摘要:

The 7-year follow-up with plasma-derived and 2-year follow-up with r-DNA vaccines have indicated the safety, immunogenicity and persistence of a vaccine-induced antibody response in hemodialysis patients. The results of our study indicate that these subjects have a lower and often inadequate immunogenic response to the HB vaccine and that the r-DNA vaccine gives a better seroconversion rate than the plasma-derived vaccines.

ISSN:1660-8151    

DOI:10.1159/000186924

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

To define the prevalence of NANB hepatitis, anti-HCV antibodies were determined in 51 patients on renal replacement therapy, in 7 transplanted patients and 17 staff members of the hemodialysis unit. Anti-HCV antibodies were evaluated using immunoenzymatic methods (Ortho HCV ELISA Test System, 1st and 2nd generation). Among hemodialysis patients, seroconversion was respectively documented in 17.6% (9/51) and 52.9% (27/51); none of the transplanted patients were positive with the 1st generation test, while 3/7 were positive with the 2nd. No statistically significant difference was found in the prevalence antibodies between transfused and nontransfused patients. ALT levels were statistically greater in patients whith anti-HCV antibodies (X2 2nd generation = 8.83; p < 0.01). Our results suggest: (1) that hemodialysis represents a risk factor; (2) the validity of substitute markers and (3) more sensitivity of the 2nd than 1st generation test.

ISSN:1660-8151    

DOI:10.1159/000186925

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The prevalence of hepatitis B virus (HBV) markers was assessed in 1,841/2,178 (84.5%) dialysis patients (DP) cared for in 38/47 dialysis units (80.9%) in Latium. Among DP, 205 (11.1%) were HBsAg positive: 13.8% of males and 7.1% of females (p < 0.001); the prevalence increased with the length of time on dialysis (p for trend < 0.001). No differences in HBV (HBsAg and/or anti-HBc) distribution were seen related to age and sex. Of 664/1,539 vaccinated DP, 150 (22.6%) were anti-HBc positive and 239 (36.0%) positive for anti-HBs alone. Of 875/ 1,539 nonvaccinated patients, 146 (16.7%) had no HBV marker. Vaccination against HBV did not influence the diffusion of HBV in our dialysis units and must be coupled with the implementation of long-standing infection control strategies.

ISSN:1660-8151    

DOI:10.1159/000186927

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

A prospective study was performed in 40 chronic uremics which included: (1) the intramuscular administration to all patients of 40 µg of a DNA-recombinant vaccine (Engerix-B) at 0,1,2,6 months; (2) an intramuscular booster dose of 40 µg at 18 months in patients having an anti-HBs titer > 100/ml at the 7th month (group A); (3) a further intramuscular supplementary dose of 40 µg at 12 months (besides that at 18 months) in patients developing an antibody titer 10 mlU/ml) was achieved, and then every month for a total of 6 months in patients who did not develop a protective titer even after 19 months (group C). At the end of the study, all patients had developed a protective titer: 77.5% after the 4th intramuscular dose, 12.5% after the 5th and 10% after 3.5 ± 0.5 (mean ± SEM) intradermal inoculations. The mean antibody titers were 1,461 ± 98 mlU/ml in group A, 594 ± 684 in group B and 131 ± 133 in group C. In conclusion, our two-step integrated protocol gives an anti-HBs protective titer in all our

ISSN:1660-8151    

DOI:10.1159/000186928

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

329 patients were evaluated from 1978 to 1990. 40 new cases of non-A non-B hepatitis were observed, all regarding patients on hemodialysis. Since the beginning of 1989, we introduced measures to limit the diffusion of the virus: reduction to a minimum of blood transfusions and a new disinfection protocol for monitors, instruments and surroundings. Of the 40 new cases, 30 took place between January 1985 and March 1989, only 2 later. If we consider the annual incidence before and after the introduction of preventive measures, we can observe a significant reduction in NANB hepatitis incidence in the last 2 years.

ISSN:1660-8151    

DOI:10.1159/000186929

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Hemodialyzed patients mean an high-risk population for hepatitis C infection. Our work was performed to evaluate the incidence of hepatitis C virus (HCV) infection in 51 hemodialyzed patients; the presence of anti-HCV antibodies was studied using the ElA and RIBA test of 1st and 2nd generation. 18 patients (35.29%) showed anti-HCV antibodies with the 1st test; 27 patients (52.94%) showed the presence of anti-HCV antibodies using 2nd generation test. The incidence of test positivity is not related to blood transfusions while it is strictly related with dialytic age. All HCV seropositive patients show antibodies against the c22-3 protein of “virus core”. The presence in serum of anti-c22-3 antibodies means that in these patients, there is viral replicat

ISSN:1660-8151    

DOI:10.1159/000186930

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Anti-HCV was tested in 77 uremic patients, 48 on hemodialysis (HD), 29 on CAPD, by immunoenzymatic 1st and 2nd generation assays (ELISA I, II) and 4-antigen (4-RIBA) immublotting. The investigation was extended to the staff (n = 29) and to HCV-positive patients’ families (n = 30). The prevalence using 2nd generation tests was double (21%) that in 1 st generation tests (11%). A greater incidence in the HD than in the CAPD group (23 vs. 17%) and a highly significative correlation to dialytic age were observed. No one among the sanitary personnel and only 2 family members were found HCV positive, suggesting a low infectivity via the parenteral inevident route. Extracorporeal circulation and particularly the exposure time to the treatment seem to be the main risk factor

ISSN:1660-8151    

DOI:10.1159/000186931

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

We evaluated anti-HBs titers 2 months after vaccination with recombinant hepatitis surface antigen (rDNA-HBsAg) in 43 maintenance hemodialysis patients (MHP). Of these, 34 had not undergone hepatitis B virus vaccination previously (NV-MHP) and 9 had shown negative response to vaccination with plasma-derived HBsAg (HEVAC Pasteur; V-MHP). 120 healthy workers from the same hospital undergoing rDNA-HBsAg immunization were used as controls. All low responders (LR) (anti-HBs < 100 mlU/ml) and nonresponders (NR; anti-HBs < 10 mlU/ml) were given a booster dose 3 months after the last dose of vaccine. Seroconversion rates were lower in NV-MHP (52.9%) than in controls (98.4%). V-MHP showed higher seroconversion rates (88.9%) than NV-MHP. In each group, the number of responders (R; anti-HBs ≥ 100 mlU/ml), LRand NR was as follows: controls 101,17,2; NV-MHP 6,12,16; V-MHP 8,0,1. After booster dose, 17/17 controls LR and no NV-MHP LR showed a rise in anti-HBs titers over 100 mlU/ml. Six months after the last dose of vaccine or the booster dose, anti-HBs titer fell under 10 mlU/ml in 4/12 MHP LR and under 100 mlU/ml in 6/14 MHP R. To achieve high seroconversion rates and to avoid the decline of anti-HBs to nonprotective titers in MHP, a booster injection should be made at different dates after the first vaccinatio

ISSN:1660-8151    

DOI:10.1159/000186932

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

We studied the prevalence and incidence of anti-hepatitis C virus (HCV) antibodies in 350 patients during 15 months and looked for some risk factors. We found a significant correlation between anti-HCV positivity and length of dialysis treatment and treatment in more than one center. We propose some prophylactic rules.

ISSN:1660-8151    

DOI:10.1159/000186934

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

A prospective study of liver disease has been conducted among patients entering our Dialysis Unit between 1987 and 1990. On entry, 7 patients had a history of blood transfusions but none had clinical or biochemical features of liver disease. During follow-up, 13 further patients were transfused; 1 case developed acute resolving hepatitis B and another acute non-A, non-B hepatitis progressing to chronicity. Eleven other cases showed transient or fluctuating ALT abnormalities. On entry, anti-HCV was negative by both 1st and 2nd generation ELISA assays (Ortho-Diagnostic Systems) in all cases. During follow-up, a positive reaction was detected in 17 cases: 4 patients were positive by both assays and 13 only by 2nd generation test (p < 0.01). HCV was implicated in 66% of cases with liver disease of the non-A, non-B type and in 50% of transfused as compared to 23% of nontransfused cases (p = n.s.). These findings suggest that HCV could play a major etiological role in liver disease of hemodialysis patients and that anti-C100 reactivity is more affected by immunosuppression associated with chronic uremia.

ISSN:1660-8151    

DOI:10.1159/000186935

出版商:S. Karger AG    

年代:1992

数据来源: Karger