RESUMO
AIM: To asses the yellow fever effectiveness in persons traveling to the endemic regions, and the frequency of adverse events related to vaccine as well as the change of neutralizing antibodies in time. METHODS: Fifty three persons (25 males and 28 females, mean 43.5 years) vaccinated against yellow fever in 2004-2008 were involved to the study. In 2009 the level of serum anti-yellow fever antibodies was measured by neutralization test. MAIN OBSERVATION AND RESULTS: None of studied person demonstrated adverse events related to yellow fever vaccine. Four subjects (7.5%) did not respond appropriately to the vaccine. There was no correlation between the level of neutralizing antibodies and gender, age, co-morbidities presence and duration of time after vaccination. CONCLUSIONS: Currently used anti-yellow fever vaccine demonstrates high level of efficacy and safety. Above 92% of studied persons had protective level of neutralizing antibodies. Moreover, the postvaccinal response seems to be long-term and does not depend on time period from vaccination or other factors.
Assuntos
Doenças Endêmicas/prevenção & controle , Viagem , Vacina contra Febre Amarela/administração & dosagem , Vacina contra Febre Amarela/imunologia , Febre Amarela/epidemiologia , Febre Amarela/prevenção & controle , Adaptação Fisiológica/imunologia , Adulto , África , América Central , Feminino , Humanos , Esquemas de Imunização , Masculino , Pessoa de Meia-Idade , Polônia , Vacina contra Febre Amarela/efeitos adversos , Adulto JovemRESUMO
BACKGROUND: Both natural history and treatment outcome of hepatitis B virus (HBV) infection are influenced by genotypes and viral load. Information about factors determining HBV genotype distribution and viraemia in HIV/HBV-co-infected patients is scarce. METHODS: All HIV-positive patients living in Europe and Argentina recruited in EuroSIDA (1994-2006) were tested for serum HBV surface antigen (HBsAg). Chronic carriers were further characterized virologically at one central laboratory. Variables influencing HBV genotype distribution and viraemia were assessed using logistic regression. RESULTS: From 16 505 HIV patients enrolled in EuroSIDA, 1179 (7.1%) were HBsAg positive, of whom 474 had specimens that allowed inclusion in the virological substudy. Overall 293 (62%) were treated with anti-HBV active antiretroviral drugs at the time of testing. Hepatitis delta virus superinfection was recognized in 14% and hepatitis C virus (HCV) antibodies in 27%. Serum HBV DNA was detectable in 315 (66.5%) and HBV genotyping gave results in 170 (35.9%) patients. HBV genotype distribution was as follows: A (72.9%), D (17.1%), G (1.8%), E (1.2%), F (1.2%) and C (0.6%); another 5.9% were co-infected with multiple HBV genotypes. In the multivariate analysis, the best predictor of HBV genotype A infection was risk exposure other than intravenous drug use, whereas predictors for detectable HBV viraemia were lower CD4 counts and lack of HCV antibodies. CONCLUSION: A substantial proportion of HIV-positive patients with chronic hepatitis B show detectable HBV viraemia despite being treated with anti-HBV active antiretroviral drugs (mainly lamivudine). Low CD4 counts were associated with an independent higher risk of detectable HBV viraemia, which supports an earlier introduction of antiretroviral therapy, including anti-HBV drug(s) more potent than lamivudine.