Liver function test results and outcomes in children with acute liver failure due to dengue infection.

This retrospective study compared the liver function test results and outcomes between children with acute liver failure (ALF) due to dengue hemorrhagic fever (DHF) and due to other causes. We retrospectively reviewed patients less than 15 years old with a diagnosis of ALF admitted to 13 participating centers from different parts of Thailand for the years 2000 and 2001, and those admitted to King Chulalongkorn Memorial Hospital for the year 1997 to 2004. The diagnosis of ALF was based on prothrombin time (PT) prolongation to greater than 2 times the normal control value and the presence of encephalopathy without pre-existing liver disease. The patients were divided into 2 groups: group I (n=16) had DHF with ALF and group II (n=37) had ALF due to other causes. DHF patients had AST levels significantly higher than ALT levels. The mortality rate in group I (50%) was lower than in group II (72.9%), although the difference was not statistically significant. The non-DHF patients who died had a significantly longer duration of jaundice before the onset of encephalopathy and a significantly higher PT ratio compared to survivors. There were no significant differences in the duration of jaundice before the onset of encephalopathy and liver function between dengue patients who died and those who survived.

The immunological response of Thai infants to haemophilus influenzae type B polysaccharide-tetanus conjugate vaccine co-administered in the same syringe with locally produced diphtheria-tetanus-pertussis vaccine.

OBJECTIVE: Comparing the immunogenicity and reactogenicity of three vaccine combinations. These were GlaxoSmithKline Biologicals' (GSK) Haemophilus influenzae type b vaccine (Hib-TT, Hiberix) administered with the local Government Pharmaceutical Organization's (GPO) diphtheria-tetanus-pertussis whole cell (DTPw) vaccine, Hib-TT mixed with GPO's DTPw vaccine, or Hib-IT mixed with GSKs' DTPw vaccine (Tritanrix). MATERIAL AND METHOD: An open, randomized, controlled, single center study of three hundred and sixty infants. They were randomized into three groups to receive either Hib-TT Hiberix mix with GPOs' DTPw vaccine (group 1), Hib-TT mixed with GPO's DTPw vaccine (group 2), or Hib-TT mixed with GSKs' DTPw vaccine (Tritanrix; group 3) at two, four and six months of age. RESULT: One month after the third dose, all subjects had antibodies level against Hib polyribosylribitol phosphate (PRP) > or = 0.15 microg/ml. All 11 subjects except two (in group 2) had anti-PRP levels > or = 1.0 microg/ml. The geometric mean concentrations were similar in all three groups. Over 96% of the subjects in all three groups demonstrated an immunological response to diphtheria, tetanus, and pertussis antigens. There was no diference among the three groups in terms of severe local reaction and fever. CONCLUSION: The present study showed that the combined vaccines produced an effective antibody response with no increase in reactogenicity compared to separately administrated vaccines.

Flexibility in the administration schedule of varicella vaccination in healthy adolescents and young adults.

A clinical trial to assess the immunogenicity and reactogenicity of two doses of varicella vaccine (live attenuated Oka-strain, GlaxoSmithKline Biologicals), when either given 8 or 4 weeks apart in healthy seronegative adolescents and young adults, was conducted in Khon Kaen and Bangkok, Thailand. Contrary to seroconversion rates generally reported for this age group, in our study all subjects were already seropositive after the first vaccine dose. After the first vaccine dose, geometric mean titers (GMTs) for anti-varicella antibodies were 78.4 (median 64) for the adolescent group and 136.5 (median 128) for the young adult group. Six weeks after administration of the second dose, anti-varicella GMTs reached 331.7 (median 256) and 636.9 (median 512) for the adolescent and young adult groups, respectively, with a 4.2-4.7-fold increase from pre-vaccination titers. The difference in GMTs between post-dose I and dose II was statistically significant for each group. The reactogenicity after the first and second doses of vaccination was low: no varicella rash was seen, in either the shorter or longer schedule. GlaxoSmithKline Biologicals varicella vaccine (Varilix) offered a high flexibility, administration possible at either 4 or 8 weeks interval, whilst eliciting good immunogenicity and good tolerability.