Hepatitis B Immune Globulin for Accidental Exposures among Medical Personnel: Final Report of a Multicenter Controlled Trial

Grady, George F.; Lee, V. A.; Prince, Alfred M.; Gitnick, Gary; Fawaz, Khaled; Vyas, Girish N.; Levitt, Michael D.; Senior, John R.; Galambos, John T.; Bynum, T. E.; Singleton, John W.; Clowdus, Bernard F.; Akdamar, Kemal; Aach, Richard D.; Winkelman, Eugene I.; Schiff, Gilbert M.; Hersh, Theodore

doi:10.1093/infdis/138.5.625

Cited by 218 publications

(54 citation statements)

References 18 publications

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“…As with HIV, the risk of HBV transmission varies depending on the characteristics of the source virus. The risk of infection increases when exposed to HBeAg-positive blood and some variant HBV strains (4,116,349). HBV has been isolated from saliva, urine, and other body fluids but usually in much lower titers than in plasma (113).…”

Section: Nosocomial Blood-borne Pathogensmentioning

confidence: 99%

Hospital Epidemiology and Infection Control in Acute-Care Settings

2011

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SUMMARY Health care-associated infections (HAIs) have become more common as medical care has grown more complex and patients have become more complicated. HAIs are associated with significant morbidity, mortality, and cost. Growing rates of HAIs alongside evidence suggesting that active surveillance and infection control practices can prevent HAIs led to the development of hospital epidemiology and infection control programs. The role for infection control programs has grown and continues to grow as rates of antimicrobial resistance rise and HAIs lead to increasing risks to patients and expanding health care costs. In this review, we summarize the history of the development of hospital epidemiology and infection control, common HAIs and the pathogens causing them, and the structure and role of a hospital epidemiology and infection control program.

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Section: Nosocomial Blood-borne Pathogensmentioning

confidence: 99%

Hospital Epidemiology and Infection Control in Acute-Care Settings

2011

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“…28 The humoral immune response plays also an essential role during HBV and HCV infections. HBV and HCV clearances are associated temporally with production of anti-envelope antibodies 29,30 and sera with high levels of antiviral antibodies (specific for the viral envelope) can prevent HBV 31 and HCV 32 infections. Therefore, the integrated activation of both the cellular and humoral arms of the adaptive immune response appears to ultimately allow control of both infections.…”

Section: H Epatitis B (Hbv) and Hepatitis C (Hcv) Virusesmentioning

confidence: 99%

Kinetics of the immune response during HBV and HCV infection

2003

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The innate immune system has a role not only in protecting the host during the initial period of virus infection, but also in shaping the nature of the adaptive immune response. In this review, we follow the kinetics of the virologic and immunologic events occurring from the time of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. We primarily discuss how the early events after infection might influence the development of the adaptive immune response in these 2 important viral infections and how new strategies for more efficient preventive and therapeutic vaccines can be derived from this knowledge. (HEPATOLOGY 2003; 38:4-13.)H epatitis B (HBV) and hepatitis C (HCV) viruses are the 2 major causes of chronic liver inflammation worldwide. 1,2 Despite distinct virologic features, both viruses are preferentially hepatotropic, not directly cytopathic, and elicit liver diseases that share several aspects of their natural history. HBV and HCV infections share also some important features of the adaptive immune response. Multispecific antiviral CD4 and CD8 responses with a T-helper type 1 profile of cytokine production are detectable in the blood of subjects with a self-limited infection. [3][4][5][6][7][8][9][10][11][12][13][14][15][16] These responses are stronger than those found in patients with chronic infection. [17][18][19][20][21] Based on these observations, it has been proposed that the ability to mount an efficient cellular immune response is the main mechanism responsible for HBV and HCV control, whereas a defect in this response leads to chronicity. 2,22 However, the lack of suitable animal models to study the pathogenesis of HBV and HCV infections has so far hampered a definitive demonstration that associations between different infection outcomes and different vigor and breadth of T-cell responses have a causative effect. A recent report in HCV-infected chimpanzees, in which a clear association between T-cell response and virus clearance was not found, 23 added a further note of caution. Even so, it is difficult to argue against the importance of the cellular immune response in HBV and HCV control. In chimpanzees infected with HCV, expansion of a multispecific and sustained HCV-specific CD8 ϩ T-cell-mediated response was observed in 2 of 2 animals that cleared the virus, but not in the 4 animals that developed a chronic infection. 24 These results have been confirmed by recent reports showing that expansion of interferon ␥ (IFN-␥) ϩ , CD8 ϩ , and CD4 ϩ T cells precedes viral clearance in patients studied during the incubation phase of acute HCV infection in man 10 and in HCV-infected chimpanzees. 25 Similar findings have been reported in animal models of HBV infection 26 and in patients studied during the incubation phase of HBV infection, 27 in whom reduced early expansion of virusspecific T cells was associated with virus persistence. Moreover, the importance of virus-specific CD8 ϩ T cells in HBV control has been confirmed further by CD8 ϩ T-cell deletion experiments performed in HBV-i...

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“…155:828, 1987), a quantity sufficient to contain up to 100 infectious doses of HBV (243). The risk of transmission after a needlestick exposure to a nonimmune person is at least 30% if the source patient is HBeAg positive but is less than 6% if the patient is HBeAg negative (17,120,277). Blood from patients with HBsAg titers below the threshold of detection using routine serologic tests is rarely infectious (4).…”

Section: Risk Of Occupational Transmission Of Hbv From Patients To Womentioning

confidence: 99%