Hepatitis vaccination of men-who-have-sex-with-men by taking the vaccine into the community

Background

Vaccination programs targeting persons with risk behaviors, such as men-who-have-sex-with-men (MSM), present difficult challenges. Innovative approaches are necessary to reach these populations.

Methods

A free, three-dose combination hepatitis A/hepatitis B (HAV/HBV) vaccine was available to MSM through a variety of venues within the community: health department clinics, community health centers, private physicians who cater to MSM, and community outreach at MSM bars.

Results

Using the recommended doses (two for HAV, three for HBV) as criteria for successful vaccination, the completion rate for HAV was 49% and for HBV 29.3%. Alternatively, a single HAV vaccination provided at least 1 year's protection in more than 94% of recipients meaning that at least 1840 of the 1957 MSM were successfully immunized against hepatitis A.

Conclusions

Multiple and interchangeable venues for hepatitis vaccination eliminate sufficient practical barriers to vaccination to empower MSM to complete the vaccination series.     

COVID-19 and liver dysfunction: A systematic review and meta-analysis of retrospective studies

Recently, Coronavirus Disease 2019 (COVID-19) pandemic is the most significant global health crisis. In this study, we conducted a meta-analysis to find the association between liver injuries and the severity of COVID-19 disease. Online databases, including PubMed, Web of Science, Scopus, and Science direct, were searched to detect relevant publications up to 16 April 2020. Depending on the heterogeneity between studies, a fixed- or random-effects model was applied to pool data. Publication bias Egger's test was also performed. Meta-analysis of 20 retrospective studies (3428 patients), identified that patients with a severe manifestation of COVID-19 exhibited significantly higher levels of alanine aminotransferase, aspartate aminotransferase, and bilirubin values with prolonged prothrombin time. Furthermore, lower albumin level was associated with a severe presentation of COVID-19. Liver dysfunction was associated with a severe outcome of COVID-19 disease. Close monitoring of the occurrence of liver dysfunction is beneficial in early warning of unfavorable outcomes.     

Pitfalls in Hemoglobin A1c Measurement: When Results may be Misleading

Since the beginning of clinical use in the 1970s, hemoglobin A1c (A1c) has become the standard tool for monitoring glycemic control in patients with diabetes. The role of the A1c test was broadened in 2010, when the American Diabetes Association added A1c as a diagnostic criterion for diabetes. Because of hemoglobin A1c’s integral role in diagnosis and treatment, it is important to recognize clinical scenarios and interfering factors that yield false results. The purpose of this review is to describe the A1c measurement, outline clinical scenarios or factors that may yield false results, and describe alternative laboratory biomarkers.