Active immunization of homosexual men using a recombinant hepatitis B vaccine

Twenty homosexual men [13 anti-human immunodeficiency virus (HIV)-positive, seven anti-HIV negative] without HBsAg, anti-HBs, and anti-HBc were vaccinated with three 20 micrograms doses of a recombinant hepatitis B vaccine. All anti-HIV-positive homosexuals were nonresponders independent of the initial number of CD4-positive cells. Among seven anti-HIV-negative individuals, five responded. After three doses of the vaccine, CD4-positive cells fell in anti-HIV positive individuals by 22.4%. A similar fall in CD4-positive cells of an average 24.9% was noted in 17 matching, but nonvaccinated, anti-HIV-positive homosexuals. The study indicates that the efficacy of vaccination in anti-HIV-positive individuals is questionable. There is, however, no evidence that vaccination against hepatitis B might be harmful to anti-HIV-positive subjects.     

CpG ODN enhances immunization effects of hepatitis B vaccine in aged mice

Oligodeoxynucleotides (ODN) containing unmethylated CpG dinucleotides in contexts of unique sequence (CpG motifs) is active as adjuvant in induction of cellular and humoral immune responses in young mice. To date, there are only limited reports about effect of CpG ODN on immune responses against hepatitis B (HB) infection in aged mice. Our studies demonstrated there were significant increases in secreting of total anti-HB IgG, IgG1 and IgG2a, as well as of IL-12 and IFN-gamma, when CpG ODNs were injected together with hepatitis B antigen in aged mice. Moreover, CpG ODN could stimulate proliferation of spleen lymphocytes in a dose-dependent manner. Taken together, the results we obtained indicate that the adding of CpG ODN into the vaccine antigen might be useful in development of more effective vaccination for inducing anti-HB virus responses in the elderly.     

乙型肝炎疫苗高覆盖率对接种人群发病的影响

目的 评价乙型肝炎(乙肝)疫苗高免疫覆盖率的免疫效果.方法 收集接种人群历年的接种报告、乙肝血清学流行率调查结果,分析乙肝疫苗接种后历年乙肝发病的疫情报告,采用酶联免疫吸附试验测定乙肝表面抗原、乙肝表面抗体和乙肝核心抗体,并与接种前期的检测结果进行比较.结果 1992—2011年(乙肝疫苗接种20年)烟台市15岁以下儿童乙肝发病下降了86.84%.5~14岁发病高峰被削平.全人群乙肝表面抗原携带率从1990年13.59%,降至2006年4.61%,从乙肝高度流行区降到了中度流行区.同期0~15岁乙肝表面抗原携带率由12.67%降至0.82%,降幅达到93.53%.结论 乙肝疫苗高覆盖率接种有显著的免疫保护效果,应继续坚持.     

Estimating vaccine coverage by using computer algebra

Email: altmannd{at}rki.deEmail: altmann{at}mathematik.hu-berlin.de The approach of N Gay for estimating the coverage of a multivalentvaccine from antibody prevalence data in certain age cohortsis complemented by using computer aided elimination theory ofvariables. Hereby, Gay's usage of numerical approximation canbe replaced by exact formulae which are surprisingly nice, too.     

乙型肝炎疫苗免疫19年后乙型肝炎病毒感染流行规律的变化

目的探讨乙肝疫苗长期免疫地区人群HBV流行规律的变化趋势。方法整群抽样结合横断面调查，用固相放射免疫法检测研究对象血清HBV感染标志并进行分析。结果（1）平均HBsAg阳性率为7．5％，0～19岁人群HBV感染指标显著低于≥20岁人群。（2）0～19岁人群HBsAg阳性率1985年高于2005年；1985年的抗-HBs水平随着年龄增长而上升，从1～岁组的12．4％到60～岁组的53．8％，而2005年0～19岁组的抗-HBs随着年龄的增长而下降；1985年抗-HBc阳性水平随着年龄增长而上升，2005年的0～19岁组的仅为2．8％～26．8％，显著下降。结论研究人群中HBV流行规律发生显著变化，0～19岁人群的HBV感染率远低于20岁以上人群，证实乙肝疫苗预防HBV感染取得显著成果。     

Hepatitis B vaccine use in Cincinnati: a community's response to the AAP recommendation of universal hepatitis B immunization.

The Committee on Infectious Diseases of the American Academy of Pediatrics (AAP) recently recommended universal immunization of infants against hepatitis B virus (HBV). We surveyed all pediatricians and family practitioners with admitting privileges to our institution to determine their degree of approval of the AAP recommendation and the anticipated compliance with the recommendation. A questionnaire was sent to 86 family practitioners and 205 pediatricians; the response rate was 38% and 47%, respectively. The survey sought information regarding prior HBV immunization practices, planned HBV immunization strategies in the physician''s office and hospital nursery, and the individual''s opinion of the AAP recommendation. Only 21% of pediatricians and 12.5% of family practitioners anticipated giving HBV vaccine to all infants. An additional 22% of pediatricians and 28% of family practitioners planned to give HBV vaccine to infants who had the means to pay for the vaccine. Only a minority of physicians, 42.6% of pediatricians and 36.4% of family practitioners, approved of the AAP recommendation. We conclude that in our community there is widespread concern about the financial practicality and scientific merit of universal HBV immunization, and many practitioners will not comply with the AAP recommendation.     

乙型肝炎疫苗的研究新进展

乙型肝炎疫苗(HepB)接种是阻断乙型肝炎病毒(HBV)传播、预防乙型肝炎的最有效方法。HepB可以分为预防性疫苗和治疗性疫苗。本文综述了HepB及其佐剂的研究新进展,指出乙型肝炎治疗性疫苗以及新型疫苗佐剂是当前HepB研究的重要方向。此外,针对HepB的免疫不良反应和无(弱)应答问题提出应对措施。     

Characterization of poliovirus vaccine strains isolated in the country with high level of immunization coverage

The frequency of vaccine poliovirus isolation from children aged under 3 years was studied in Belarus, a country with a high level of immunization against poliomyelitis. Antigenic and genetic characteristics of the isolated strains were studied. Vaccine poliovirus detection rate was high (11.8%). Polioviruses were isolated from children immunized recently (27.2%), immunized more than 2 months before (7.5%), and from non-immunized children (9.8%). An appreciable number (36.1%) of the isolated strains were antigenically and/or genetically modified derivatives of Sabin virus. Epidemiological data and genetic characteristics of the isolated polioviruses indicate that some of them can be sufficiently transmissive for maintaining their "silent" circulation even in a population with a high level of immunization.     

Autoimmune hazards of hepatitis B vaccine

According to Hippocratic tradition, the safety level of a preventive medicine must be very high, as it is aimed at protecting people against diseases that they may not contract. This paper points out that information on the safety of hepatitis B vaccine (HBV) is biased as compared to classical requirements of evidence-based medicine (EBM), as exemplified by a documented selectivity in the presentation or even publication of available clinical or epidemiological data. Then, a review is made of data suggesting that HBV is remarkable by the frequency, the severity and the variety of its complications, some of them probably related to a mechanism of molecular mimicry leading to demyelinating diseases, and the others reproducing the spectrum of non-hepatic manifestations of natural hepatitis B. To be explained, this unusual spectrum of toxicity requires additional investigations based upon complete release of available data.     

Characterization of a human monoclonal antibody obtained after immunization with plasma vaccine and a booster with recombinant-DNA hepatitis B vaccine.

A human monoclonal antibody type IgG4, designated 1Ff4, was obtained by Epstein Barr virus transformation of peripheral blood lymphocytes from a hepatitis B vaccinee (HB-VAX: plasma-derived vaccine) after one boost of yeast recombinant DNA derived vaccine (Engerix-B). 1Ff4 binds preferentially to HBsAg/adw(2) and HBsAg/ayw(1). In binding experiments, it competes with antibodies induced by vaccination with HB-VAX-DNA (yeast recombinant) and HB-VAX (plasma-derived vaccine). 1Ff4 competes in part with a monoclonal antibody for the w/r region. Partial inhibition of binding of HBsAg/adw(2) to solid phase anti-HBs was detected, resembling inhibition obtained using other human monoclonal specific for the "a"-loop. 1Ff4 does not bind to linear peptides covering the two "a"-loops or to an adw(2)/G145R mutant, its binding to wild type HBsAg strongly depends on the presence of disulphide bonds. In a large series of HBsAg-positive samples from an endemic area, 1Ff4 antibodies were successfully used to discriminate between an adw(2) and an adrq+ strain. The characterisation of 1Ff4 and other human monoclonal anti-HBs antibodies may help to understand the fine specificity of protective antibodies elicited by immunization.     

Antibody detection and kinetics of antibody production during early stages of immunization with hepatitis B virus vaccine

Antibodies to influenza virus and human immunodeficiency virus are detectable in B cells during the early stages of the immune response, prior to their occurrence in plasma. To investigate similar phenomena in a model of immunization against hepatitis B virus (HBV) infection, medical students in Ghana were screened for HBV markers, HBV surface (HBs) antigen (HBsAg), and HBV core antibodies (anti-HBc). Consenting volunteers, 24 of whom were seronegative (susceptible) and 2 of whom were positive for anti-HBc (prior infection), were vaccinated on day 0, day 40, and 6 months. Two sets of 10 blood samples, sequentially collected at intervals of 2 days following each immunization on days 0 and 40, were processed into B-cell lysates and plasma. Solid-phase HBsAg coated on microtiter plates for enzyme immunoassay or nitrocellulose membranes for dot blot assay was used to detect anti-HBs activity by an indirect antiglobulin assay. A commercially procured sandwich immunoassay was used, along with an enzyme-linked immunosorbent assay and a dot blot assay, for the detection of anti-HBs in B-cell lysates and plasma. Following the first injection of vaccine, a single sample of B-cell lysate collected between 5 and 21 days revealed anti-HBs in 18/21 subjects with no plasma antibodies detectable by sandwich immunoassay. After the booster dose was injected on day 40, a single sample of B-cell lysate collected between 44 and 49 days showed anti-HBs in 16/19 subjects, and this was accompanied by plasma antibodies in 8 subjects. In contrast, between 8 and 13 days, both subjects with prior HBV infection showed anti-HBs in B-cell lysates and plasma. Thus, primary immunization with the HBV vaccine appears to transiently elicit low-affinity anti-HBs in B-cell lysates into plasma.     

Assessment of inactivation of hepatitis A vaccine by compound PCR.

Assuring the complete inactivation of hepatitis A virus (HAV) vaccine commonly requires prolonged tissue culture amplification, followed by detection of virus antigen in cell lysates. A reliable, but faster, alternative procedure is highly desirable since it will permit the prescreening of experimental batches of killed HAV, prior to tissue-culture amplification. We established experimental conditions for simultaneous, polymerase chain reaction (PCR)-based amplification of viral and cellular mRNA sequences from infected cell RNA (compound PCR). Under these conditions, the presence of virus-specific amplified sequences, as detected by Southern blot, allows the identification of incompletely inactivated vaccine batches with a threshold practically identical to that of the more time-consuming subculture and ELISA. Compound PCR is, by its nature flexible enough for adaption to different requirements and it should prove useful for rapid prescreening of vaccine batches and pilot studies for improvement of inactivation protocols.     

乙型肝炎卡介苗联合疫苗与单价乙型肝炎疫苗免疫效果的比较

目的：比较乙型肝炎卡介苗联合疫苗与单价乙型肝炎疫苗的免疫效果。方法：实验动物采用豚鼠，按0、1、2月三针免疫程序接种，并于每针免疫后1个月采血，ELISA方法检测血清抗体滴度。实验分三部分进行。实验一：三种不同规格的联合疫苗与单价乙型肝炎疫苗的比较；实验二：同一规格连续三批联合疫苗与单价乙型肝炎疫苗的比较；实验三：联合疫苗与两种单价疫苗同时免疫的比较。结果：在三个实验中，联合疫苗组第一针血清抗体滴度均低于对照组，但无统计学差异：联合疫苗组第二、三针血清抗体滴度均高于对照组，也无统计学差异，实验组各组之间无明显差异。结论：联合疫苗组三针免疫程序的HBsAg的效力与单价乙型肝炎疫苗组相似。     

Inactivated polio vaccine: Time to introduce it in India's national immunization schedule

Polio is a communicable disease caused by poliovirus that may attack nerve cells of the brain and spinal cord. The victims develop neurological complications, likes stiffness of the neck, muscular weakness, or paralysis of one or more limbs. In severe cases, it may be fatal due to respiratory paralysis. The world has seen tremendous gains in polio eradication over the past year. India and Nigeria saw a reduction in cases of almost 95% from 2009 to 2010, and cases of wild poliovirus type 3 (WPV3) fell by 92% globally over the same period. In fact, no case has been reported in India since February 2011, such that India may be on the verge of eradicating polio. Nevertheless, polio control experts are particularly worried about Vaccine-Derived Poliovirus (VDPV). Global surveillance efforts picked up 430 cases of VDPV from several countries between July 2009 and March 2011. In India, 7 cases of VDPV were reported during the year 2011. As long as OPV is used, virologists say that the world is at risk of VDPV causing polio in unprotected children. Achieving a polio-free world will require the "cessation of all OPV" and with it the elimination of the risk of vaccine-associated paralytic polio (VAPP) or VDPV infections. To this effect, in 2011 the Global Polio Eradication Initiative (GPEI) will produce and develop a new roadmap for VDPV Elimination. Several countries have shifted from all OPV to sequential OPV-IPV schedules and all-IPV schedules with elimination of live poliovirus. IPV will be indispensable in the post-eradication era when use of OPV has to stop but "vaccination against polio" cannot stop. IPV offers complete individual protection and has been considered as an additional tool at present for those who can afford the vaccine, and since we are nearing the eradication of polio, it is time to shift from OPV to sequential OPV-IPV schedule in India. Such a strategy will avoid inevitable problems with VAPP.