Evaluation of safety and immunogenicity of hepatitis E vaccine in maintenance hemodialysis patients / 中华预防医学杂志

Objective: To evaluate the safety and immunogenicity of hepatitis E vaccine(HEV)in Maintenance hemodialysis(MHD)patients. Methods: Based on an open-labeled controlled trial, from May 2016 to March 2018, 35 eligible MHD patients were recruited in the Hemodialysis Center of Zhongshan Hospital Affiliated to Xiamen University as the experimental group, and 70 MHD patients with matched age, gender and underlying diseases as the control group. The experimental group received HEV at 0, 1 and 6 months according to the standard vaccination procedures, while the control group received routine diagnosis and treatment without vaccine and placebo injection to observe the safety and immunogenicity of the vaccine. The safety of vaccine in MHD population was evaluated by the incidence of adverse reactions/events in the experimental and control groups. The immunogenicity of HEV in MHD patients was evaluated by comparing the data from the phase Ⅲ clinical trial. Results: The overall incidence of adverse reactions/events was 17.1% (18/105), and there were no grade 3-4 adverse reactions/events related to vaccination. In the experimental group, the incidence of local adverse reactions/events was 20.0% (7/35), and the incidence of systemic adverse reactions/events was 17.1% (6/35).There was no significant difference in the incidence of systemic adverse reactions/events between the experimental group and the control group (P>0.05). There were 23 patients receiving 3 doses with the standard schedule. The positive rate of HEV-IgG antibody was 100% and the GMC was 14.47(95%CI:13.14-15.80) WU/ml, which showed no significant difference compared with the 46 patients in Phase Ⅲ clinical trial (t=-1.04, P>0.05). Conclusion: Recombinant HEV has good safety and immunogenicity in MHD patients.

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: hepatites virais / Brazilian Protocol for Sexually Transmitted Infections 2020: viral hepatitis / Protocolo Brasileño para las Infecciones de Transmisión Sexual 2020: hepatitis virales

Este artigo aborda as hepatites virais, tema tratado no Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis e, mais precisamente, nos Protocolos Clínicos e Diretrizes Terapêuticas para Hepatite B e para Hepatite C e Coinfecções, publicados pelo Ministério da Saúde do Brasil. Além do espectro ampliado de acometimento da saúde, os vírus das hepatites A, B e C também apresentam diferentes formas de transmissão, seja parenteral, sexual, vertical ou oral. Entre as estratégias sugeridas para o controle das hepatites virais, além das medidas comportamentais, estão o diagnóstico ampliado, a vacinação precoce contra os vírus da hepatite A e hepatite B e o acesso aos recursos terapêuticos disponíveis. Considerando a transmissão vertical dos vírus da hepatite B e hepatite C, a triagem das gestantes portadoras crônicas desses vírus é uma importante estratégia de saúde perinatal, indicando com precisão quem pode se beneficiar das intervenções profiláticas disponíveis.

This article discusses viral hepatitis, a theme addressed by the Clinical Protocol and Therapeutic Guidelines to Comprehensive Care for People with Sexually Transmitted Infections and, more precisely, by the Clinical Protocols and Therapeutic Guidelines for Hepatitis B and Hepatitis C and Coinfections, published by the Brazilian Ministry of Health. Besides the broad spectrum of health impairment, hepatitis A, B and C viruses also present different forms of transmission, whether parenteral, sexual, vertical or oral. Among the strategies suggested for the control of viral hepatitis, in addition to behavioral measures, are expanded diagnosis, early vaccination against hepatitis A and hepatitis B viruses, and access to available therapeutic resources. Considering vertical transmission of the hepatitis B and hepatitis C viruses, screening for pregnant women with chronic hepatitis B and C is an important perinatal health strategy, indicating with precision those who can benefit from the prophylactic interventions.

Este artículo aborda las hepatitis virales, tema que hace parte del Protocolo Clínico y Directrices Terapéuticas para la Atención Integral a Personas con Infecciones de Transmisión Sexual y más precisamente de los Protocolos Clínicos y Guías Terapéuticas para Hepatitis B, Hepatitis C y Coinfecciones, publicados por el Ministerio de Salud. Además del amplio espectro de deterioro de la salud, los virus de las hepatitis A, B y C presentan diferentes formas de transmisión, como parenteral, sexual, vertical u oral. Entre las estrategias sugeridas para el control de las hepatitis virales, están las medidas conductuales, el diagnóstico ampliado, la vacunación precoz contra los virus de las hepatitis A y B y el acceso facilitado a los recursos terapéuticos disponibles. Considerando la transmisión vertical de los virus de la hepatitis B y C, la identificación de embarazadas portadoras crónicas de estos virus es importante estrategia de salud perinatal, indicando quiénes pueden beneficiarse de las intervenciones profilácticas.

High-risk behaviors for hepatitis B and C infections among female sex workers

Abstract INTRODUCTION: The prevalence of hepatitis B and hepatitis C and risk behaviors among 402 female sex workers in Central Brazil were investigated by respondent-driven sampling. METHODS: Blood samples were tested for hepatitis B and C markers by enzyme-linked immunosorbent assay. Two hepatitis B vaccination schedules were performed. RESULTS: The prevalence of hepatitis B and C infections were 9.3% and 0.5%, respectively. Susceptibility to hepatitis B infection was observed in 61.5% of subjects. There was no significant difference in adherence index (p=0.52) between vaccination schedules and all participants had protective antibody titers. CONCLUSIONS: This hard-to-reach population requires hepatitis B and C surveillance.

Las hepatitis B y C bajo la lupa La respuesta de salud pública en la Región de las Américas, 2016 / Hepatitis B and C in the Spotlight. A public health response in the Americas, 2016

El presente informe ofrece un panorama de las epidemias actuales de hepatitis B y hepatitis C, así como de la respuesta del sector de la salud en la Región de las Américas. Su finalidad es proporcionar, en el marco de un entorno en constante cambio, un conocimiento básico de los temas principales relacionados con la respuesta a estas epidemias en la Región, para lo cual presenta un panorama de los grupos de población afectados y de la carga de las infecciones por el virus de la hepatitis B (VHB) y el virus de la hepatitis C (VHC) en la Región, además de las actuales políticas y de las prácticas del sector de la salud. Este informe, el primero en su tipo que aborda el seguimiento de los progresos en la consecución de las metas establecidas en el Plan de acción para la prevención y el control de las hepatitis virales,tiene por objeto ayudar a los Estados Miembros a adaptar sus políticas y prioridades para que puedan establecer una respuesta de salud pública eficaz e integral. Se ha producido un cambio importante en la conciencia mundial sobre las epidemias de hepatitis virales: ya no se consideran silenciosas y actualmente se observa una evolución hacia la adopción de medidas a escala mundial para eliminarlas como problema de salud pública. En la Región de las Américas, la principal carga de las hepatitis virales se debe a las hepatitis B y C; unos 2,8 millones de personas (2,2 a 8,0 millones)1presentan la infección crónica por el virus de la hepatitis B (VHB), de las cuales 2,1 millones viven...

Development and evaluation of an inactivated bivalent vaccine against duck viral hepatitis / 生物工程学报

The rapid mutation and widely spread of duck hepatitis A virus (DHAV) lead to the vast economic loss of the duck industry. To prepare and evaluate bivalent inactivated vaccine laboratory products of DHAV, 6 strains were screened from 201 DHAV-1 strains and 38 DHAV-3 strains by using serotype epidemiological analysis in most of the duck factory. Vaccine candidate strains were selected by ELD50 and LD50 tests in the 6 strains. Continuously passaged, the 5th passaged duck embryos bodies grinding fluid was selected as vaccine virus seeds. The virus seeds were treated with formaldehyde and water in oil in water (W/O/W) emulsions, making into three batches of two bivalent inactivated vaccine laboratory products. The safety test, antibody neutralization test, challenged protection and cross immune protection experiment suggested that the vaccines possessed good safety, and neutralizing antibodies were detected at 7th day and the challenged protection rate reached 90% to 100% at the 14th and 21st day. Moreover, immune duration of ducklings lasted more than five weeks. However, cross-immunity protection experiments with DHAV-SH and DHAV-FS only had 20%-30%. The two bivalent inactivated vaccine laboratory products of duck viral hepatitis were effective and reliable, providing a new method as well as a new product for DHAV prevention and control.

Immunogenicity and heterologous protection in mice with a recombinant adenoviral-based vaccine carrying a hepatitis C virus truncated NS3 and core fusion protein / 病毒学报

To develop a safe and broad-spectrum effective hepatitis C virus (HCV) T cell vaccine,we constructed the recombinant adenovirus-based vaccine that carried the hepatitis C virus truncated NS3 and core fusion proteins. The expression of the fusion antigen was confirmed by in vitro immunofluorescence and western blotting assays. Our results indicated that this vaccine not only stimulated antigen-specific antibody responses,but also activated strong NS3-specific T cell immune responses. NS3-specific IFN-γ+ and TNF-α+ CD4+ T cell subsets were also detected by a intracellular cytokine secretion assay. In a surrogate challenge assay based on a recombinant heterologous HCV (JFH1,2a) vaccinia virus,the recombinant adenovirus-based vaccine was capable of eliciting effective levels of cross-protection. These findings have im- portant implications for the study of HCV immune protection and the future development of a novel vaccine.

Notícias do Levantamento de Recursos e Necessidades de Enfermagem na Revista Brasileira de Enfermagem (1955-1958) / News of the Inquiry about Nursing Needs and Resources in the Brazilian Journal of Nursing (1955-1958) / Noticias del Levantamiento de Necesidades y Recursos de Enfermería en la Revista Brasileña de Enfermería (1955-1958)

Estudo Histórico Social que tem como objeto notícias sobre o Levantamento de Recursos e Necessidades de Enfermagem no Brasil, publicadas na Revista Brasileira de Enfermagem entre 1955 e 1958. A fonte primária foi constituída pelos exemplares da Revista Brasileira de Enfermagem, publicados dentro do recorte temporal do estudo. As fontes secundárias foram constituídas por livros, artigos, dissertações e teses relativas à história da Enfermagem. A análise dos dados teve apoio das fontes secundárias e do pensamento do sociólogo Pierre Bourdieu. Os dados evidenciaram que a Revista Brasileira de Enfermagem, além de oportunizar a divulgação de notícias acerca do Levantamento, proporcionou visibilidade ao mesmo mediante a veiculação dessas notícias e, por fim, teve o efeito simbólico de conferir poder e prestígio à Enfermagem Brasileira.

Social historical study that has as object news related to the Assessment of the Resources and Needs of Nursing in Brazil published in the Revista Brasileira de Enfermagem between 1955 and 1958. The primary source is constituted of copies of Revista Brasileira de Enfermagem published within the selected period of the study. The secondary sources are constituted of books, papers, dissertations and thesis related to the Nursing history. The data analysis was supported by the secondary sources and the thought of the sociologist Pierre Bourdieu. The results evidenced that Revista Brasileira de Enfermagem, in addition to making possible the dissemination of news about the Assessment provided visibility to it and, at last, had the symbolic effect of giving power and prestige to the Brazilian Nursing.

Estudio Histórico Social que tiene como objeto noticias referentes al Levantamiento de Recursos y Necesidades de Enfermería en Brasil publicadas en la Revista Brasileira de Enfermagem entre 1955 y 1958. La fuente primaria se constituye de los ejemplares de la Revista Brasileira de Enfermagem publicados dentro del recorte temporal do estudio. Las fuentes secundarias están constituidas de libros, artículos disertaciones y tesis relativas a la historia de la Enfermería. El análisis de los datos tuvo apoyo de las fuentes secundarias y del pensamiento del Sociólogo Pierre Bourdieu. Los resultados evidencian que la Revista Brasileira de Enfermagem, además de posibilitar la divulgación de noticias acerca del Levantamiento proporcionó visibilidad al mismo mediante la divulgación de esas noticias y, por fin, tuve el efecto simbólico de conferir poder y prestigio a la Enfermería Brasileña.

Induction of antibody and interferon-gamma production in mice immunized with virus-like particles of swine hepatitis E virus

Virus-like particles (VLPs) composed of the truncated capsid protein of swine hepatitis E virus (HEV) were developed and immune responses of mice immunized with the VLPs were evaluated. IgG titers specific for the capsid protein of swine HEV were significantly higher for all groups of mice immunized with the VLPs than those of the negative control mice. Splenocytes from mice immunized with the VLPs also produced significantly greater quantities of interferon (IFN)-gamma than interleukin (IL)-4 and IL-10. These newly developed swine HEV VLPs have the capacity to induce antigen-specific antibody and IFN-gamma production in immunized mice.

Implication of reported viral hepatitis incidence rate change in Hubei Province, China, between 2004-2010 / 华中科技大学学报（医学）（英德文版）

This study examined the change of reported incidence rate for viral hepatitis in Hubei province, China, between 2004 to 2010 to provide scientific evidence for viral hepatitis control. Reported viral hepatitis infection cases were queried from Centre for Disease Control of Hubei Province, China. The incidence of viral hepatitis A decreased steadily across the study period. Viral hepatitis B composed 85% of the viral hepatitis cases. When reported incidence rates for chronic hepatitis B increased, the rates of acute and unclassified cases dropped from 2005 to 2010. The reported viral hepatitis B incidence rate for males was around 1.5-2 times higher than for females. The average annual percentage change of reported viral hepatitis B incidence rates was 4%. The same index for viral hepatitis C was 28%. The reported viral hepatitis B incidence rate of people under 20 years old declined over the period. This decrease was mainly attributed to the recent implementation of vaccination plan. Reported incidence rate of viral hepatitis E also rose in those years. Having a better understanding on reported incidence rates of the present surveillance system is important for developing strategies for further prevention of viral hepatitis. In addition, the data showed that a surveillance system that differentiates new and former infected cases will be more effective in providing evidence for disease control.

La hepatitis C como un problema de salud pública en México / Hepatitis C as a public health problem in Mexico

Se reportan resultados de un seminario multidisciplinario que aborda el reconocimiento y construcción de la hepatitis C como problema de salud en México. La prevalencia es de 1.4 por ciento. La incidencia se estima en 19 300 nuevos casos por año. Al disminuir los casos relacionados a transfusión, aumentan en importancia la transmisión nosocomial y uso de drogas vía intravenosa o intranasal. Es necesario construir nuevos contenidos para las representaciones sociales y percepción de riesgo. El tratamiento basado en respuesta por PCR-ARN ha modificado los esquemas de manejo, situación importante al considerar políticas de tratamiento. Jurídicamente existe poca incidencia legislativa en el tema. La distribución de competencias entre el Gobierno Federal y las entidades federativas en materia de salubridad general se encuentra establecida en el artículo 13 de la Ley General de Salud (México). Es necesario definir una estrategia que adquiera el carácter de política pública de alcance nacional.

We report the results of a multidisciplinary seminar approaching the recognition and construction of hepatitis C as a health issue in Mexico. Its prevalence is 1.4 percent and its incidence is estimated in 19 300 new cases per year.As transfusion decreases as a risk factor, the relevance of nosocomial transmision and use of intravenous or intranasal drugs increases. It is necessary to develop new contents for the social representation and risk perception of the disease. Response guided treatment based on PCR-RNA has modified the treatment schemes, a very important issue when considering policies for management. Legislation about hepatitis C in the country is limited. Assignments of the Federal Government and the federative entities in the country regarding health issues are framed in the 13th article of the General Mexican health law. It is necessary to advance towards the development of a public health policy at the national level for hepatitis C.

Construction and evaluation of hepatitis C virus (HCV) DNA vaccine containing E2-gAD fusion gene / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To rational design HCV DNA vaccine candidates and evaluate their specific We design to construct two DNA vaccine candidates, one consists of immunity to HCV in mice.</p><p><b>METHODS</b>We design to construct two DNA vaccine candidates, one consists of E2 (the envelope glycoprotein 2 of HCV) gene only, the second consists of E2-gAD (Globular Domain of Human Adiponectin) fusion gene via overlapping PCR. Confirm the expression of the DNA vaccines by Western blotting, and then vaccinated by injection of DNA vaccines with gene electrotransfer (GET) in BALB/c mice. The immune response was measured by IFN-gamma ELISPOT.</p><p><b>RESULTS</b>The DNA vaccine candidate consists of E2-gAD could effectively express in vitro , and it could induced a higher anti-HCV T cell response in mice than the one consists of E2 only.</p><p><b>CONCLUSION</b>The HCV DNA vaccine consists of E2-gAD fusion can increase the immunity of the E, to some extend, and the research paved a way to develop and optimize the novel HCV DNA vaccine.</p>

Plan de la campaña nacional de vacunación contra la hepatitis B / Plan of the national vaccination campaign against hepatitis B

La presente publicación describe el plan de acción de la campaña de vacunación para el control acelerado de hepatitis B en el Perú

Treatment and vaccination for hepatitis C: present and future

Hepatitis C is caused by Hepatitis C Virus [HCV], detriments the quality of life of 170 million people around the globe. Although, much has been known about the biology of the virus in recent years, a complete cure of hepatitis C remains difficult in a large majority of patients. The current treatment regimen comprising pegylated interferon alpha and ribavirin has sub-optimal effectiveness especially in patients infected with HCV genotype 1. The development of an effective vaccine against the virus as well as a potent anti-viral therapy remains urgently needed. Herein, we give a brief overview of the molecular biology of hepatitis C and the postulated mechanisms of hepatitis C pathogenesis. The issues surrounding the current treatment of hepatic C, the promising new therapies on the horizon and the experimental strategies to develop a vaccine have also been discussed in a greater detail

Cambios en la epidemiología de las hepatitis virales en Chile y consideraciones en estrategias de prevención / The changing epidemiology of viral hepatitis in Chile

The social and sanitary changes that Chile is experiencing will change the epidemiologic profile of viral hepatitis. Virus A hepatitis will displace to older ages, and immunization plans with specific vaccines should be considered. The real prevalence of hepatitis B may be higher, due to an underreporting of the disease. The education and vaccination of high risk groups should be reinforced. E virus hepatitis requires more research in risk groups and in certain animal species consumed by humans. C virus hepatitis is the greatest challenge as it causes chronic liver disease and is the main cause for liver transplantation.

Comparison of immune responses induced by recombinant attenuated Salmonella typhi carrying eukaryotic expression plasmid or prokaryotic expression plasmid of HCV core protein / 生物工程学报

Hepatitis C virus (HCV) core protein is considered to be an attractive candidate for development of protective HCV vaccines. However, this protein may attenuate the induction of systemic immune responses due to its immunomodulatory properties. In this study, we constructed a HCV core gene-containing eukaryotic expression plamid pCI-C, and an in vivo-inducible prokaryotic expression plasmid pZW-C, and transformed the recombinant plasmids into an attenuated Salmonella typhimurium aroA strain SL7207. The resulting bacterial strains SL7207/pCI-C and SL7207/pZW-C were used to orally immunize BALB/c mice, and the immune responses specific to HCV core protein were assessed. Immunization with the recombinant bacteria SL7207/pCI-C led to a persistent drop in percentage of CD3 CD4 T cells, and induced a weak anti-core IgG production. Splenocytes from SL7207/pCI-C immunized mice developed a relatively weak proliferation response and inferior cytotoxic activity compared to those from the mice immunized with bacteria SL7207/pZW-C. Boost immunization with SL7207/ pCI-C yielded limited improvement in immune strength, while the boost with bacteria SL7207/pZW-C significantly enhanced the immune response. These results suggest that de novo synthesis of native HCV core protein may blunt the induction of immune responses. Attenuated S. typhimurium carrying HCV core protein could efficiently activate systemic cellular and humoral responses, and may be a promising strategy for the development of core-based HCV vaccines.

Expression of ORF2 protein of HEV genotype IV in Hansenula polymorpha / 生物工程学报

Hepatitis E, an acute infectious disease transmitted via the fecal-oral route, is caused by hepatitis E virus. However, no effective treatment currently exists for hepatitis E, and the only epidemic control approach is vaccination. But so for there are no commercial vaccine for hepatitis E available in the world. To find a new expression system to develop recombinant hepatitis E vaccine, in this study the expression system of methylotrophic yeast Hansenula polymorpha was used to express the gene encoding amino acid 112 - 607 of the open reading frame 2 (ORF2) of hepatitis E virus (HEV) genotype IV. In order to achieve high expression level, the coding sequence was optimized according to codon usage bias of Hansenula polymorpha and synthesized through overlapping PCR. Subsequently the gene was subcloned into the multi-copy expression vectors of Hansenula polymorpha, which include pDGXHP1.0 (MOX promotor), pDGXHP2.0 (MOX promotor) and pDGXHP2.1 ( FMD promotor). The series of one-copy and multi-copy recombinant plasmids were transformed into ATCC26012(Ura3-) by electroporation. The transformants were cultured in selection media MDL and screened for the existence of foreign gene by PCR. Then the strains were induced in MM media and the expression products were detected by SDS-PAGE, ELISA and Western blot assays to select the high-level expression strains. The result of SDS-PAGE showed that the HEV ORF2 expression product was accumulated up to 12% of total cellular protein and its molecular weight is 56kD. The expression product showed high immunoreactivity detected by ELISA and the highest titer is 1:2048. The result of Western blot demonstrated that the expression product could be specifically recognized by the polyclonal antibody against HEV. The successful expression of HEV ORF2 protein in Hansenula polymorpha provides foundation for the further development of recombinant subunit vaccine against hepatitis E.