Duration of Hepatitis B Surface Antigenemia (HBs Ag) in Hemodialysis Patients

Ribot, Seymour

doi:10.1001/archinte.1979.03630390036015

Cited by 63 publications

(26 citation statements)

References 30 publications

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“…However, dialysis patients show a marked propensity to become chronic carriers of HBsAg because of the defective immune responses associated with chronic uremia [14]. An impairment of cell-mediated immunity despite a normal number of T cells and an increased CD4/CD8 ratio has been described in this population.…”

Section: Natural History Of Hbv Infection In Dialysis Patientsmentioning

confidence: 99%

Hepatitis B Virus Infection in Dialysis Patients

Fabrizi¹,

Martin²

2000

Am J Nephrol

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Section: Natural History Of Hbv Infection In Dialysis Patientsmentioning

confidence: 99%

Hepatitis B Virus Infection in Dialysis Patients

Fabrizi¹,

Martin²

2000

Am J Nephrol

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“…With poor protection against HBV, virus elimination is rare beyond 10 months in chronic HD patients and leads to a chronic hepatitis B surface antigen (HBsAg) carrier state in 60% of these patients. These patients are at a higher risk of developing long-term morbidity due to prolonged HBV infection, and have high infectivity as demonstrated by hepatitis Be antigen (HBeAg) rate of 70-90% [6][7][8]. Moreover, HBV infection has also a significant impact on the long-term hepatic morbidity and mortality after renal transplantation.…”

Section: Introductionmentioning

confidence: 99%

Granulocyte-Macrophage Colony-Stimulating Factor as an Adjuvant to Hepatitis B Vaccination in Maintenance Hemodialysis Patients

Bastani²,

Ballal³

2000

Am J Nephrol

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Patients on maintenance hemodialysis (HD) have poor seroconversion rate after hepatitis B vaccination. The present study was designed to test the efficacy of granulocyte-macrophage colony-stimulating factor (GM-CSF) as an adjuvant to hepatitis B vaccination for improving seroconversion rate in maintenance HD patients. Twelve chronic HD patients were randomly assigned to receive either hepatitis B vaccination alone or hepatitis B vaccination 24 h after 1 dose of GM-CSF for primary immunization. A group of 16 chronic HD patients who had not seroconverted after a standard two-dose hepatitis B vaccination were randomly assigned either to a booster dose of hepatitis B vaccine alone or a booster dose given 24 h after one dose of GM-CSF. In the primary immunization group only 2 of 6 patients (33%) who had received vaccination alone, versus 5 of 6 patients (83%) who had received hepatitis B vaccine after one dose of GM-CSF, developed seroprotective antibody titers. Moreover, seroprotective antibody titers (IU/ml) were significantly higher in the latter group (275 ± 286.5 vs. 14 ± 22, p < 0.05). In patients who had not seroconverted with prior hepatitis B vaccination, GM-CSF adjuvant therapy significantly increased the seroconversion rate versus booster dose alone (87.5 vs. 25%, respectively, p < 0.02), with significantly higher seroprotective antibody titers (84 ± 80 vs. 19 ± 33 IU/ml, respectively, p < 0.05). These findings suggest that administration of one dose of GM-CSF, as adjuvant therapy, prior to primary or booster dose hepatitis B vaccination may significantly increase seroconversion rate and seroprotective antibody titers in chronic HD patients.

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“…For that reason GSK Bio developed an alternative HBV vaccine formulation targeted to this specific population [91]. Up to 60% of infected patients on haemodialysis are not able to clear the virus and therefore become chronic HBV carriers [92]. Moreover, even though patients are vaccinated and appropriate measures to prevent transmission of the virus have been put in place, HBV outbreaks in dialysis centres still occur [93,94].…”

Section: Hbvmentioning

confidence: 99%

Designing Vaccines against Human Papillomavirus and Hepatitis B Virus: Similarities and Differences for Preventable Viral Infections and role of AS04 Adjuvant System in Addressing Specific Challenges

Garçon¹

2012

J Vaccines Vaccin

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IntroductionSeveral intracellular pathogens can establish long-lasting chronic infections and may lead to clinical disease. Two examples of such pathogens are the Human papillomavirus (HPV) and the Hepatitis B virus (HBV). Immunological mechanisms are involved both in the establishment and maintenance of the tolerance to these infections. Chronic infections and diseases are the results of a delicate interplay between the pathogen's actions to survive in the host and the attempts of the immune system to eradicate it.HPV is one of the most common chronic viral infections in humans. The virus consists of circular, double stranded DNA and has no envelope. Approximately 130 different HPV types have been identified so far [1] and about 40 of these infect the human genital tract, including 15 of types considered as oncogenic [2]. It is estimated that up to 80% of women will acquire a HPV infection in their lifetime [3]. Cervical HPV infections are asymptomatic; although most of them clear spontaneously and only 5-10% will become persistent infection possibly leading to the development of clinical pre-cancerous lesions and cancer.Upon natural infection, HPV remains at the site of infection, evades the immune system, and does not reliably induce protective immunity as the virus does not kill infected cells and hence neither inflammation nor release of danger signals to be recognised by the immune system is triggered. As a result, new infections and re-infection can occur [4]. A prophylactic HPV vaccine should therefore induce a better immune response than natural infection by overcoming the challenges due to the pathogen (i.e. have the ability to block the virus at the site of entrance), hence induce higher level of antibodies, and provide longterm protection [4].HBV infects hepatocytes and consists of a double-stranded circular DNA genome, an outer envelope protein (HBsAg), an inner nucleocapsid protein, (HBcAg), and a soluble small molecular weight protein (HBeAg) produced by the core gene. The HBsAg envelope protein can be shed and is also found as a non-infectious self-assembling tubular or spherical particle in the bloodstream of infected patients [5]. Overall eight genotypes of HBV are known [6,7]. AbstractPathogen characteristics and the mechanism of host/pathogen interaction play a key role in design, formulation, and development of vaccines. Here we present the experience of GSK Bio in developing two vaccines with a novel Adjuvant System (AS04) against two viral infections, Human papillomavirus (HPV) and Hepatitis B virus (HBV), that have some similarities and many differences.Developing a vaccine against HPV is difficult because the virus remains local, evades the immune system, and does not induce a reliable long lasting protection upon natural infection. Vaccination of pre-haemodialysis and haemodialysis patients against hepatitis B represents a challenge as well, because these patients are immunocompromised and develop a reduced and short lasting immune response to administration of conventional HBV vaccine...

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Duration of Hepatitis B Surface Antigenemia (HBs Ag) in Hemodialysis Patients

Cited by 63 publications

References 30 publications

Hepatitis B Virus Infection in Dialysis Patients

Hepatitis B Virus Infection in Dialysis Patients

Granulocyte-Macrophage Colony-Stimulating Factor as an Adjuvant to Hepatitis B Vaccination in Maintenance Hemodialysis Patients

Designing Vaccines against Human Papillomavirus and Hepatitis B Virus: Similarities and Differences for Preventable Viral Infections and role of AS04 Adjuvant System in Addressing Specific Challenges

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