RESUMEN
Calendario de Inmunizaciones 2024 de población infantil, escolar y adulta.
Asunto(s)
Virus Sincitiales Respiratorios , Vacuna BCG , Vacunas contra la Influenza , Vacuna contra Viruela , Vacunas , Vacunas contra Hepatitis Viral , Vacuna contra Difteria, Tétanos y Tos Ferina , Chile , Inmunización , Vacunas contra Hepatitis B , Vacunas Combinadas , Programas de Inmunización , Vacuna contra la Varicela , Vacunas Meningococicas , Vacunas Neumococicas , Vacuna contra el Sarampión-Parotiditis-Rubéola , Vacuna contra la Fiebre Amarilla , Vacunas contra Papillomavirus , Vacuna Neumocócica Conjugada Heptavalente , Vacunas contra la COVID-19RESUMEN
INTRODUCTION: Inflammatory Bowel Disease (IBD) treatment may increase the risk of infections. Vaccines are part of the comprehensive IBD patient care. The aim of this study was to describe indications and adherence of immunizations in IBD and identify possible associated factors. METHODS: A cross-sectional, analytic study was conducted in patients from an IBD Program of a tertiary center in Chile, between April - June 2019. Patients were asked to answer a vaccine survey and information also was obtained from the National Immunization Registry. Descriptive and association statistic were used (χ2; p<0.05). RESULTS: A total of 243 patients were included (148 ulcerative colitis (UC), 86 Crohn's disease (CD) and 9 non-classifiable IBD). Only six patients (2%) of IBD patients received a complete immunization schedule. The highest vaccine rates were against influenza (67%), hepatitis B virus (40%), 13-valent pneumococcal (34%) and 23-polysaccharide pneumococcal (16%). The influenza vaccine rate has significantly increased, reaching 67% in 2019. The survey showed that 23% of patients have not been immunized with any vaccine, mainly due to lack of time, lack of medical prescription and high cost. CONCLUSIONS: In this cohort, although vaccination rates are higher than previously reported, adherence to IBD immunization program would be improved, being considered since diagnosis by the multidisciplinary team.
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Vacuna contra Difteria, Tétanos y Tos Ferina , Inmunización/estadística & datos numéricos , Enfermedades Inflamatorias del Intestino/complicaciones , Vacunas contra la Influenza , Vacunas Meningococicas , Vacunas Neumococicas , Vacunas contra Hepatitis Viral , Adolescente , Adulto , Anciano , Chile , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Este artigo aborda as hepatites virais, tema tratado no Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis e, mais precisamente, nos Protocolos Clínicos e Diretrizes Terapêuticas para Hepatite B e para Hepatite C e Coinfecções, publicados pelo Ministério da Saúde do Brasil. Além do espectro ampliado de acometimento da saúde, os vírus das hepatites A, B e C também apresentam diferentes formas de transmissão, seja parenteral, sexual, vertical ou oral. Entre as estratégias sugeridas para o controle das hepatites virais, além das medidas comportamentais, estão o diagnóstico ampliado, a vacinação precoce contra os vírus da hepatite A e hepatite B e o acesso aos recursos terapêuticos disponíveis. Considerando a transmissão vertical dos vírus da hepatite B e hepatite C, a triagem das gestantes portadoras crônicas desses vírus é uma importante estratégia de saúde perinatal, indicando com precisão quem pode se beneficiar das intervenções profiláticas disponíveis.
This article discusses viral hepatitis, a theme addressed by the Clinical Protocol and Therapeutic Guidelines to Comprehensive Care for People with Sexually Transmitted Infections and, more precisely, by the Clinical Protocols and Therapeutic Guidelines for Hepatitis B and Hepatitis C and Coinfections, published by the Brazilian Ministry of Health. Besides the broad spectrum of health impairment, hepatitis A, B and C viruses also present different forms of transmission, whether parenteral, sexual, vertical or oral. Among the strategies suggested for the control of viral hepatitis, in addition to behavioral measures, are expanded diagnosis, early vaccination against hepatitis A and hepatitis B viruses, and access to available therapeutic resources. Considering vertical transmission of the hepatitis B and hepatitis C viruses, screening for pregnant women with chronic hepatitis B and C is an important perinatal health strategy, indicating with precision those who can benefit from the prophylactic interventions.
Este artículo aborda las hepatitis virales, tema que hace parte del Protocolo Clínico y Directrices Terapéuticas para la Atención Integral a Personas con Infecciones de Transmisión Sexual y más precisamente de los Protocolos Clínicos y Guías Terapéuticas para Hepatitis B, Hepatitis C y Coinfecciones, publicados por el Ministerio de Salud. Además del amplio espectro de deterioro de la salud, los virus de las hepatitis A, B y C presentan diferentes formas de transmisión, como parenteral, sexual, vertical u oral. Entre las estrategias sugeridas para el control de las hepatitis virales, están las medidas conductuales, el diagnóstico ampliado, la vacunación precoz contra los virus de las hepatitis A y B y el acceso facilitado a los recursos terapéuticos disponibles. Considerando la transmisión vertical de los virus de la hepatitis B y C, la identificación de embarazadas portadoras crónicas de estos virus es importante estrategia de salud perinatal, indicando quiénes pueden beneficiarse de las intervenciones profilácticas.
Asunto(s)
Humanos , Enfermedades de Transmisión Sexual/epidemiología , Hepatitis C/epidemiología , Hepatitis A/epidemiología , Hepatitis B/epidemiología , Hepatitis Viral Humana/epidemiología , Brasil/epidemiología , Vacunas contra Hepatitis Viral/inmunología , Enfermedades de Transmisión Sexual/prevención & control , Protocolos Clínicos , Transmisión Vertical de Enfermedad Infecciosa/prevención & controlAsunto(s)
Investigación Biomédica , Gastroenterología , Hepatitis C , Antivirales/uso terapéutico , Infecciones Asintomáticas , Bancos de Sangre , Transfusión Sanguínea/normas , Carcinoma Hepatocelular/epidemiología , Carcinoma Hepatocelular/etiología , Infección Hospitalaria/prevención & control , Desarrollo de Medicamentos , Farmacorresistencia Viral , Hepacivirus , Hepatitis C/complicaciones , Hepatitis C/tratamiento farmacológico , Hepatitis C/prevención & control , Humanos , Neoplasias Hepáticas/epidemiología , Neoplasias Hepáticas/etiología , Apoyo a la Investigación como Asunto , Vacunas contra Hepatitis Viral/uso terapéuticoRESUMEN
INTRODUCTION: The prevalence of hepatitis B and hepatitis C and risk behaviors among 402 female sex workers in Central Brazil were investigated by respondent-driven sampling. METHODS: Blood samples were tested for hepatitis B and C markers by enzyme-linked immunosorbent assay. Two hepatitis B vaccination schedules were performed. RESULTS: The prevalence of hepatitis B and C infections were 9.3% and 0.5%, respectively. Susceptibility to hepatitis B infection was observed in 61.5% of subjects. There was no significant difference in adherence index (p=0.52) between vaccination schedules and all participants had protective antibody titers. CONCLUSIONS: This hard-to-reach population requires hepatitis B and C surveillance.
Asunto(s)
Hepatitis B/epidemiología , Hepatitis C/epidemiología , Trabajadores Sexuales/estadística & datos numéricos , Adolescente , Adulto , Brasil/epidemiología , Ensayo de Inmunoadsorción Enzimática , Femenino , Hepacivirus/inmunología , Hepatitis B/diagnóstico , Hepatitis B/prevención & control , Virus de la Hepatitis B/inmunología , Hepatitis C/diagnóstico , Hepatitis C/prevención & control , Humanos , Persona de Mediana Edad , Prevalencia , Asunción de Riesgos , Factores Socioeconómicos , Vacunas contra Hepatitis Viral/administración & dosificación , Vacunas contra Hepatitis Viral/inmunología , Adulto JovenRESUMEN
Abstract INTRODUCTION: The prevalence of hepatitis B and hepatitis C and risk behaviors among 402 female sex workers in Central Brazil were investigated by respondent-driven sampling. METHODS: Blood samples were tested for hepatitis B and C markers by enzyme-linked immunosorbent assay. Two hepatitis B vaccination schedules were performed. RESULTS: The prevalence of hepatitis B and C infections were 9.3% and 0.5%, respectively. Susceptibility to hepatitis B infection was observed in 61.5% of subjects. There was no significant difference in adherence index (p=0.52) between vaccination schedules and all participants had protective antibody titers. CONCLUSIONS: This hard-to-reach population requires hepatitis B and C surveillance.
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Humanos , Femenino , Adolescente , Adulto , Adulto Joven , Vacunas contra Hepatitis Viral/administración & dosificación , Hepatitis C/epidemiología , Trabajadores Sexuales/estadística & datos numéricos , Hepatitis B/epidemiología , Asunción de Riesgos , Factores Socioeconómicos , Brasil/epidemiología , Ensayo de Inmunoadsorción Enzimática , Vacunas contra Hepatitis Viral/inmunología , Virus de la Hepatitis B/inmunología , Prevalencia , Hepatitis C/diagnóstico , Hepatitis C/prevención & control , Hepacivirus/inmunología , Hepatitis B/diagnóstico , Hepatitis B/prevención & control , Persona de Mediana EdadRESUMEN
Drug users have been reported to have an increased risk for acquisition of viral hepatitis. This study aims to evaluate the prevalence of HBV and HCV infection and usefulness of saliva for HBsAg and anti-HCV detection in alcoholic patients.A total of 90 alcoholic patients were recruited in 2013. HBsAg and anti-HCV were tested in serum and saliva, anti-HBc and anti-HBs were tested in serum using commercial enzyme immunoassays (EIA).Using serum samples, anti-HCV, HBsAg, anti-HBc and anti-HBs prevalences were 5.6%, 0%, 15.7%, and 29.2%. HBsAg detection in saliva showed 100% of specificity and anti-HCV detection demonstrated 100% of sensitivity and 94.7% of specificity. Low prevalence of HBV and high prevalence of anti-HCV were found and reinforced the recommendation of HBV vaccination to avoid the acute and chronic cases and HCV screening in this group to identify cases for antiviral therapy. Saliva samples could be used for anti-HCV detection in this population, what could increase the diagnosis access.
Asunto(s)
Alcoholismo/epidemiología , Anticuerpos contra la Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/sangre , Hepatitis B/epidemiología , Anticuerpos contra la Hepatitis C/sangre , Hepatitis C/epidemiología , Anciano , Alcoholismo/complicaciones , Brasil/epidemiología , Femenino , Hepatitis B/complicaciones , Hepatitis B/diagnóstico , Hepatitis C/complicaciones , Hepatitis C/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Vacunación , Vacunas contra Hepatitis ViralRESUMEN
OBJECTIVES: To quantify the number of missed opportunities for vaccination with hepatitis A vaccine in children and assess the association of missed opportunities for hepatitis A vaccination with covariates of interest. STUDY DESIGN: Weighted data from the 2013 National Immunization Survey of US children aged 19-35 months were used. Analysis was restricted to children with provider-verified vaccination history (n = 13 460). Missed opportunities for vaccination were quantified by determining the number of medical visits a child made when another vaccine was administered during eligibility for hepatitis A vaccine, but hepatitis A vaccine was not administered. Cross-sectional bivariate and multivariate polytomous logistic regression were used to assess the association of missed opportunities for vaccination with child and maternal demographic, socioeconomic, and geographic covariates. RESULTS: In 2013, 85% of children in our study population had initiated the hepatitis A vaccine series, and 60% received 2 or more doses. Children who received zero doses of hepatitis A vaccine had an average of 1.77 missed opportunities for vaccination compared with 0.43 missed opportunities for vaccination in those receiving 2 doses. Children with 2 or more missed opportunities for vaccination initiated the vaccine series 6 months later than children without missed opportunities. In the fully adjusted multivariate model, children who were younger, had ever received WIC benefits, or lived in a state with childcare entry mandates were at a reduced odds for 2 or more missed opportunities for vaccination; children living in the Northeast census region were at an increased odds. CONCLUSIONS: Missed opportunities for vaccination likely contribute to the poor coverage for hepatitis A vaccination in children; it is important to understand why children are not receiving the vaccine when eligible.
Asunto(s)
Hepatitis A/prevención & control , Programas de Inmunización/estadística & datos numéricos , Vacunas contra Hepatitis Viral/administración & dosificación , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Masculino , Encuestas y Cuestionarios , Estados UnidosRESUMEN
Hepatitis C virus (HCV) is a significant global public health problem with >185 million infections worldwide. A series of genome-wide association studies (GWAS) has identified IL-28B polymorphisms as a predictor of sustained virologic response (SVR), as well as spontaneous clearance in chronic HCV genotype 1 patients. The objective of this work was to evaluate the prevalence of IL-28B rs12979860 and rs8099917 polymorphisms in Cuban chronic HCV patients. The study cohort included 73 chronic HCV patients treated with concomitant administration of CIGB-230 and nonpegylated IFN-α plus ribavirin (non-pegIFN-α/R) antiviral therapy. The genotype distribution of IL-28B rs12979860CC, -CT, and -TT was 29, 41, and 30%, respectively, and the distribution for rs8099917TT, -TG, and -GG was 63, 31, and 5%, respectively. The allele frequencies for rs12979860C and -T alleles were 51 and 49%, respectively, and for rs8099917G and -T alleles, the values were 21 and 79%, respectively. SVR rates were 55, 42, and 35% for rs12979860CC, -CT, and -TT, respectively, and 52, 30, and 25% for rs8099917TT, -GT, and -GG, respectively. The combined assessment of both single nucleotide polymorphisms (SNPs) resulted in 3 major genotypes (rs12979860CC/rs8099917TT, rs12979860CT/rs8099917TT, and rs12979860CT/rs8099917GG) with a frequency of 30.1, 21.9, and 20.5%, respectively. In patients with heterozygous variant rs12979860CT, the additional genotyping of rs8099917 contributed to increase the SVR rate. It is concluded that in Cuban HCV-infected patients, the responder homogeneous variant rs8099917TT is the most frequent genotype. The simultaneous genotyping of 2 IL-28B SNPs could improve the prediction of SVR contributing to better therapeutic decisions and treatment management.
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Hepatitis C Crónica/genética , Interleucinas/genética , Polimorfismo de Nucleótido Simple , Adolescente , Adulto , Antivirales/uso terapéutico , Estudios de Casos y Controles , Estudios de Cohortes , Cuba , Femenino , Frecuencia de los Genes , Hepatitis C Crónica/tratamiento farmacológico , Humanos , Interferón-alfa/uso terapéutico , Interferones , Masculino , Persona de Mediana Edad , Ribavirina/uso terapéutico , Resultado del Tratamiento , Vacunas de ADN/uso terapéutico , Vacunas contra Hepatitis Viral/uso terapéuticoRESUMEN
Hepatitis C virus (HCV) has dominated the field of hepatology for the past 25 years, and its cure in the majority of treated patients is one of the greatest achievements in all of medicine. However, the latter has led to the belief by some that HCV research should be shelved for other, more pressing areas. The mission for HCV eradication is far from accomplished. As a historical reference, we should consider that disease elimination has required vaccination with all previously controlled infections including smallpox and polio and that simple, effective treatment is not sufficient in most infections to lead to substantial control. Syphilis is the best example, for which a single dose of penicillin (which literally costs pennies and that we have had since 1945) is curative in early stages. Not only have we not eradicated syphilis, rates of infection have increased in many places within the United States in recent years. Most HCV-infected subjects are unaware of their infection, remaining at risk for transmission to others and disease progression, including cirrhosis and hepatocellular carcinoma. In the era of highly effective direct-acting antivirals (DAAs), many questions pertaining to HCV remain, but they are more complex and difficult to answer. Here, I provide my perspective on some of these salient issues: the residual risk for disease progression after sustained virologic response, the optimal approach to current DAA failures, the impact of targeting people who inject drugs with DAAs, vaccine prospects, and application of neutralizing HCV glycoprotein antibodies. (Hepatology 2017;65:341-349).
Asunto(s)
Antivirales/uso terapéutico , Investigación Biomédica , Hepacivirus , Hepatitis C Crónica/tratamiento farmacológico , Anticuerpos Neutralizantes/uso terapéutico , Investigación Biomédica/economía , Progresión de la Enfermedad , Administración Financiera , Hepatitis C Crónica/epidemiología , Hepatitis C Crónica/prevención & control , Humanos , Riesgo , Insuficiencia del Tratamiento , Vacunas contra Hepatitis ViralRESUMEN
El presente informe ofrece un panorama de las epidemias actuales de hepatitis B y hepatitis C, así como de la respuesta del sector de la salud en la Región de las Américas. Su finalidad es proporcionar, en el marco de un entorno en constante cambio, un conocimiento básico de los temas principales relacionados con la respuesta a estas epidemias en la Región, para lo cual presenta un panorama de los grupos de población afectados y de la carga de las infecciones por el virus de la hepatitis B (VHB) y el virus de la hepatitis C (VHC) en la Región, además de las actuales políticas y de las prácticas del sector de la salud. Este informe, el primero en su tipo que aborda el seguimiento de los progresos en la consecución de las metas establecidas en el Plan de acción para la prevención y el control de las hepatitis virales,tiene por objeto ayudar a los Estados Miembros a adaptar sus políticas y prioridades para que puedan establecer una respuesta de salud pública eficaz e integral. Se ha producido un cambio importante en la conciencia mundial sobre las epidemias de hepatitis virales: ya no se consideran silenciosas y actualmente se observa una evolución hacia la adopción de medidas a escala mundial para eliminarlas como problema de salud pública. En la Región de las Américas, la principal carga de las hepatitis virales se debe a las hepatitis B y C; unos 2,8 millones de personas (2,2 a 8,0 millones)1presentan la infección crónica por el virus de la hepatitis B (VHB), de las cuales 2,1 millones viven...
Asunto(s)
Humanos , Hepatitis C/epidemiología , Programas de Inmunización/normas , Hepatitis B Crónica/epidemiología , Hepatitis Viral Humana/complicaciones , Vacunas contra Hepatitis Viral/normas , Hepatitis C/prevención & control , Carcinoma Hepatocelular/complicaciones , Hepatitis B Crónica/prevención & control , Política de Salud , Cirrosis Hepática/complicacionesRESUMEN
Hepatitis C is a contagious liver disease caused by hepacivirus of the Flaviviridae family. It has a RNA genome, a unique highly variable molecule. It encodes ten proteins which are necessary to infect cells and multiply. Replication occurs only in hepatocytes. Because of its wide genomic variability and the absence of symptoms, it is difficult to make an early diagnosis and successful treatment. In this review we analyze the molecular mechanism by which the virus infects the hepatocytes and causes the disease. We focused the analysis on different therapies, with the possibility of improving treatment with the use of new specific vaccines. We highlight the use of new therapies based on nucleic acids, mainly DNA vectors. In the near future, once this treatment is adequately evaluated in clinical trials, and the costs are calculated, it could be a very beneficial alternative to conventional methods.
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Hepacivirus/efectos de los fármacos , Vacunas contra Hepatitis Viral/uso terapéutico , Animales , Progresión de la Enfermedad , Diseño de Fármacos , Evaluación Preclínica de Medicamentos , Genoma Viral , Genotipo , Hepacivirus/genética , Hepacivirus/inmunología , Hepacivirus/fisiología , Hepatitis C/tratamiento farmacológico , Hepatitis C/epidemiología , Hepatitis C/virología , Anticuerpos contra la Hepatitis C/inmunología , Hepatocitos/virología , Humanos , Inmunogenicidad Vacunal , Ratones , ARN Viral/genética , Vacunas de ADN , Vacunas de Subunidad , Proteínas Virales/fisiologíaRESUMEN
Estudo Histórico Social que tem como objeto notícias sobre o Levantamento de Recursos e Necessidades de Enfermagem no Brasil, publicadas na Revista Brasileira de Enfermagem entre 1955 e 1958. A fonte primária foi constituída pelos exemplares da Revista Brasileira de Enfermagem, publicados dentro do recorte temporal do estudo. As fontes secundárias foram constituídas por livros, artigos, dissertações e teses relativas à história da Enfermagem. A análise dos dados teve apoio das fontes secundárias e do pensamento do sociólogo Pierre Bourdieu. Os dados evidenciaram que a Revista Brasileira de Enfermagem, além de oportunizar a divulgação de notícias acerca do Levantamento, proporcionou visibilidade ao mesmo mediante a veiculação dessas notícias e, por fim, teve o efeito simbólico de conferir poder e prestígio à Enfermagem Brasileira.
Social historical study that has as object news related to the Assessment of the Resources and Needs of Nursing in Brazil published in the Revista Brasileira de Enfermagem between 1955 and 1958. The primary source is constituted of copies of Revista Brasileira de Enfermagem published within the selected period of the study. The secondary sources are constituted of books, papers, dissertations and thesis related to the Nursing history. The data analysis was supported by the secondary sources and the thought of the sociologist Pierre Bourdieu. The results evidenced that Revista Brasileira de Enfermagem, in addition to making possible the dissemination of news about the Assessment provided visibility to it and, at last, had the symbolic effect of giving power and prestige to the Brazilian Nursing.
Estudio Histórico Social que tiene como objeto noticias referentes al Levantamiento de Recursos y Necesidades de Enfermería en Brasil publicadas en la Revista Brasileira de Enfermagem entre 1955 y 1958. La fuente primaria se constituye de los ejemplares de la Revista Brasileira de Enfermagem publicados dentro del recorte temporal do estudio. Las fuentes secundarias están constituidas de libros, artículos disertaciones y tesis relativas a la historia de la Enfermería. El análisis de los datos tuvo apoyo de las fuentes secundarias y del pensamiento del Sociólogo Pierre Bourdieu. Los resultados evidencian que la Revista Brasileira de Enfermagem, además de posibilitar la divulgación de noticias acerca del Levantamiento proporcionó visibilidad al mismo mediante la divulgación de esas noticias y, por fin, tuve el efecto simbólico de conferir poder y prestigio a la Enfermería Brasileña.
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Animales , Femenino , Ratones , Antígenos de Superficie de la Hepatitis B/genética , Vacunas contra Hepatitis B/genética , Proteínas del Envoltorio Viral/genética , Proteínas del Envoltorio Viral/inmunología , Vacunas contra Hepatitis Viral/genética , Fusión Artificial Génica , Secuencia de Bases , Hepacivirus/genética , Hepacivirus/inmunología , Virus de la Hepatitis B/genética , Virus de la Hepatitis B/inmunología , Inmunización , Técnicas In Vitro , Datos de Secuencia Molecular , Vacunas de ADN/genéticaRESUMEN
AIM: To analyze hepatitis C virus (HCV)-specific immune responses in chronically infected patients under triple therapy with interferon-α (IFN-α) plus ribavirin and CIGB-230. METHODS: CIGB-230 was administered in different schedules with respect to IFN-α plus ribavirin therapy. Paired serum and peripheral blood mononuclear cells (PBMC) samples from baseline and end of treatment were analyzed. The HCV-specific humoral response was tested by enzyme-linked immunosorbent assay, neutralizing antibodies were evaluated by cell culture HCV neutralization assays, PBMC proliferation was assayed by carboxyfluorescein succinimidyl ester staining and IFN-γ secretion was assessed by enzyme-linked immunospot. Data on virological and histological response and their association with immune variables are also provided. RESULTS: From week 12 to week 48, all groups of patients showed a significant reduction in mean leukocyte counts. Statistically significant reductions in antibody titers were frequent, but only individuals immunized with CIGB-230 as early add-on treatment sustained the core-IgG response, and the neutralizing antibody response was enhanced only in patients receiving CIGB-230. Cell-mediated immune responses also tended to decline, but significant reductions in IFN-γ secretion and total absence of core-specific lymphoproliferation were exclusive of the control group. Only CIGB-230-immunized individuals showed de novo induced lymphoproliferative responses against the structural antigens. Importantly, it was demonstrated that the quality of the CIGB-230-induced immune response depended on the number of doses and timing of administration in relation to the antiviral therapy. Specifically, the administration of 6 doses of CIGB-230 as late add-on to therapy increased the neutralizing antibody activity and the de novo core-specific IFN-γ secretion, both of which were associated with the sustained virological response. CONCLUSION: CIGB-230, combined with IFN-α-based therapy, modifies the immune response in chronic patients. The study provides evidence for the design of more effective therapeutic vaccine interventions against HCV.
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Antivirales/administración & dosificación , Hepacivirus/efectos de los fármacos , Hepatitis C Crónica/tratamiento farmacológico , Interferón-alfa/administración & dosificación , Ribavirina/administración & dosificación , Vacunas de ADN/administración & dosificación , Vacunas contra Hepatitis Viral/administración & dosificación , Adulto , Antivirales/efectos adversos , Biomarcadores/sangre , Células Cultivadas , Cuba , Método Doble Ciego , Esquema de Medicación , Quimioterapia Combinada , Femenino , Hepacivirus/genética , Hepacivirus/inmunología , Anticuerpos contra la Hepatitis C/sangre , Hepatitis C Crónica/diagnóstico , Hepatitis C Crónica/inmunología , Humanos , Inmunidad Celular/efectos de los fármacos , Inmunidad Humoral/efectos de los fármacos , Esquemas de Inmunización , Interferón alfa-2 , Interferón-alfa/efectos adversos , Interferón gamma/metabolismo , Leucocitos Mononucleares/efectos de los fármacos , Leucocitos Mononucleares/inmunología , Leucocitos Mononucleares/virología , Masculino , Persona de Mediana Edad , Proteínas Recombinantes/administración & dosificación , Proteínas Recombinantes/efectos adversos , Ribavirina/efectos adversos , Factores de Tiempo , Resultado del Tratamiento , Vacunas de ADN/efectos adversos , Vacunas contra Hepatitis Viral/efectos adversosRESUMEN
Hepatitis E virus is one of the most common causes of acute hepatitis worldwide, with the majority of cases occurring in Asia. In recent years, however, an increasing number of acute and chronic hepatitis E virus infections have been reported in industrialized countries. The importance of this infection resides in the associated morbidity and mortality. In acute cases, a high mortality rate has been reported in patients with previously undiagnosed alcoholic liver disease. Hepatitis E infection can become chronic in immunocompromised patients, such as solid organ transplant recipients, patients receiving chemotherapy, and HIV-infected patients, and lead to the development of hepatic fibrosis and cirrhosis. Hence, treatment strategies involving reductions in immunosuppressive regimens and therapy with ribavirin or peg-interferon have been evaluated. In terms of prevention, a promising new vaccine was recently licensed in China, although its efficacy is uncertain and potential adverse effects in risk groups such as chronic liver disease patients and pregnant women require investigation. In conclusion, physicians should be aware of hepatitis E as a cause of both acute and chronic hepatitis in immunocompromised patients. The best treatment option for HEV infection remains to be defined, but both ribavirin and peg-interferon may have a role in therapy for this condition.
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Hepatitis E , Hepatitis Crónica , Enfermedad Aguda , Antivirales/uso terapéutico , Hepatitis E/diagnóstico , Hepatitis E/tratamiento farmacológico , Hepatitis E/epidemiología , Hepatitis E/prevención & control , Hepatitis Crónica/diagnóstico , Hepatitis Crónica/epidemiología , Hepatitis Crónica/prevención & control , Hepatitis Crónica/terapia , Humanos , Factores de Riesgo , Resultado del Tratamiento , Vacunas contra Hepatitis Viral/uso terapéuticoRESUMEN
Covalently modified albumin (BSA) microparticles were developed for potential use as an adjuvant in mucosal vaccines against hepatitis B. To synthesize consistent protein particles, a covalent approach was proposed to modify BSA. Our strategy was to bond maleic anhydride (MA) molecules to BSA structure by nucleophilic reaction for further radical cross-linking/polymerization reaction with N',N'-dimethylacrylamide (DMAAm). The presence of poly(N',N'-dimethylacrylamide) in the protein network enables the microparticles to show well-defined, homogeneous forms. Cytotoxicity tests showed that the cytotoxic concentration for 50% of VERO cells (CC50) was 216.25 ± 5.30 µg mL(-1) in 72 h of incubation. The obtained CC50 value is relatively low for an incubation time of 72 h, suggesting an acceptable biocompatibility. Assay of total protein showed that the encapsulation efficiency of the microparticles with hepatitis B surface antigen (HBsAg) was 77.7 ± 0.2%. For the reference sample, which was incubated without HBsAg, the quantity of protein was below the limit of detection.
Asunto(s)
Hepatitis B/prevención & control , Albúmina Sérica Bovina/química , Adyuvantes Inmunológicos/química , Amidas/química , Animales , Supervivencia Celular/efectos de los fármacos , Chlorocebus aethiops , Reactivos de Enlaces Cruzados/química , Composición de Medicamentos , Emulsiones , Antígenos de Superficie de la Hepatitis B/química , Humanos , Dosificación Letal Mediana , Límite de Detección , Anhídridos Maleicos/química , Tamaño de la Partícula , Células Vero , Vacunas contra Hepatitis Viral/síntesis química , Vacunas contra Hepatitis Viral/toxicidad , Difracción de Rayos XRESUMEN
Viral hepatitis B, C and delta still remain a serious problem in Latin America. Data from the 1980s indicated that HBV and HDV infection are the main causes of chronic hepatitis. However, the spread of HBV infection could be controlled through the implementation of immunization programmes. Different countries from Mexico to Argentina display marked differences in terms of HBV genotype distribution. HBV genotype F has been identified as the most frequent in most Latin America countries, except for Mexico and Brazil, where genotypes H and A are the most frequent, respectively. In Latin America, the overall prevalence of HCV antibody is estimated to be 1.5%. Latin American countries have been very proactive in screening their blood supplies, thus minimizing risk of HCV transmission through transfusion. The number of diagnosed and treated patients is still low, thereby increasing the burden of complications such as liver cirrhosis or hepatocellular carcinoma. The most prevalent HCV genotype is 1, which is the genotype with the greatest worldwide spread, but it is a different genotype from other regions like Africa and Asia. HDV is present worldwide but its distribution pattern is not uniform. HDV was recently detected in novel geographic regions, reinforcing that it is a very serious health threat in under-developed countries. The main prevalence areas are the Mediterranean basin, the Middle East, central and northern Asia, western and central Africa, the Amazonian basin (Brazil, Peru, Venezuela and Colombia) and the Pacific islands. Novel strategies to increase HBV immunization in the Latin American population are needed to warrant thorough coverage in the rural areas.
Asunto(s)
Hepatitis B/epidemiología , Hepatitis C/epidemiología , Hepatitis D/epidemiología , Anticuerpos Antivirales/sangre , Carcinoma Hepatocelular/complicaciones , Carcinoma Hepatocelular/virología , Países en Desarrollo , Hepacivirus/genética , Hepacivirus/inmunología , Hepatitis B/prevención & control , Hepatitis B/transmisión , Virus de la Hepatitis B/genética , Virus de la Hepatitis B/inmunología , Hepatitis C/prevención & control , Hepatitis C/transmisión , Hepatitis D/prevención & control , Hepatitis D/transmisión , Humanos , Programas de Inmunización , América Latina/epidemiología , Cirrosis Hepática/complicaciones , Cirrosis Hepática/virología , Neoplasias Hepáticas/complicaciones , Neoplasias Hepáticas/virología , Vacunas contra Hepatitis ViralRESUMEN
Hepatitis C virus (HCV) infects approximately 3% of global population. This pathogen is one of the main causes of chronic viral hepatitis, cirrhosis, and liver cancer, as well as the principal reason for liver transplant in Western countries. Therapy against HCV infection is effective in only half of treated patients. There is no vaccine available against HCV. Some vaccine candidates have reached the clinical trials but several factors, including the incomplete definition of immunological correlates of protection and treatment-related clearance have slowed down vaccine development. Precisely, the present review discusses the state of the art in the establishment of parameters related with immunity against HCV. Validity and limitations of the information accumulated from chimpanzees and other animal models, analysis of studies in humans infected with HCV, and relevance of aspects like type, strength, duration, and specificity of immune response related to successful outcome are evaluated in detail. Moreover, the immune responses induced in some clinical trials with vaccine candidates resemble the theoretical immunological correlates, raising questions about the validity of those correlates. When all facts are taken together, complete definition of immunological correlates for protection or treatment-related clearance is an urgent priority. A limited or wrong criterion with respect to this relevant matter might cause incorrect vaccine design and selection of immunization strategies or erroneous clinical evaluation.