variants present. In Chapter 5 I demonstrate that early viral load kinetics of patients initiating treatment are indicative of treatment outcome. Strain differences are also evident in the virologic response to treatment with hard-to-treat genotype 1 exhibiting a slower rate of viral load decline than genotypes 2 and 3.
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Mastrodomenico, Jessica. "An Examination of the Socio-Demographic Characteristics Associated with Adult Vaccination Prevalence for Preventable Diseases in the United States." Digital Archive @ GSU, 2010. http://digitalarchive.gsu.edu/iph_theses/93.
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JESSICA MASTRODOMENICO
An Examination of the Socio-Demographic Characteristics Associated with Adult Vaccination Prevalence for Preventable Diseases in the United States
Background: An estimated 50,000 adults in the United States (U.S.) die each year from one of 10 vaccine preventable diseases. For those who survive vaccine preventable infections, health care costs and loss of income become more significant. While children in the U.S. aged 0-2 exhibit vaccine prevalence rates of almost 90%, some adult vaccine prevalence rates in the U.S. population are reported to be nearly 30-40% less than the goals set forth by Healthy People 2010. The purpose of this study was to examine the associations between socio-demographic characteristics of U.S. adults and adult vaccination prevalence for pneumococcal, hepatitis A, hepatitis B, tetanus, and pertussis.
Methods: Data from the 2008 National Health Interview Survey were assessed examining various health indicators and characteristics of non-institutionalized adults and children. The sample was restricted to adults ≥18 years of age. Odds ratios were calculated and multivariate logistic regression was also conducted. P-values of <0.05 and 95% confidence intervals were used to determine statistical significance.
Results: There were 21781 total observations; 19.3% received the pneumococcal vaccine, 9.4% received the hepatitis A vaccine, 27.2% received the hepatitis B vaccine, 55.1% received the tetanus vaccine, and 15.2% received the pertussis vaccine. Of the socio-demographic characteristics examined, age, health insurance, marital status, and education were significant for either all five or at least four of the vaccines included in this study. As one might expect those who reported health insurance and those who had a higher level of education usually had a higher likelihood of vaccine receipt as compared to those without health insurance and those with less than a high school education. Age associations varied due to age-related recommendations for certain vaccines such as pneumococcal (recommended for adults ≥65). Compared to the married population (referent), marital status results varied, but for reasons unclear. Whites, the referent group, were the most likely to be vaccinated as compared to Blacks, Hispanics/Latinos, and Asians. Hispanics/Latinos typically had the lowest likelihood of vaccination in this examination.
Conclusions: This study further explores the impact of socio-demographic disparities on vaccination status and adds new information to the literature regarding adult vaccination rates for preventable diseases. While research exists related to strengthening interventions such as patient reminder systems, those who do not see the same health care providers on a regular basis remain at risk for lower vaccination prevalence. It is important to better understand the role of social determinants of health, specifically in terms of vaccinations. Future research is needed to further characterize the association of socio-demographic factors with receipt of optional vaccines in adults.
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Wald, Alexandra, Lea Deterding, Melanie Maier, Uwe G. Liebert, Thomas Berg, Hubert Wirtz, and Johannes Wiegand. "Hepatitis B vaccination in end-stage pulmonary disease patients evaluated for lung transplantation." Universitätsbibliothek Leipzig, 2016. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-205791.
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Background: In times of limited organs for transplantation, anti-HBc positive organs can be accepted for lung transplantation to increase the number of donors. Transplant recipients should be vaccinated against hepatitis B to prevent HBV infection. However, response after HBV vaccination has only been poorly evaluated in patients with end-stage pulmonary disease. Material/Methods: Anti-HBs titers of 40 anti-HBc negative patients with end-stage pulmonary disease evaluated for lung transplantation were analyzed with the Architect® system (Abbott, Germany). Responders, partial responders, or non-responders after HBV vaccination were defined by anti-HBs titers >100 IU/L, 10–100 IU/L, and <10 IU/L, respectively. Results: There were 34/40 individuals (85%) vaccinated against hepatitis B, and 6 were not vaccinated. Response, partial response, and non-response after vaccination were observed in 10/34 (29.4%), 11/34 (32.4%), and 13/34 (38.2%) of patients, respectively. Response to vaccination did not correlate with sex, pulmonary disease, comorbidities, immunosuppressive therapy, or smoking status. Conclusions: Although 85% of patients evaluated for lung transplantation were vaccinated against hepatitis B, 38.2% did not show an anti-HBs titer >10 IU/L. Thus, anti-HBs titers should be regularly monitored. Nonresponders should be considered for booster vaccinations, alternative vaccination schedules, or prophylactic treatment with a nucleos(t)ide analogue in case of transplantation of an anti-HBc–positive organ.
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De, La Hoz Fernando. "Hepatitis B vaccination in the Columbian Amazon : effectiveness and factors influencing vaccine coverage." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2003. http://researchonline.lshtm.ac.uk/1544171/.
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A vaccination coverage survey was carried out in the Colombian Amazon, a former high endemic area for hepatitis B, involving 3573 children less than II years old. It was carried out in Leticia, Puerto Narifio, and Araracuara, both urban and rural areas. Children were selected using a one stage cluster sampling, randomly selecting clusters in urban and rural areas where all children under 11 were surveyed. At the same time blood samples were taken from all children with known vaccination status (n=1603), and from their mother, when she was available (n=8l2). These samples were processed for hepatitis B surface antigen (HBsAg), antibodies to hepatitis B core antigen (Anti-HBc) and antibodies to HBsAg (Anti- HBs). A sample of children without vaccination data available was also bled to compare their results with those of children with vaccination data. Full vaccination coverage was found to range between 39% and 69% among different areas while hepatitis B vaccination ranged between 73% and 95%. Factors which improve the likelihood of being fully vaccinated in this study were: Age above one year, living in Leticia, being. affiliated to the social security, mother's years of schooling. Health worker's knowledge on vaccine contraindications and perceptions of logistical barriers against vaccination or importance of hepatitis B as a public health problem were also related to full vaccine coverage. Prevalence of hepatitis B infection reached 5% among those who were bled (8211603) while HBsAg positive status was 1.6% (26/1603). Since the introduction of the vaccine prevalence of hepatitis B infection has fallen from 40%, an 85% reduction, while carrier prevalence has fallen from 5%, a 68% reduction. Age above 7 years, living in a rural area, birth delivery supervised by other than a MD or nurse, and being born from an Anti-HBc+ mother were the most important general factors related to being infected with HBV. Having an incomplete schedule for hepatitis B vaccine was associated with an increase in the risk of being Anti- HBc or HBsAg+. However, some characteristics of the vaccination process were related to being HBsAg+/Anti-HBc+. Delays in receiving the first dose of hepatitis B after birth and delays to receiving the second dose after the first dose were associated with an increased risk of being HBsAg+/Anti-HBc+. None of these characteristics were related to being Anti-Hlic+ alone. In conclusion, the introduction of a recombinant Cuban manufactured hepatitis B vaccine has produced a marked decline in the high infection prevalence of children in the Colombian Amazon area. A higher coverage has been achieved from the beginning of the program though intervals from birth to first dose and between doses are too long leading to new infections that could have been avoided. There is still room to make improvements in the control program, including the implementation of a surveillance system of the HBV serological status for pregnant women, in order to ensure better vaccination schemes for those born to infected or HBsAg+ mothers.
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Лисенко, Н. А., Андрій Олегович Сніцар, Микола Дмитрович Чемич, Николай Дмитриевич Чемич, Mykola Dmytrovych Chemych, Ірина Олександрівна Троцька, Володимир Вікторович Рябіченко, et al. "Реалізація програми "Антигепатит" на 2007-2011 роки у Сумській області: досягнення та проблеми." Thesis, Вид-во СумДУ, 2010. http://essuir.sumdu.edu.ua/handle/123456789/3781.
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Dahlström, Elin, and Viberg Ellinor Funegård. "Knowledge about hepatitis B virus infection and attitudes towards hepatitis B virus vaccination among Vietnamese university students in Ho Chi Minh City : – A quantitative study." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-200430.
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Introduktion: Hepatit B är ett virus med hög smittsamhet som är orsak till den vanligaste leversjukdomen globalt. I Vietnam är prevalensen av hepatit B hög.Syfte: Att undersöka vietnamesiska universitetsstudenters kunskap om hepatit B och attityder till hepatit B vaccination, samt att undersöka om det fanns någon skillnad mellan könen.Metod: En kvantitativ tvärsnittsstudie med hjälp av en enkät. Studien genomfördes på University of Medicine and Pharmacy i Ho Chi Minh City. Förstaårsstudenter på sjuksköterske- och medicinsk teknikprogrammet valdes ut och 233 studenter fyllde i enkäten korrekt och inkluderades i studien.Resultat: Majoriteten av studenterna (95,3%) hade hört om hepatit B viruset (HBV) innan studien ägde rum. Fler än hälften av studenterna (55,4%) visste att HBV inte sprids genom att dela mat med en infekterad person, och 58,4% visste att HBV kan orsaka levercancer. Endast 47,6% visste att HBV är sexuellt överförbart och 39,5% visste att HBV kan smitta från mor till barn perinatalt. Fler manliga studenter än kvinnliga visste att HBV kan överföras genom att dela tandborste med en infekterad person (p= 0,026). Majoriteten av studenterna (93,1%) trodde att de skulle vaccineras mot HBV i framtiden.Slutsats: Studenterna visade att de hade kunskap i ämnet, men studien visar också på en viss brist på kunskap, som är allvarlig. Förbättrad utbildning om HBV är nödvändigt för att vietnamesiska universitetsstudenter ska utöka sin kunskap om HBV.Introduction: The hepatitis B virus is highly contagious and causes the world’s most common liver infection. Vietnam is a country where the endemicity of hepatitis B is high.Aim: To investigate Vietnamese university students’ knowledge about hepatitis B infection and attitudes towards hepatitis B virus vaccination and to examine if there is a difference between genders.Method: A cross-sectional study with quantitative method using a questionnaire. The study was carried out at the University of Medicine and Pharmacy in Ho Chi Minh City. First year students from the nursing and medical technician programme were selected and 233 students completed the questionnaire and were included in the study.Result: The majority of the university students (95.3%) had heard about hepatitis B virus (HBV). More than half (55.4%) knew correctly that HBV can not be transmitted by sharing food with an infected person, and 58.4% knew that HBV can cause liver cancer. Only 47.6% knew that HBV can be sexually transmitted and 39.5% knew that HBV can be transmitted from mother to child at birth. More male than female students answered correctly that HBV can be transmitted by sharing a toothbrush with an infected person (p= 0.026). Almost all students (93.1%) thought that they would receive HBV vaccination.Conclusion: The students showed insight into the subject, but the result also showed some gaps of knowledge among the university students considered as serious. Improved education about HBV is necessary for university students to increase their knowledge about HBV.
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Wright, Conschetta. "Determinants of Hepatitis B Vaccination among Adults in the United States: NHANES 1999-2006." VCU Scholars Compass, 2009. http://scholarscompass.vcu.edu/etd/1732.
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Purpose: The primary objective of this study was to estimate the prevalence of vaccination and HBV infection status of adults and to evaluate the trend in self reported vaccination and seroprevalence for Hepatitis B for this population. Additionally, this study sought to assess the association between vaccination rates, seroprevalence (HBsAg, anti-HBc, and anti-HBs), demographic (age, gender, location of birth, race/ethnicity), and socioeconomic (annual household income, education level, insurance coverage and access to care, marital status) characteristics. Methods: Eight years, 1999-2006, of the National Health and Nutrition Examination Survey (NHANES) data were used. NHANES participants aged 20-59 years who contributed data via the household interview and laboratory component were eligible for this study. Two sources of vaccination status were available. The vaccination status was identified through self-report. Those who answered yes to “less than three doses” and “at least three doses” were classified as vaccinated. Vaccination status was also verified through serologic markers. All analyses were weighted to consider the complex weighting scheme and adjusted to the 2000 US census population. Vaccination rates were calculated for both low and high risk populations. 95% confidence intervals (95% CI) of each estimate were also calculated. The association between potential predictors of vaccination (demographic variables, socioeconomic status, high risk, and health care access and utilization variables) and vaccination status was assessed using bivariate analysis. We used logistic regression model to obtain odds ratios and their 95% confidence intervals for the association between predictor variables and vaccination status after adjusting for all potential confounding factors. Results: Vaccinated adults were more likely to be female, younger (20-29), Non-Hispanic white, married, born in the United States, have some education beyond high school, have a household income greater than $20000, health insurance coverage, a source of usual medical care, report a health status of good or higher, be non-smokers, and have no history of alcohol abuse. High risk adults comprised about 16% of adults who had received at least one dose of the Hepatitis B vaccine. Unvaccinated adults were more likely to be male, over the age of 40, Non-Hispanic white, born in the United States, married, have some education beyond high school, have a household income greater than $20,000, live in a household of 6 or fewer people, have health insurance coverage, and a source of usual care. When comparing the self reported vaccination status with serologic status, almost half of the adults who reported receiving all three doses of the vaccine tested negative for immunity. For all adults the prevalence increased from 23.4% to 39.1%. Compared to adults in 1999-2000, adults were twice as likely to report vaccination in 2005-2006 (OR=2.1 95% CI [1.77, 2.49]). Conclusions: Although, hepatitis B vaccination rates are rising, only 32% of high risk adults are vaccinated. The rise in vaccination rates in young adults is mostly related to childhood immunization strategies and not strategies aimed at adults. Older males, those with less than high school education, without health insurance coverage and a source of usual care were least likely to be vaccinated. More targeted interventions are needed to educate and vaccinate the adult population and to create a means for identifying those at risk and those already vaccinated.
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Yeung, Man Mandy, and 楊敏. "Nurse-led evidence based (hepatitis B) vaccination programme for nurses in the out-patient department." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46583518.
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Hartlage, Alex S. "T CELL IMMUNITY IN A SMALL ANIMAL SURROGATE OF HEPATITIS C VIRUS INFECTION." The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1584101091684162.
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Salem, Hanaa A. "Design and evaluation of a hepatitis B immunization program for pharmacy students." Scholarly Commons, 1992. https://scholarlycommons.pacific.edu/uop_etds/2226.
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The objectives of this study are: (1) To compare the effectiveness of two dosing schedules of hepatitis B vaccine in achieving compliance within the vaccines; (2) To determine the immunization requirements in U.S. pharmacy schools both at admission and before the students begin clinical clerkships; and, (3) To design an immunization program for pharmacy students at the University of the Pacific in an attempt to enhance compliance.
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Africa, Patricia N. "Knowledge, attitudes and practices of health care workers regarding hepatitis B vaccination, in the Ekurhuleni Metro, Gauteng Province." Thesis, University of Limpopo (Medunsa Campus), 2010. http://hdl.handle.net/10386/246.
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Thesis (MPH)--University of Limpopo, 2010.Introduction: Hepatitis B is a serious liver disease caused by the hepatitis B virus (HBV), with an estimated 360 million chronic infections worldwide, about a million of which die each year from chronic liver diseases. In South Africa (SA) over 50% of the population has been infected by HBV, and at least 3 million people are chronic HBV carriers. Chronic HBV carriers have the potential of transmitting HBV parenterally in the hospital setting, thus health care workers (HCWs) are at risk of contracting HBV, with the most likely exposure being via a needle stick injury (NSI). There is an effective vaccine against HBV which is recommended by the SA Department of Health, yet previous studies have shown that most HCWs are not vaccinated. Aim and objectives: The study aimed to investigate the knowledge, attitudes and practices regarding hepatitis B vaccination amongst HCWs in the Ekurhuleni Metro. Objectives were to determine: (1) the level of knowledge of HCWs about vaccination against HBV; (2) the attitudes of HCWs towards vaccination against HBV; (3) the practices of HCWs regarding HBV prevention and (4) the barriers to / predictors for effective HBV vaccination among HCWs at Ekurhuleni Metro Materials and Methods: This was a cross-sectional descriptive study which made use of a self-administered questionnaire that was sent to Ekurhuleni nurses and doctors who were working in 3 public hospitals, 7 district clinics, and 110 general practices. Results: Two hundred and fifteen questionnaires were distributed and 161 were returned giving an overall response rate of 74.9%. HCWs do not report their NSI; over a third [37.6% (41/81)] always reported the NSI; while 72% (116/161) of HCWs had been vaccinated, only 61.2% (71/116) of those vaccinated had received all 3 doses of the vaccine. For knowledge of HBV vaccination, 66.5% (107/161) scored poor; 31.7% (51/161) scored moderate; and 1.8% (3/161) scored high. For attitudes towards HBV vaccination, 0.6% (1/160) scored negative; 24.4% (39/160) scored neutral; and 74.5% (120/160) scored positive. A positive attitude score was a significant predictor for being vaccinated (OR=1.13, p=0.007) Conclusion: Guidelines should be put in place to increase vaccination uptake and reduce the risk of exposure to HBV infection by HCWs
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Peto, Thomas Julian. "Long-term efficacy and effectiveness of hepatitis B vaccination in The Gambia : Gambia Hepatitis Intervention Study (GHIS, 1986-90) and subsequent nationwide immunisation programme." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.558367.
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ISHIKAWA, TETSUYA. "IMMUNOREGULATION OF HEPATITIS B VIRUS INFECTION : RATIONALE AND CLINICAL APPLICATION." Nagoya University School of Medicine, 2012. http://hdl.handle.net/2237/16732.
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Halliday, John. "Vaccination against Hepatitis C - Characterising the host immune response and its implications for a successful therapeutic vaccine." Thesis, University of Oxford, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.598044.
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This thesis explores the firs t-ever administration of a prime/ boost combination of aden ovirus and MVA vector based vaccin es that target hepatitis C virus (HeV) infection to humans. Therapeutic application of these vaccines in patients with chronic HeV infection is first detailed. together with an interrogation of the immune responses genera ted. Vaccination safely ind uces novel T cells that target HeV immunogen in 5/11 vacci nated patients. However, assessment of circulating virus reveals significant sequence differences between autologous virus and the corresponding peptide in the vaccine immunogen. Further analysis shows that T cells induced by vaccination are poorly cross-reactive aga inst autologous virus epitopes. Compared with vaccination in healthy individuals, T cell responses are red uced in their frequency, magnitude and breadth in Hev infected patients who receive combination with standard HCV treatment IF N) / ribaviri n). vaccination, (pegylated either alone or in interferon-a (PEGTo help explain the reason for attenuated vaccin e responses in Hev infected patients, I next explored baseline and PEG-IFN/ribavirin induced differences in circulating lymphocyte subpopulations. At baseline, high proportions of regulato ry T cells and NK~ rl&ht cells suggest both adaptive and innate immunity is altered by chronic HCV infection. During the first 28 days of therapy, complex changes in the activation, differentiation status and cytokine profiles of circulating lymphocytes are observed over tim e. Intriguingly, PEG-IFN causes a transient but significant decrease in circulating lymphocytes that express CXCR3, a liver homing ch emokine receptor. Finally, the hypothesis that HCV th erapy ind uces CXCR3 mediated hepatic sequestration of lymphocytes was explored. In-vivo, PEG-IFN caused a transient but profound elevation of plasma IP-10 (a CXCR3-b inding chemokin e) and this co rrelated with declines in circulating CXCR3· CDS· T cells in HCV infected patients. Although in-vitro experiments show IFN-a drives hepatocytes to produce IP-10, it also causes lymphocytes to down-regulate CXCR3. Unfortunately, exogenous IFN-a does not objectively demonstrate hepatic enrichment of CXCR3·lymphocytes in a murine model.
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Macfarlane, Chelsea E., University of Western Sydney, and School of Applied Social and Human Sciences. "A comparison of the predictors of hepatitis B vaccination acceptance amongst health care and public safety workers in Australia." THESIS_XXX_ASH_MacFarlane_C.xml, 2001. http://handle.uws.edu.au:8081/1959.7/784.
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This thesis examines the results of a hepatitis B vaccination questionnaire study that was completed by medical officers, nurses, carers of the developmentally disabled, and correctional officers in the Greater Western Sydney area of New South Wales, Australia. The main aim of the study was to contrast these four high risk occupational groups for their acceptance of hepatitis B vaccination, seroconversion status, and behavioural, attitudinal, motivational and institutional determinants of their vaccination status. The results of the thesis revealed that medical officers and nurses were the most likely to be tested and vaccinated for seroconversion, while DD carers and correctional officers had the largest number of Not Vaccinated respondents. The findings of the questionnaire are discussed in some detail. It is also suggested that groups differ in the degree of hepatitis risk anxiety they experience as well as the degree of control felt over their health status. A number of indications for personal, institutional and governmental interventions to increase vaccination levels are discussed.Doctor of Philosophy (PhD)
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Mangtani, Punam. "An economic and epidemiological evaluation of vaccination strategies for the control of hepatitis B in England and Wales." Thesis, King's College London (University of London), 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.243611.
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Bottero, Julie. "L'application d'algorithmes de décision et l'utilisation de tests rapides permettent-elles d'optimiser le dépistage et la prévention de l'hépatite B ?" Thesis, Paris 6, 2014. http://www.theses.fr/2014PA066213/document.
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En France, plus de la moitié des personnes infectées par le VHB ignore leur statut. Le programme " Optiscreen B " visait à évaluer l'intérêt des algorithmes de décision et des tests rapides pour optimiser le dépistage et la prévention de l'hépatite B. Les principaux résultats étaient : La mise en évidence d'occasions manquées de dépistage, principalement liées à une sous-estimation du risque d'exposition lié au pays de naissance.L'application des recommandations de dépistage du CDC pourrait largement diminuer la part des personnes infectées ignorant leur statut mais au prix de très nombreux dépistages.16% des personnes dépistées ont une indication à un traitement antiviral dans les mois suivant le dépistage.100% des personnes ayant des AcHBc isolés avaient une charge virale indétectable.Les TROD AgHBs ont une sensibilité comprise entre 90.5 et 96.5% et une spécificité supérieure à 99%.Le test AcHBs QuickProfileTM a une très bonne spécificité (97.8%) mais une faible sensibilité (58.3%).L'utilité en pratique des TROD VHB pour améliorer la prise en charge des personnes dépistées n'a pas été établie en population générale non ciblée, ceci en partie du fait d'une faible prévalence d'infection et de la sensibilité insuffisante des TROD AcHBs.L'utilisation de TROD AgHBs couplés aux TROD VIH et VHC semble fortement améliorer la cascade de dépistage des personnes migrantes en situation de précarité sociale, à fort risque viral.Les pratiques vaccinales post-dépistage apparaissent extrêmement faibles et le plus souvent liées à l'inertie globale du système.Suite à ce travail, l'analyse médico-économique des différentes stratégies de dépistage est à réaliserIn France, more than half of those infected with HBV are unaware of their status. The Optiscreen B program aimed to evaluate the interest of testing recommendations and rapid tests (RT) and in optimizing screening, linkage-to-care, and prevention of hepatitis B. The main results were : Identification of missed opportunities for screening, mainly caused by underestimating country of birth as an important risk factor. Implementing screening recommendations from the CDC could significantly reduce the proportion of infected individuals unaware of their status, but with the disadvantage of many tests. 16% of persons testing HBsAg-positive after screening have an indication for antiviral treatment. 100% with isolated anti-HBcAb had undetectable HBV viral load. HBsAg RTs have sensitivities between 90.5 and 96.5% and specificities greater than 99%. The anti-HBsAb QuickProfileTM has very good specificity (97.8%) but low sensitivity (58.3%). The effectiveness of HBV RT in improving linkage-to-care was not established among persons eligible for HBV-screening. This was due in part to low infection prevalence and insufficient sensitivity of the anti-HBsAb RT. Nevertheless, combined use of HBsAg, HIV, and HCV RT seems to greatly improve the cascade of care among migrants in socially precarious situations and at high-risk of infection. HBV-vaccination after HBV screening does not occur often, mainly because of insufficient physician-patient motivation. Increased vaccination coverage might be achieved by emphasizing its need at the organizational level. Following this work, cost-benefit analysis of different screening strategies is greatly needed
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Ramsey, Priscilla W., and L. Lee Glenn. "Nurses' Body Fluid Exposure Reporting, HIV Testing, and Hepatitis B Vaccination Rates: Before and After Implementing Universal Precautions Regulations." Digital Commons @ East Tennessee State University, 1996. https://dc.etsu.edu/etsu-works/7543.
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The purpose of this study was to investigate whether mandatory universal precautions changed nurses' body fluid exposure and reporting rates, hepatitis B vaccination rates, and human immunodeficiency virus (HIV) testing rates. Random cross-sectional surveys of nurses in Tennessee were conducted in 1991 and 1993 (n = 145 in 1991; n = 143 in 1993). The questionnaire in both surveys included frequency of body fluid exposures and reporting in the past year, and whether or not the respondent had received the hepatitis B vaccine or had been HIV tested. Findings indicated that self reported needlestick injuries decreased by 69%, and other sharps injuries decreased by 81%. Only 4.1% of all exposure incidents reported on this anonymous survey were reported to employee health officials, as required. Body fluid exposure incidents were the most common form of exposure (81%) and the most underreported. Hepatitis B vaccinations significantly increased (61.4% to 82.5%), with a nonsignificant increase in HIV testing (47.2% to 55.6%) from 1991 to 1993. Findings of this study suggest that the universal precautions regulatory mandate has been effective in increasing nurses' compliance to universal precautions. Body fluid contacts were significantly underreported and showed no decrease between 1991 and 1993.
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Adati, Élen Monteiro. "Vacinação de Hepatite A em receptores de células tronco hematopoiéticas (TCTH)." Botucatu, 2016. http://hdl.handle.net/11449/143904.
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Orientador: Clarisse Martins MachadoResumo: Estudos sorológicos têm demonstrado que a prevalência da infecção provocada pelo vírus da hepatite A (VHA) diminuiu no Brasil. Nessas circunstancias, o vírus pode circular entre um número crescente de indivíduos suscetíveis provocando surtos. Embora a resposta à vacinação contra o VHA não tenha sido avaliada em receptores de TCTH, as orientações de imunização pós transplante tem indicado o uso da vacina após o 4º mês do TCTH em receptores suscetíveis vivendo ou viajando para áreas endêmicas. No presente estudo 46 receptores de TCTH receberam duas doses da vacina VHA. A prevalência dos anticorpos anti-VHA (IgG) imediatamente antes da vacina e a resposta a vacinação entre pacientes suscetíveis ao VHA foram avaliadas, assim como a ocorrência de eventos adversos da vacina. A prevalência de anticorpos anti-VHA em receptores de TCTH adultos avaliada por ensaio imunoenzimático comercial foi de 93,5%. Apenas 3 pacientes foram considerados suscetíveis e a resposta à vacina foi alcançada em dois deles, ambos com mais de dois anos após TCTH. Não houve aparecimento de anticorpos anti-VHA após duas doses da vacina. A resposta à vacina medida através do aumento da concentração de anticorpos anti-VHA entre receptores previamente soropositivos não pode ser avaliada no presente estudo. A vacina foi bem tolerada sem nenhum evento adverso significativo. Concluímos que a sorologia do VHA deveria ser recomendada a receptores de TCTH antes do encaminhando para a vacinação. Embora segura, a vacina ... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Serological studies have demonstrated that the prevalence of the hepatitis A virus infection (HAV) has decreased in Brazil. In these circumstances, the virus may circulate among a growing number of susceptible individuals causing outbreaks. Although the response to vaccination against HAV has not been evaluated in HSCT recipients, post-transplant immunization guidelines have indicated the vaccine after the 4th month of HSCT to susceptible recipients living or traveling to endemic areas. In the present study 46 HSCT recipients received two doses of HAV vaccine. The prevalence of anti-HAV antibody (IgG) immediately before the vaccine and the response to vaccination among HAV susceptible patients were evaluated, as well as the occurrence of adverse events to the vaccine. The prevalence of pre vaccine antiHAV antibodies in adults HSCT recipients evaluated by a commercial immunoassay was 93.5%. Only 3 patients were considered susceptible and the response to the vaccine was assessed in two of them, both with more than two years after HSCT. There was no appearance of anti-HAV antibodies after two doses of vaccine. The boost effect of the vaccine among previously seropositive recipients could not be evaluated in the present study. The vaccine was well tolerated without any significant adverse events. We concluded that HAV serology should be recommended in HSCT recipients before the referral to vaccination. Although safe, the vaccine against HAV was ineffective in the evaluated patien... (Complete abstract click electronic access below)
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Macfarlane, Chelsea Elizabeth. "A comparison of the predictors of hepatitis B vaccination acceptance amongst health care and public safety workers in Australia /." View thesis, 2001. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20031222.150943/index.html.
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Thesis (Ph.D.) -- University of Western Sydney, 2001."A thesis submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy, University of Western Sydney" Bibliography : leaves 193-208.
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Lin, Chung-hsi. "The politics of scientific practice in Taiwan : the hepatitis B control program /." Diss., This resource online, 1994. http://scholar.lib.vt.edu/theses/available/etd-10022007-144838/.
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Donate, Amy Lynn. "Development of a Non-Invasive Electrode for Intradermal Electrically Mediated DNA Vaccination." Scholar Commons, 2011. http://scholarcommons.usf.edu/etd/3077.
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Current progress in the development of vaccines has decreased the incidence of fatal and non-fatal infections and increased longevity. However, new technologies need to be developed to combat an emerging generation of infectious diseases. DNA vaccination has been demonstrated to have great potential for use against a wide variety of diseases. Alone, this vaccine technology does not generate a significant immune response for vaccination, but combined with delivery by electroporation (EP), can enhance plasmid expression and immunity against the expressed antigen. Most EP systems, while effective, can be invasive and painful making them less desirable for use in vaccination. Our lab recently developed a non-invasive electrode known as the multi-electrode array (MEA), which lies flat on the surface of the skin without penetrating the tissue. This study evaluated the use of the MEA for the development of DNA vaccines. We assessed the appropriate delivery conditions for gene expression and the development of humoral immunity. We used both B. anthracis and HBV as infectious models for our experiments. Our results indicated that the MEA can enhance gene expression in a mouse model with minimal to no tissue damage. Optimal delivery conditions, based on generation of antibodies, were determined to be 125-175V/cm and 150ms with 200ug and a prime boost protocol administered on Day 0 and 14. Under these conditions, end-point titers of 20,000-25,000 were generated. Neutralizing antibodies were noted in 40-60% of animals.
Additionally, we utilized a guinea pig model to assess the translation potential of this electrode. The plasmid encoding HBsAg, pHBsAg, was delivered intradermally with the MEA to guinea pig skin. The results show increased protein expression resulting from plasmid delivery using the MEA as compared to injection alone. Within 48 hours of treatment, there was an influx of cellular infiltrate in the experimental groups. Humoral responses were also increased significantly in both duration and intensity as compared to the injection only groups. Results from both experimental models demonstrate that protective levels of humoral immunity can be generated and that this electrode should translate well to the clinic.
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Lara, Amanda Nazareth. "Avaliação de marcadores sorológicos de proteção e infecção pelo vírus da hepatite B em pessoas vivendo com HIV/Aids, vacinadas previamente para hepatite B." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5134/tde-07082017-092803/.
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INTRODUÇÃO: A infecção pelo vírus da hepatite B (VHB) é responsável por grande parte das doenças hepáticas crônicas em todo o mundo. Em pessoas vivendo com HIV/Aids (PVHA) a infecção pelo VHB tem maior risco de evolução para cirrose e carcinoma hepatocelular. A vacina da hepatite B é importante na prevenção de doença potencialmente grave, particularmente em PVHA, já que ambos os vírus têm as mesmas vias de transmissão e a coinfecção tem uma alta morbidade. Indivíduos imunocompetentes têm uma boa resposta humoral após uma primeira série de vacina da hepatite B e não há recomendações de rotina para doses de reforço. PVHA podem ter uma pior resposta à vacina da hepatite B, quando comparada à resposta em indivíduos imunocompetentes e a duração da imunidade nesses pacientes é desconhecida. OBJETIVOS: Geral: Avaliar os marcadores sorológicos de proteção e infecção pelo VHB em pacientes adultos vivendo com HIV/Aids, vacinados previamente para hepatite B. Específicos: Avaliar a persistência dos anticorpos anti-HBs em PVHA vacinadas previamente para hepatite B e que apresentaram resposta humoral protetora inicial; avaliar a resposta sorológica à revacinação para hepatite B nos pacientes vacinados previamente e que não apresentaram resposta humoral protetora inicial; investigar a presença de marcadores sorológicos de infecção pelo VHB em PVHA vacinadas previamente para hepatite B. MÉTODOS: Estudo observacional de coorte retrospectiva de PVHA vacinadas primariamente para hepatite B entre 2001 e 2002. Marcadores sorológicos de infecção e proteção para o vírus da hepatite B foram investigados nesses pacientes que ainda estavam em acompanhamento no Serviço de Extensão ao Atendimento de Pacientes HIV/Aids (SEAP), da divisão de Clínica de Moléstias Infecciosas e Parasitárias do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo entre 2012 e 2014. RESULTADOS: Uma coorte de 121 PVHA foi analisada quanto à soroconversão e persistência do anti-HBs. A maioria era do sexo feminino (54,5%) com média de idade de 50,1 anos. Destes pacientes, 58 (grupo 1) eram inicialmente respondedores à primeira série da vacina (anti- HBs >=10 mUI/mL) e 63 (grupo 2) eram não respondedores. Após um período mediano de avaliação de 11 anos, nenhum dos pacientes teve evidência sorológica de infecção pelo VHB e 41/58 (70.7%) dos inicialmente respondedores mantinham anti-HBs >= 10 mUI/mL. Maior contagem de células T CD4+ e anti-HBs >= 100 mUI/mL, no momento da primeira série vacinal, estiveram associados à persistência de anti-HBs. Durante o período avaliado, 35/63 (55.6%) dos pacientes inicialmente não respondedores (grupo 2) soroconverteram com sucesso (anti-HBs >= 10 mUI/mL) em resposta a uma ou mais doses de reforço vacinal. Foi associado à soroconversão do anti-HBs o número de doses de reforço recebidas. A partir do momento da soroconversão (anti-HBs >=10 mUI/mL), 70 pacientes não receberam nenhuma dose adicional de vacina de hepatite B (grupo 3). Após um período mediano de 10 anos, 54/70 (77,1%) destes indivíduos mantinham anti- HBs >= 10 mUI/mL. CONCLUSÕES: A avaliação dos marcadores sorológicos para VHB em PVHA vacinadas previamente para hepatite B evidenciou: alta persistência de anti-HBs após um período de 10 a 11 anos; doses adicionais de vacina foram capazes de induzir resposta humoral em indivíduos inicialmente não respondedores; não foram detectados marcadores sorológicos de infecção (HbsAg ou Anti-HBc) após 11 anos da vacinação inicialBACKGROUND: Hepatitis B Virus (HBV) infection is responsible for great part of chronic hepatic diseases worldwide. In people living with HIV (PLHIV), HBV infection has more risk of progressing to cirrhosis and hepatocarcinoma. Hepatitis B vaccine is important in the prevention of a potentially severe disease, particularly in PLHIV, since both viruses have the same routes of transmission and co-infection has greater morbidity. Immunocompetent individuals have a good humoral response after the first hepatitis B vaccine series and no recommendation is made regarding booster doses. PLHIV may have a poor hepatitis B vaccine response, when compared to immunocompetent and the duration of immunity in these patients is unknown. OBJECTIVES: General: Evaluate serological markers of infection and protection from HBV in PLHIV previously vaccinated for hepatitis B. Specific: Evaluate anti-HBs persistence in PLHIV previously vaccinated for HBV who responded to a primary vaccine series; evaluate response to revaccination for hepatitis B in patients who did not respond to first vaccine series; investigate serological markers of infection from HBV in PLHIV previously vaccinated for hepatitis B. METHODS: Observational retrospective study of a PLHIV cohort primarily vaccinated between 2001 and 2002 for hepatitis B. Serological markers of infection and protection from HBV were investigated in those patients who were still attending the HIV/AIDS Patient Care Extension Service at the Clinical Division of Infectious and Parasitic Diseases attached to Hospital das Clínicas at Faculdade de Medicina at Universidade de São Paulo between 2012 and 2014. RESULTS: A cohort of 121 PLHIV was analyzed for seroconversion and persistence of anti-HBs. The majority were female (54.5%) and mean age 50.1 years. From these patients, 58 (group 1) were initially responders to the first vaccine series (anti- HBs >=10 mIU/mL) and 63 (group 2) were non- responders. After a median period of 11 years, none of the patients had serologic evidence of HBV infection and 41/58 (70.7%) of the initially responders had maintained anti-HBs >=10 mIU/mL. Greater CD4+ cell counts and anti- HBs>= 100mIU/mL at the time of first vaccine series were associated with persistence of anti-HBs. During evaluation period, 35/63 (55.6%) of the initially non-responders (group 2) successfully seroconverted (anti-HBs >=10 mIU/mL) in response to one or more booster doses. Booster doses may be effective in PLHIV. Number of booster doses were associated to seroconversion. Seventy of the 121 patients did not receive any further booster doses of hepatitis B vaccine from the time of their seroconversion (anti-HBs >=10 mIU/mL) (group 3). After 10 years of the seroconversion, 54/70 (77,1%) of these individuals has maintained anti- HBs >= 10 mIU/mL. CONCLUSIONS: Evaluation of serological markers for HBV in PLHIV previously vaccinated for hepatitis B showed: strong persistence of anti-HBs after a period of 10 to 11 years; additional vaccine doses elicited humoral response in initially non-responders; there was no serologic evidence of HBV infection (HbsAg ou Anti-HBc) about 11 years after initial vaccination
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Miller, Erin Suzanne. "Increasing Expression of Hepatitis B Surface Antigen in Maize through Breeding." DigitalCommons@CalPoly, 2015. https://digitalcommons.calpoly.edu/theses/1359.
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The hepatitis B virus (HBV) is a common virus, with two billion people infected worldwide. It causes approximately 600,000 deaths each year, despite the availability of an effective vaccine since 1982. Maize as a platform for oral vaccination can supply a heat stable vaccine, which does not require syringes or trained personnel to administer. The Hepatitis B Surface antigen was transformed into maize and this seed was used to evaluate expression levels through the breeding process. The transgene was transferred into two elite maize inbreds by backcrossing. Highest expressing ears were selected each generation until approximately 99% commercial parent was obtained with a single gene coding for the vaccine present. Selected individuals were crossed to create hybrid plants. This work was done to create high expressing high yielding lines that could be used as a plant-based oral vaccine for Hepatitis B.
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Sangfelt, Per. "Prevention and treatment of hepatitis B virus infection /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-301-9/.
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Rimkuvienė, Jūratė. "Infekcijų kontrolė odontologijoje odontologinės sveikatos priežiūros specialistų požiūriu." Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2011. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2011~D_20110630_133915-85031.
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Burna yra viena labiausiai infekuotų žmogaus organizmo sričių. Įrodyta, kad bet kuri odontologinė intervencija – dantų preparavimas, profesionali burnos higiena, dantų šalinimas, įprastinė profilaktinė paciento burnos apžiūra – yra susijusi su galimu infekcijų plitimu. Todėl vienas iš svarbiausių odontologine praktika besiverčiančių asmenų uždavinių yra užkirsti kelią infekcijų plitimui ir sudaryti saugią aplinką pacientui, gydytojui odontologui ir kitam personalui.
Darbo tikslas – nustatyti ir įvertinti Lietuvos odontologinės sveikatos priežiūros specialistų požiūrį į infekcijų kontrolę ir atliekamas infekcijų kontrolės procedūras, išsiaiškinti vakcinacijos nuo hepatito B apimtį tarp Lietuvos odontologinės sveikatos priežiūros specialistų.
Odontologinės sveikatos priežiūros specialistų požiūrio į infekcijų kontrolę, atliekamas infekcijų kontrolės procedūras, infekcijų kontrolės procedūrų neatitikimus galiojantiems norminiams dokumentams tyrimas atliktas 2008 – 2010 metais Vilniaus universiteto Medicinos fakulteto Odontologijos institute. Tyrime buvo pakviesti dalyvauti visi 2235 Lietuvos gydytojai odontologai, 2008 metais registruoti Lietuvos odontologų rūmuose ir turintys bendros praktikos gydytojo odontologo licenciją ir visi 1814 gydytojų odontologų padėjėjai bei visi 370 burnos higienistai, registruoti 2010 metais (pagal Lietuvos odontologų rūmų duomenų bazę). Tyrimo dalyviams buvo išsiųsti anoniminiai klausimynai.
Odontologinės sveikatos priežiūros specialistų požiūris... [toliau žr. visą tekstą]The oral flora is one of the most ecologically diverse microbial populiations known to man. It has been proved that any dental intervention: dental preparation, professional oral hygiene, extraction of teeth, regular prophylactic examination of patient‘s mouth is related with a possible spread of infection. Therefore, one of the most important tasks for the dental care professionals is to prevent the spread of infection and create safe environment for a patient, the dentist himself and other dental staff The aim of the present study is to identify and evaluate the attitudes of Lithuanian dental health care professionals towards infection control and carried out infection control procedures, and to determine vaccination frequency against hepatitis B among dental health care professionals. The study highlighteningt the dental health care professionals‘ attitude towards infection control and infection control procedures as well as incompliance of infection control procedures with the valid normative documentation was conducted at the Institute of Odontology, Faculty of Medicine, Vilnius University in 2008-2010. All 2,235 Lithuanian dentists, registered in the Lithuanian Dental Chamber Registry in 2008 and carrying general practice dentist‘s license, all 1,814 dental assistants and all 370 dental hygienists registered in 2010 (according to the database of the Lithuanian Dental Chamber Registry) were invited to take part in the investigation. The participants of the study survey... [to full text]
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Rimkuvienė, Jūratė. "Attitudes towards infection control among dental health care professionals." Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2011. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2011~D_20110630_133927-98023.
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The oral flora is one of the most ecologically diverse microbial populiations known to man. It has been proved that any dental intervention: dental preparation, professional oral hygiene, extraction of teeth, regular prophylactic examination of patient‘s mouth is related with a possible spread of infection. Therefore, one of the most important tasks for the dental care professionals is to prevent the spread of infection and create safe environment for a patient, the dentist himself and other dental staff
The aim of the present study is to identify and evaluate the attitudes of Lithuanian dental health care professionals towards infection control and carried out infection control procedures, and to determine vaccination frequency against hepatitis B among dental health care professionals.
The study highlighteningt the dental health care professionals‘ attitude towards infection control and infection control procedures as well as incompliance of infection control procedures with the valid normative documentation was conducted at the Institute of Odontology, Faculty of Medicine, Vilnius University in 2008-2010. All 2,235 Lithuanian dentists, registered in the Lithuanian Dental Chamber Registry in 2008 and carrying general practice dentist‘s license, all 1,814 dental assistants and all 370 dental hygienists registered in 2010 (according to the database of the Lithuanian Dental Chamber Registry) were invited to take part in the investigation. The participants of the study survey... [to full text]Burna yra viena labiausiai infekuotų žmogaus organizmo sričių. Įrodyta, kad bet kuri odontologinė intervencija – dantų preparavimas, profesionali burnos higiena, dantų šalinimas, įprastinė profilaktinė paciento burnos apžiūra – yra susijusi su galimu infekcijų plitimu. Todėl vienas iš svarbiausių odontologine praktika besiverčiančių asmenų uždavinių yra užkirsti kelią infekcijų plitimui ir sudaryti saugią aplinką pacientui, gydytojui odontologui ir kitam personalui. Darbo tikslas – nustatyti ir įvertinti Lietuvos odontologinės sveikatos priežiūros specialistų požiūrį į infekcijų kontrolę ir atliekamas infekcijų kontrolės procedūras, išsiaiškinti vakcinacijos nuo hepatito B apimtį tarp Lietuvos odontologinės sveikatos priežiūros specialistų. Odontologinės sveikatos priežiūros specialistų požiūrio į infekcijų kontrolę, atliekamas infekcijų kontrolės procedūras, infekcijų kontrolės procedūrų neatitikimus galiojantiems norminiams dokumentams tyrimas atliktas 2008 – 2010 metais Vilniaus universiteto Medicinos fakulteto Odontologijos institute. Tyrime buvo pakviesti dalyvauti visi 2235 Lietuvos gydytojai odontologai, 2008 metais registruoti Lietuvos odontologų rūmuose ir turintys bendros praktikos gydytojo odontologo licenciją ir visi 1814 gydytojų odontologų padėjėjai bei visi 370 burnos higienistai, registruoti 2010 metais (pagal Lietuvos odontologų rūmų duomenų bazę). Tyrimo dalyviams buvo išsiųsti anoniminiai klausimynai. Odontologinės sveikatos priežiūros specialistų požiūris... [toliau žr. visą tekstą]
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Oliveira, Marina Pedroso de. "Rastreamento sorológico e molecular do vírus da hepatite B em homens que fazem sexo com homens em Goiânia-Goiás, utilizando o método respondent-driven sampling (RDS)." Universidade Federal de Goiás, 2017. http://repositorio.bc.ufg.br/tede/handle/tede/7001.
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Outro
Men who have sex with men (MSM) are more vulnerable to hepatitis B virus (HBV) infection when compared to the general population. In Brazil, the epidemiological profile of hepatitis B in MSM is still poorly understood. This study aimed to estimate the prevalence of HBV infection in MSM in Goiânia-Goiás and to analyze the associated factors, perform a molecular characterization of the viral isolates, as well as to investigate the vaccine situation against hepatitis B in this population. A cross-sectional study was conducted among MSM in the City of Goiânia, Central Brazil. From March to November 2014, a total of 522 participants were recruited using respondent-driven sampling (RDS). After signing the consent form, MSM were interviewed and a blood sample was collected. All samples were tested for HBV serological markers and HBV DNA. HBV isolates were sequenced for the determination of HBV genotypes and subgenotypes by phylogenetic analysis and for identification of mutations in viral genome. Data were analyzed using the RDSAT and SPSS programs. The overall prevalence of HBV infection (presence of anti-HBc marker) was 15.4% (95% CI: 8.7-25.8) and the rate of HBsAg carriers was 0.6% (95% CI: 0.2-1.6). Age over 25 years old, receptive anal intercourse, previous sex with women, and history of sexually transmitted infection (STI) were factors associated with HBV infection. Viral DNA was detected only in HBsAg-positive individuals, and occult HBV infection was not observed in the study population. HBV isolates were classified into genotype A (subgenotypes A1 and A2).Mutations in the S (T131N), basal core promoter (BCP) (A1762T/G1764A) and Pre-C/C (G1862T/G1888A and G1862T) regions of the HBV genome were identified. About 40% (95% CI: 32.3-48.8) of the participants had serological evidence of previous HBV vaccination (reactive for isolated anti-HBs), while 76.2% reported having previously received the vaccine. In addition, 44.3% (95% CI: 36.1-52.9) of MSM were susceptible to HBV infection. A greater frequency of positivity for anti-HBs alone was observed among MSM up to 25 years old, followed by declining vaccination with increasing age. By contrast, an increase in HBV infection with increasing age was found. HBV vaccination was associated with unprotected anal intercourse and history of STI (with a borderline p-value). In this study, we observed a poor agreement when comparing the self-reported and serologic evidence of HBV vaccination (k = 0.17). These results reveal a high overall prevalence of HBV infection in the study population associated with sexual risk behaviors, and in contrast, a low frequency of hepatitis B vaccination, evidencing a need for public health strategies to increase vaccine coverage in MSM, in addition to monitoring HBV carriers.
Homens que fazem sexo com homens (HSH) apresentam maior vulnerabilidade para infecção pelo vírus da hepatite B (HBV) quando comparados à população em geral. No Brasil, o perfil epidemiológico da hepatite B em HSH ainda é pouco conhecido. Este estudo teve como objetivos estimar a prevalência da infecção pelo HBV em HSH em Goiânia-Goiás e analisar os fatores associados, realizar a caracterização molecular dos isolados virais, bem como investigar a situação vacinal contra hepatite B e fatores associados. Estudo transversal conduzido em HSH na região metropolitana de Goiânia-GO. De março a novembro de 2014, um total de 522 participantes foi recrutado utilizando o método respondent-driven sampling (RDS). Após assinatura do termo de consentimento livre e esclarecido, os HSH foram entrevistados e amostras sanguíneas coletadas. Todas as amostras foram testadas por ensaio imunoenzimático (ELISA) para detecção dos marcadores sorológicos da hepatite B e submetidas à extração e amplificação do HBV DNA. Os isolados do HBV foram sequenciados para determinação dos genótipos e subgenótipos do vírus por análise filogenética e para identificação de mutações no genoma viral. Os dados foram analisados utilizando os programas RDSAT e SPSS. A prevalência global da infecção pelo HBV (anti-HBc) foi de 15,4% (IC 95%: 8,7-25,8) e do HBsAg de 0,6% (IC 95%: 0,2-1,6). Idade acima de 25 anos, sexo anal receptivo, relação sexual com mulheres e história de infecções sexualmente transmissíveis (IST) foram fatores associados à infecção pelo HBV. O DNA viral foi detectado apenas nos indivíduos HBsAg positivos, não sendo observada infecção oculta na população estudada. Os isolados do HBV foram classificados como pertencentes ao genótipo A (subgenótipos A1 e A2) do HBV. Mutações nas regiões S (T131N), promotora basal do core (BCP) (A1762T/G1764A) e Pré-C/C (G1862T/G1888A e G1862T) do genoma viral foram identificadas. Cerca de 40% (IC 95%: 32,3-48,8) dos participantes tinham evidência sorológica de vacinação contra hepatite B (anti-HBs isolado), enquanto que 76,2% relataram ter recebido a vacina previamente. Além disso, 44,3% (IC 95%: 36,1-52,9) dos HSH eram suscetíveis à infecção pelo HBV. Observou-se uma maior positividade para anti-HBs isolado entre os HSH com até 25 anos de idade, seguido de seu declínio com o aumento da idade e, por outro lado, verificou-se aumento da infecção pelo HBV. A vacinação contra a hepatite B foi associada ao sexo anal desprotegido e marginalmente à história de IST. Neste estudo, notou-se, ainda, uma baixa concordância entre evidência sorológica e auto relato de vacinação (k = 0,17). Estes resultados revelam uma prevalência global elevada da infecção pelo HBV na população estudada e sua associação com comportamentos sexuais de risco e, em contraste, uma frequência baixa de vacinação contra hepatite B, evidenciando a necessidade de políticas públicas contínuas de saúde voltadas para os HSH, incluindo estratégias para aumentar a cobertura vacinal, além do monitoramento dos indivíduos portadores do HBV.
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Суременко, М. С., О. П. Шевченко-Макаренко, О. А. Савченко, Л. О. Гавриленко, М. І. Білий, and І. В. Діброва. "Захворюваність на гострі вірусні гепатити на Дніпропетровщині." Thesis, Сумський державний університет, 2015. http://essuir.sumdu.edu.ua/handle/123456789/43142.
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Захворюваність на гострі вірусні гепатити у практиці інфекціоніста не втрачає своєї актуальності. Хоч
здавалось, що вірусні гепатити А та В давно є керованими інфекціями, бо проти них застосовується специфічна профілактика, а саме вакцинація. Але ж, що стосується України – вакцинація проти вірусного гепатиту А (ВГА) входить до складу рекомендованих вакцин та не є обов’язковою для
широкого кола населення. Вакцинація проти гепатиту В (ВГВ), також введена в Календар щеплень нещодавно та більш чітко прищеплюються тільки деякі групи ризику. Проблемою остається відсутність вакцини проти вірусного гепатиту С (ВГС), який дуже рідко реєструється в гострий період захворювання та виявляється вже на стадії хронічного перебігу гепатиту С.
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Williams, John. "A mathematical model of the dynamics of hepatitis B virus transmission in the UK under the influence of different vaccination control strategies." Thesis, University of Oxford, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.298721.
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Zeuner, Thomas. "Untersuchungen zur humoralen und zellulären Immunantwort auf HBs-Antigen unter Berücksichtigung des Impfstatus." Doctoral thesis, Universitätsbibliothek Leipzig, 2015. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-175098.
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Die Virushepatitis gehört weltweit zu einer der häufigsten viralen Erkrankungen. Doch durch die Entwicklung von immer effizienteren Impfstoffen kann bei einer frühzeitigen Immunisierung eine Infektion verhindert werden. Ziel dieser Arbeit war es, ein Patientenkollektiv zu untersuchen, welches eine Impfung mit einem Hepatitis B-Impfstoff erhalten hatte, und dieses mit Probanden zu vergleichen, die nicht immunisiert waren. Diese Proben wurden auf ihre serologische und zelluläre Reaktivität mittels ELISA und ELISpot untersucht. Im ELISA zeigte sich bei 95 % der geimpften Personen eine positive Serokonversion nach zurückliegender Hepatitis B-Impfung. Um den Impfstatus genauer zu analysieren und bei seronegativen geimpften Probanden den zellulären Arm des Immun-systems zu verifizieren, wurde mittels ELISpot die IFN-γ-Sekretion von HBs-reaktiven
T-Zellen untersucht und mit den Ergebnissen, welche in der Serologie gewonnen wurden, verglichen. Dabei zeigte sich, dass die zelluläre Untersuchung bei 43 von 94 untersuchten Patientenproben (46 %) ein positives Ergebnis aufwies. Zweiundzwanzig der 48 geimpften Patienten (46 %) hatten eine antigenspezifische IFN-γ-Sekretion und 21 der 46 Proben der aktuell nicht geimpften Patienten fielen im ELISpot positiv aus. Bei zwei seronegativ geimpften Patienten konnte jeweils ein positives Ergebnis im ELISpot gezeigt werden. Ein direkter Zusammenhang zwischen der Höhe des anti-HBs-Titers im ELISA und Anzahl der spot-bildenden Zellen im ELISpot konnte nicht gezeigt werden. Die Ergebnisse dieser Arbeit zeigen, dass die serologische Untersuchung mittels ELISA weiterhin als Goldstandard verwendet werden soll, um den aktuellen Schutz gegenüber einer Hepatitis B-Infektion zu verifizieren. Durch die zelluläre Untersuchung mit dem ELISpot-Verfahren kann bei weiterer Testoptimierung in Zukunft eine Nachweismethode für seronegative Geimpfte entwickelt werden. Vor allem sollten diese mit Hilfe des ELISpots genauer analysiert werden, um gegebenenfalls bei nicht vorhandener humoralen Immunität und einer ebenfalls fehlenden zellulären Immunität prophylaktische Maßnahmen einzuleiten.
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Kosinska, Anna [Verfasser], Michael [Akademischer Betreuer] Roggendorf, and Astrid [Akademischer Betreuer] Westendorf. "Improvement of therapeutic vaccination for the treatment of chronic hepatitis B in a preclinical model (woodchuck) / Anna Kosinska. Gutachter: Astrid Westendorf. Betreuer: Michael Roggendorf." Duisburg, 2011. http://d-nb.info/1015428320/34.
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Storer, Fábio Luiz. "Soropositividade, cobertura e resposta vacinal para hepatite vital do tipo B em cirurgiões dentistas em Porto Velho, Rondônia, Brasil." Universidade de Taubaté, 2008. http://www.bdtd.unitau.br/tedesimplificado/tde_busca/arquivo.php?codArquivo=467.
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Neste estudo, hipotetizou-se que existia alta incidência de cirurgiões dentistas com baixa cobertura vacinal para hepatite B e positividade para contato prévio ou corrente para a hepatite viral do tipo B. O presente estudo transversal avaliou a condição
vacinal e perfil sorológico dos cirurgiões dentistas para hepatite viral do tipo B no município de Porto Velho/RO - Brasil. Foram analisadas pela técnica de ELISA oitenta amostras de sangue (soro) dos cirurgiões dentistas residentes no município de Porto
Velho/RO, visando a detecção dos marcadores sorológicos do Vírus da hepatite B: HBsAg, anti HBc total, anti-HBc IgM e anti-HBs. As amostras anti HBc Total positivas foram testadas para o marcador anti HBc IgM. Foram analisados os achados laboratoriais com dados de formação profissional, uso de equipamento de proteção individual (EPI) e índice vacinal entre os profissionais. Os dados foram comparados utilizando-se o teste Kruskal-Wallis (p< 0,05). Dos cirurgiões dentistas avaliados, 45% faziam clínica geral e 38% relataram atualizar-se profissionalmente uma vez ao ano. A maioria (p< 0,05) dos participantes (59%) recebeu as três doses da vacina contra hepatite B e 11% apenas duas doses. Dentre os que receberam três doses a maior (p< 0,05) frequência (47%) apresentou soroconversão decorrente da vacinação. Embora abaixo do número esperado de 100%, a maioria dos cirurgiões dentistas de
Porto Velho recebeu as três doses da vacina o que em geral acarretou imunidade. Entretanto, o perfil sorológico nem sempre foi compatível com a cobertura vacinal. Nossos achados sugerem a necessidade de execução de provas laboratoriais para
confirmação e/ou monitoramento do perfil sorológico decorrente da vacinação contra hepatite B.This search supposed that it had a high incidence of dentists with low vaccine covering for hepatitis B and a positive for previous or current contact for the virus hepatitis of type B. The transversal study evaluated the vaccines condition and serum profile of the dentists for viral hepatitis of type B in Porto Velhos city in Rondonias state Brazil. eighty samples of blood (serum) of the resident surgeons had been analyzed by the ELISAs technique of the dentists in Porto Velhos city, to only find out about the serums detention markers of the Virus of hepatitis B: HBsAg, anti total HBc, anti-HBc IgM and anti-HBs. The positive samples anti Total HBc had been tested for the marker anti HBc IgM. And also it had been analyzed at the lab findings with data of professional formation, equipment used as an individual protection (EPI) and vaccine index between the professionals. The data had been compared using the test Kruskal-Wallis ( p< 0,05) from the people that had been participated. As a result we can say that from dentists analyzed, 45% were in a general clinical and 38% told that to bring up to date once a year. Most of them (59%) received three quantities against Hepatitis B and 11% only with two quantities. Between the people that received three quantities, showed another serum due to the vaccine. Although the number was not expected, most of the dentists from Porto Velho received three doses of the vaccine which it caused immunity. However, the serum profile nor always it was compatible the vaccine covering. Our findings suggest the necessity of execution of labs tests for confirmation and/or a coordination of the serum profile of the vaccination against hepatitis B.
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Al, Thaqafy Majid Seraj K. "Hepatitis B, measles and varicella infections, among newly recruited military and healthcare employees in the Saudi National Guard : associated knowledge, concerns and barriers to vaccination." Thesis, University of Newcastle upon Tyne, 2017. http://hdl.handle.net/10443/3938.
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Background: Vaccine-preventable diseases are easily transmitted in healthcare and military facilities. Despite deliberate efforts being instigated, vaccine preventable diseases in KSA remain the most commonly reported infectious diseases among adults. This study aimed to enhance understanding of the epidemiological pattern, seroimmunity, associated knowledge, and concerns on Hepatitis B virus (HBV), measles and varicella infections; investigating barriers to vaccine compliance among newly recruited health care workers (HCWs) and soldiers. Methods: A mixed methods model of analysis was performed: (1) A quantitative analysis through a cross-sectional survey and gathering results of blood samples and (2) a qualitative analysis through in-depth interviews and focus group discussions. Results: 315 multinational HCWs and 426 male Saudi soldiers completed similar questionnaires. The HCWs scored an intermediate median knowledge level of 43 HBV, 27 measles and 33 varicella questions, 32, 15 and 19 respectively, with the soldiers scoring a low median knowledge level 8, 4 and 7 respectively. Blood samples of 4,328 multinational HCWs and 1,030 male Saudi soldiers were screened. The HBsAg seroprevalence among HCWs was 0.4% and among soldiers 0.2%. The HBcAb positive seroimmunity was 6.7% and 0.8% respectively, and HBsAb positive seroimmunity 68.3%, and 29.4% respectively. Among HCWs IgG measles positive seroimmunity was 64.3% and for soldiers 31.2%, IgG varicella positive seroimmunity was 85.2% and 68.3% respectively. Vaccine barriers and acceptability for the vaccination were identified, comprising five main barriers related to: individual, vaccine, HCWs providing vaccine, organisation, and social and cultural factors. Conclusion: Low and intermediate levels of awareness among military and HCWs respectively confirm the need for educational campaigns to reduce infection transmission and increase vaccine compliance. The rate of HBV, measles and varicella immunity was low indicating the need to vaccinate susceptible groups.
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Cheung, Chun Kidd. "Proportion of children born to infected mothers at risk of contracting Hepatitis B, and associated risk factors for inadequate Hepatitis B Timely Birth Dose vaccination : Analysis of the São Tomé and Príncipe Demographic Health Survey Program data, 2008-2009." Thesis, Uppsala universitet, Internationell mödra- och barnhälsovård (IMCH), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-324169.
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Background The Hepatitis B Virus (HBV) is a blood-borne infection affecting around 2 billion people at any given time and is commonly transmitted through Mother to Child Transmission (MTCT). Preventative measures include vaccinations, particularly the timely Birth Dose (TBD) given within 24 hours of birth. Timing is crucial for the efficacy of the TBD, and is influenced by various factors. São Tomé and Príncipe is one of seven sub-Saharan African countries with a TBD policy. This study aims to observe the different proportions of children receiving adequate or inadequate vaccinations against HBV, as well as to analyse the risk factors that may lead to inadequate vaccination. Methods Secondary data from the São Tomé and Príncipe Demographic Health Survey from 2008-2009 was analysed in this study. Dose delays for all children and those at risk were described. An associative analysis looked at the potential risk factors for inadequate TBD vaccination. Results A high coverage rate for vaccinations was found (>85%), however, the majority were delayed, with only 1% and 4% on time, and mean a TBD administration of 2(SD±2) months after birth, in all children, versus children at risk. Children born to mothers with positive HBV status and low wealth were significantly more likely to receive the TBD on time. Conclusion The majority of vaccinations, including the TBD were inadequately administered, denoting a concern of transmission to children born at risk. Additionally, socioeconomic factors were found to be factors influencing the provision of the TBD
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Chotun, Bibi Nafiisah. "The prevalence of Hepatitis B virus infection in an HIV-exposed paediatric cohort from the Western Cape, South Africa." Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71771.
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Thesis (MScMedSc))--Stellenbosch University, 2012.Includes bibliography
ENGLISH ABSTRACT: Despite the availability of Hepatitis B virus (HBV) vaccination for over three decades, this infection remains a major public health problem. Whilst the WHO recommends giving a birth dose of the vaccine, in South Africa, routine infant HBV vaccination commences at six weeks of age. This schedule is based on data from the pre-HIV era which showed transmission occurred via the horizontal, rather than the vertical route. In the era of HIV however, maternal HIV co-infection may release HBV from immune control, resulting in higher HBV loads and increasing the risk of vertical transmission. The aim of this study was to determine the prevalence and character of HBV infection in HIV-exposed infected and uninfected infants. Residual plasma samples from routine HIV nucleic acid testing of 1000 HIV-exposed infants aged between 0 and 18 months from the Western Cape were tested. Samples were tested for HBsAg by ELISA (Murex HBsAg Version 3) and confirmed by neutralisation. HBV DNA was quantified using an in-house real-time PCR assay. Infants with HBsAg positive samples were followed up and a blood sample was collected from mother and child. Those HBsAg positive samples were tested for HBeAg/antiHBe (Diasorin) and HBsAg negative samples were tested for antiHBs. HBV DNA was quantified. The surface gene was sequenced and the HBV genotype determined by phylogenetic analysis using HepSEQ (www.hepseq.org.uk). Whole genome sequencing was also performed. Of 1000 samples tested, four samples were positive for HBsAg and/or HBV DNA, indicating a prevalence of HBV transmission of 0.4%. At follow-up, two of three infected infants were positive for HBsAg, with HBV viral loads of greater than 108 IU/ml. The third infant was found to have cleared his infection and the fourth child was lost to follow up. These infected infants had all received HBV vaccination. All four mothers were HBeAg positive. Sequencing analysis showed the HBV strains from the two infants and four mothers belonged to subgenotype A1. The two mother-child paired sequences were identical. The data from this study shows that vertical transmission of HBV infection in HIV-exposed infants from the Western Cape is occurring, despite vaccination. Data from the Western Cape, showing an HBV prevalence of 3.4% in HIV-infected pregnant women, and those presented here suggest a vertical transmission rate of HBV of 12%. This is despite the widespread use of tenofovir and lamivudine in HIV-infected women with low CD4 counts. This study provides data supporting calls to bring HBV vaccination closer to the time of birth. Further work is urgently needed to confirm these findings and to determine the rates of transmission in HIV-unexposed infants.
AFRIKAANSE OPSOMMING: Ten spyte van die beskikbaarheid van die Hepatitis B virus (HBV) inenting vir meer as drie dekades, hierdie infeksie bly 'n groot openbare gesondheid probleem. Terwyl die WGO aan beveel dat'n geboorte dosis van die entstof, in Suid-Afrika, roetine baba HBV inenting op die ouderdom van ses weke gegee word. Hierdie skedule is gebaseer op data van die pre-MIV era wat getoon het dat die oordrag plaasgevind het via die horisontale, eerder as die vertikale roete. In die era van MIV egter, moeder MIV ko-infeksie kan HBV vrylaat van immuun beheer, wat lei in hoër HBV vlakke en die verhoging van die risiko van vertikale oordrag. Die doel van hierdie studie was om die voorkoms en karakter van die HBV infeksie in MIV-besmette en onbesmette babas te bepaal. Residuele plasma monsters van roetine-MIV-nukleïensuur toetse van 'n 1000 MIV-blootgestelde babas tussen die ouderdomme van 0 en 18 maande van die Wes-Kaap was getoets. Monsters was getoets vir HBsAg deur ELISA (Murex HBsAg Version 3) en bevestig deur neutralisering. HBV DNA is gekwantifiseer deur gebruik te maak van 'n in-huis real-time PCR assay. Babas met HBsAg positiewe monsters was opgevolg en 'n bloedmonster is versamel van moeder en kind. Die HBsAg positiewe monsters was getoets vir HBeAg/antiHBe (Diasorin) en HBsAg negatiewe monsters was getoets vir antiHBs. HBV DNA was gekwantifiseer. Die oppervlak gene volgorde en genotipes was bepaal deur filogenetiese analise met behulp van HepSEQ (www.hepseq.org.uk). Die hele genoom-volgordebepaling was ook uitgevoer. Van die 1000 monsters wat getoets was, was vier monsters positief vir HBsAg en of HBV DNA, dit dui op 'n voorkoms van HBV oordrag van 0.4%. By op volg, twee van die drie besmette babas was positief vir HBsAg, met HBV virale vlakke van groter as 108 IE/ml. Die derde baba was gevind dat sy infeksie opgeklaar het en die vierde kind was verlore as gevolg van op volg. Hierdie besmette babas het almal HBV inenting ontvang. Al vier moeders was HBeAg positief. Volgordebepaling analise het getoon die HBV stamme van die twee babas en vier moeders behoort aan subgenotype A1. Die twee moeder-kind gepaarde rye was homoloë. Die data van hierdie studie toon dat die vertikale oordrag van HBV infeksie in MIV-blootgestelde babas van die Wes-Kaap vind plaas, ten spyte van inenting. Data van die Wes-Kaap, wat 'n HBV voorkoms van 3.4% in MIV-besmette swanger vroue, en dié wat hier aangebied is dui op 'n vertikale oordrag koers van 12% van die HBV. Dit is ten spyte van die wydverspreide gebruik van tenofovir en lamivudine in MIV-geïnfekteerde vroue met 'n lae CD4-telling. Hierdie studie bied data wat ondersteunende oproepe van HBV inenting nader aan die tyd van die geboorte bring. Verdere werk is dringend nodig om die bevindinge te bevestig en die pryse van die oordrag in MIV-blootgestelde babas te bepaal.
National Health Laboratory Service Research Trust
Poliomyelitis Research Foundation (PRF)
Harry Crossley Foundation
Stellenbosch University
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Faya, Jean. "La vérité plurielle des médecins : Approche anthropologique de la vaccination contre l’hépatite B, sur les pentes de la Croix-Rousse à Lyon." Thesis, Lyon 2, 2013. http://www.theses.fr/2013LYO20068/document.
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La vaccination contre l’hépatite B est loin d’être un objet de consensus pour les médecins du quartier des pentes de la Croix-Rousse à Lyon. Cette diversité des opinions interroge quand cette maladie semble tuer aujourd’hui en France, sept fois plus que le VIH. Alors nous nous demandons comment se construisent les vérités de chacun et de quelle façon les médecins pensent leur capacité à se mettre en lien avec la réalité du vivant ? Pour tenter de comprendre, nous avons suivi la voie classique de l’enquête de terrain, et nous avons saisi l’opportunité méthodologique d’être à la fois médecin généraliste et chercheur, pour proposer un point de vue anthropologique original, et promouvoir la réflexivité. Ainsi, nous voyons comment les discours de vérité des médecins généralistes, alternatifs ou spécialistes, à l’échelle d’un quartier, prennent forme dans la construction des identités et les jeux de pouvoir qui règlent les positions de chacun. Ces mécanismes offrent aux soignants du sens, autant pour leur existence que pour leur pratique professionnelle. Mais les vérités sont aussi le résultat d’un authentique effort pour accéder au réel. La science est alors considérée comme le principal outil. Le médecin aime encore à trouver d’autres médiateurs, un maître ou une société savante. Et la question de l’expérience vient timidement en dernier, comme non politiquement correcte ou non politiquement souhaitable. Le savoir par l’agir et le voir de la pratique, semble pourtant le point commun de tous. La différence entre le scientifique et le praticien est ainsi questionnée, tout comme la pensée objectiviste des professeurs de médecine et de la science en généralVaccination against Hepatitis B is far from being an object of consensus for physicians in the district of the ‘pentes de la Croix-Rousse’ in Lyon. This diversity of opinions questions when this disease seems to kill seven times more than HIV nowadays in France. So we ask ourselves how to construct our truths and how doctors are thinking their ability to establish a connection with the reality of living? To try understanding, we followed the traditional path of the field survey, and we took the methodological opportunity to be both general practitioner and researcher to propose an original anthropological point of view, and to promote reflexivity. Thus we see how the discourse of truth of GPs, specialists or alternative practitioners at the local level, taking shape in the construction of identities and the power games that regulate each other's positions. These mechanisms provide meaning for medical professionals, both for their existence and for their professional practice. But truths are also the result of a genuine effort to access to the reality. Science is then considered as the main tool. Doctors still like to find other mediators, a master or a learned society. And the issue of experience comes timidly last, as not politically correct or not politically desirable. Knowledge through action and seeing things in practice, seems though the common point of all. The difference between the scientist and the practitioner is thus questioned, as the objectivist thinking of professors of medicine and science in general
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Stubbe, Muriel. "Lymphocytes T CD4 et réponses vaccinales: du processus de différenciation à la mémoire immunologique." Doctoral thesis, Universite Libre de Bruxelles, 2007. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/210593.
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Les lymphocytes T CD4 (LT CD4) jouent un rôle central dans la régulation des réponses immunitaires vis-à-vis des agents infectieux et des vaccins. Cependant, leur différenciation in vivo est encore mal comprise et les caractéristiques des LT CD4 capables de persister à long terme tout en assurant une réponse immunitaire protectrice sont mal définies. L’approfondissement de ces connaissances est indispensable pour le développement de nouveaux vaccins. Pour approcher cette question, nous avons utilisé deux approches expérimentales. La première est un suivi de la différenciation des LT CD4 au cours de la réponse immune primaire chez des sujets vaccinés contre l’hépatite B ;la deuxième est la caractérisation phénotypique et fonctionnelle des LT CD4 mémoires antigène(Ag)-spécifiques pendant la phase d’état. Cette analyse a été réalisée au sein des LT CD4 spécifiques d’Ag vaccinaux, l’Ag de surface du virus de l’hépatite B (HBs) et la toxine tétanique (TT), ainsi que ceux spécifiques des Ag du cytomégalovirus (CMV). Les LT CD4 Ag-spécifiques ont été mis en évidence par cytométrie de flux après marquage intracytoplasmique du ligand du CD40 (CD40L) exprimé en réponse à une stimulation de courte durée par l’Ag. Des expériences basées sur la stimulation par la toxine du syndrome du choc toxique et le marquage du segment Vbeta2 du récepteur des LT ont démontré la bonne sensibilité et spécificité de cette méthode.
Le suivi de la réponse primaire chez 11 donneurs jusqu’à plus d’un an après immunisation par le vaccin anti-hépatite B a permis d’établir un modèle de différenciation des LT CD4 Ag-spécifiques in vivo chez l’homme. Nous avons mis en évidence des LT CD4 spécifiques d’un nombre limité de peptides immunodominants de la protéine HBs suggérant une réponse de type oligoclonale. Grâce à l’utilisation d’un cytomètre neuf couleurs, nous avons mené une analyse détaillée de l’hétérogénéité de la population mémoire HBs-spécifique. L’expression du CCR7 permet de distinguer des cellules de type mémoire centrale (LTCM, CCR7+) et effectrice (LTEM, CCR7-) se distinguant notamment par leur capacité à migrer vers les ganglions lymphatiques ainsi que par leurs propriétés fonctionnelles. Nous avons montré l’existence de ces deux sous-populations au sein des cellules HBs-spécifiques mais par opposition à leur définition initiale, ces LTCM sont capables de produire des cytokines effectrices. La proportion importante de LTCM exprimant le Ki67 témoigne d’une activité proliférative persistante in vivo et suggère la capacité de ces cellules à s’auto-renouveler et éventuellement à alimenter le pool des LTEM. La proportion importante de LTCM exprimant la chaîne alpha du récepteur à l’IL-7 (CD127) suggère que ces cellules sont sensibles aux signaux émanant de l’IL-7, une cytokine dont le rôle dans le maintien de la mémoire lymphocytaire T est connu. Compte tenu de la relevance potentielle de ces caractéristiques uniques pour le développement de vaccins et de l’accumulation de travaux montrant l’avantage sélectif des LTCM à conférer une immunité protectrice, nous avons focalisé la dernière partie de ces recherches sur cette sous-population. Une étude transversale des LTCM spécifiques de plusieurs types d’Ag (éliminés (HBs et TT) ou persistants (CMV)) a été menée. Nos résultats montrent une hétérogénéité, variable selon l’Ag, de la capacité de ces cellules à produire des cytokines effectrices et de leur phénotype de différenciation. Cette donnée nouvelle soulève la possibilité que les LTCM soient hétérogènes dans leur capacité à conférer une immunité protectrice. L’acquisition du marqueur KLRG1 par une fraction des LTCM s’associe à une capacité accrue à produire des cytokines effectrices et à une expression élevée du CD127. La possibilité que ces cellules soient particulièrement aptes à conférer une immunité protectrice et durable est discutée, tout comme les mécanismes menant à leur génération et l’intérêt de ces connaissances pour la conception de nouveaux vaccins.
Doctorat en Sciences médicales
info:eu-repo/semantics/nonPublished
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DRAI, MOLKHOU MARTINE. "Epidemiologie de l'hepatite b : campagnes de vaccination." Aix-Marseille 2, 1992. http://www.theses.fr/1992AIX20207.
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