Hepatitis B vaccines: WHO position paper-Recommendations.
ABSTRACT This article presents the WHO recommendations on the use of hepatitis B vaccines excerpted from the recently published Hepatitis B vaccines: WHO position paper. This document replaces the WHO position paper on hepatitis B vaccines published in the Weekly Epidemiological Record in July 2004. Footnotes to this paper provide a limited number of core references; their abstracts as well as a more comprehensive list of references may be found at http://www.who.int/immunization/documents/positionpapers/en/index.html. Grading tables assessing the level of scientific evidence are also available through this link and are referenced in the position paper. In accordance with its mandate to provide guidance to Member States on health-policy matters, WHO is issuing a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with the current WHO position concerning their use in the global context. This updated paper reflects the recent recommendations of WHO's strategic Advisory Group of experts on immunization.
SourceAvailable from: Ivailo Alexiev Ivanov[Show abstract] [Hide abstract]
ABSTRACT: Viral hepatitis, particularly hepatitis B and C, are diseases with worldwide distribution that present a significant public health problem. Seroprevalence studies allow assessment of the extent of the disease burden, the identification of populations at risk and the monitoring trends over time. A multi-center seroprevalence study, carried out in Bulgaria (covering the five largest cities – Sofia, Plovdiv, Varna, Pleven, and Stara Zagora) in 1999–2000 estimated a crude seroprevalence rate of 3.9% for HBsAg and 1.3% for anti-HCV. A decade later, comparable rates were observed in a study including 865 outpatients consulting a clinical laboratory in Plovdiv, the second largest administrative region in Bulgaria. The crude seroprevalence rate measured for hepatitis B (HBsAg) was 3.9%. The HBsAg prevalence rate in individuals ≤19 years of age (targeted by vaccination) was significantly lower compared to the rate in adults ≥20 years of age –1% versus 4.8%. The lack of dynamics in the overall level of HBsAg carriers is likely related to the excessively low hepatitis B vaccine coverage in individuals, born before the introduction of the universal vaccination of newborns in August 1991. Anti-HCV antibodies were detected in 0.7% of the subjects. J. Med. Virol. 2014. © 2014 Wiley Periodicals, Inc.Journal of Medical Virology 08/2014; DOI:10.1002/jmv.24065 · 2.22 Impact Factor
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ABSTRACT: BackgroundNewborns who have received hepatitis B immunization in 1980s are now young adults joining healthcare disciplines. The need for booster, pre- and post-booster checks becomes a practical question.AimsThe aim of this study is to refine the HBV vaccination policy for newly admitted students in the future.MethodsA prospective study on medical and nursing school entrants to evaluate hepatitis B serostatus and the response to booster doses among young adults.FindingsAmong 212 students, 17–23-year-old, born after adoption of neonatal immunization, 2 (0.9%) were HBsAg positive, 40 (18.9%) were anti-HBs positive. At 1 month after a single-dose booster for anti-HBs-negative students, 14.5% had anti-HBs <10 mIU/mL, 29.0% and 56.5% were 10–100 and >100 mIU/mL, respectively. The anti-HBs levels were significantly higher for females than males (mean [SD]: 431  vs. 246  mIU/mL, P = 0.047). At 2–4 month after the third booster dose, 97.1% had anti-HBs >100 mIU/mL and 2.9% had 10–100 mIU/mL.ConclusionsPre-booster check is still worthwhile to identify carriers among newly recruited healthcare workers born after adoption of neonatal immunization. A 3-dose booster, rather than a single dose, is required for the majority to achieve an anti-HBs level >100 mIU/mL, as memory immunity has declined in a substantial proportion of individuals. Cost-effectiveness of post-booster check for anti-HBs is low and should be further evaluated based on contextual specific utilization of results.PLoS ONE 09/2014; 9(9):e107163. DOI:10.1371/journal.pone.0107163 · 3.53 Impact Factor
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ABSTRACT: The long-term duration of cell-mediated immunity induced by neonatal hepatitis B virus (HBV) vaccination is unknown.Hepatitis Monthly 09/2014; 14(9):e22223. DOI:10.5812/hepatmon.22223 · 1.80 Impact Factor