ABSTRACT
BACKGROUND: Single-dose hepatitis A virus (HAV) vaccination was implemented in all Argentinean children 12 months of age in 2005. Previous studies demonstrated high prevalence of protective antibody response 4 years after single-dose vaccination. This study assessed long-term seroprotection against HAV after vaccination. METHODS: Children who received 1 dose of HAV vaccine at 1 year of age at least 6 years before enrollment were included at 5 centers in Argentina between 2013 and 2014. Demographic and socioeconomic characteristics were collected through a questionnaire. Blood samples were tested for anti-HAV antibodies. Antibody values ≥10 mIU/mL were considered seroprotective. Logistic regression analysis was performed to evaluate the association between demographic and socioeconomic variables and seroprotection. RESULTS: A total of 1088 children were included, with a median postvaccination interval of 7.7 years (range 6.3-9.2 years). Of these children, 97.4% (95% confidence interval: 96.3%-98.3%) had protective antibodies against HAV. No association between demographic or socioeconomic variables and seroprotection was found. Geometric mean concentration of antibody levels against HAV was 170.5 mUI/mL (95% confidence interval: 163.2-178.2 mUI/mL). CONCLUSIONS: Single-dose universal hepatitis A immunization in 1-year-old children resulted in sustained immunologic protection for up to 9 years in Argentina. These findings, along with the low current disease burden, confirm the success of the intervention.
Subject(s)
Hepatitis A Antibodies/blood , Hepatitis A Vaccines/immunology , Hepatitis A virus/immunology , Hepatitis A/prevention & control , Argentina , Child , Female , Follow-Up Studies , Hepatitis A Vaccines/administration & dosage , Humans , Infant , Male , PrevalenceABSTRACT
The objective of this study was to identify, by early screening, one-month old infants with acholic or hypocholic stools for the early detection of biliary atresia and other causes of neonatal cholestasis. The study was essentially exploratory (observational, prospective, statistically underpowered and with no clinical intervention) and used a color card screening of all newborns attending the first month of life checkup from 1999 to 2002 in a public hospital in Argentina. Of 12 484 newborn infants, 4239 were examined at their first month of life checkup visit with the stool color card. Eighteen infants were identified with hypocholic stools, of whom only four were proven to have cholestasis. Although no case of biliary atresia was detected, screening by stool color cards proved useful for the detection of other causes of neonatal cholestasis.
El objetivo del presente estudio fue identificar, mediante el tamizaje precoz, a los lactantes de un mes de edad con deposiciones acólicas o hipocólicas, para la detección temprana de la atresia biliar y otras causas de colestasis neonatal. El estudio fue esencialmente exploratorio (observacional, prospectivo, sin potencia estadística y sin intervención clínica experimental), usando un método de tamizaje de las heces con tarjetas colorimétricas en todos los recién nacidos atendidos en el control de salud del primer mes durante el período 1999- 2002 en un hospital público de la Argentina. De los 12 484 recién nacidos, 4239 fueron atendidos en la visita del primer mes con la tarjeta colorimétrica. Se identificaron 18 niños con deposiciones hipocólicas, de los cuales solo 4 demostraron tener enfermedad colestásica. Si bien no se identificó ningún caso de atresia biliar, la prueba de tamizaje mostró ser de utilidad para la detección de otras causas de colestasis neonatal.
ABSTRACT
MATERIAL AND METHODS: With the aim of analyzing the influence of presence of cirrhosis at baseline on the outcome, we revised the evolution of a cohort of patients with type 1 autoimmune hepatitis, prospectively followed at a single hospital. 139 patients (113 females, 26 males), median age 45.7 years, interquartile range 13-59 years, were followed-up for a median period of 58 months (interquartile range 27-106). RESULTS: At baseline, 55 patients had cirrhosis and they were significantly older, had lower prothrombin activity and serum albumin than patients without cirrhosis. In contrast, patients without cirrhosis had significantly higher bilirubin, AST and ALT levels at diagnosis time. There was no significant difference in the follow-up time between patients with and without cirrhosis at baseline and either in the percentage of patients receiving immunosupresor treatment (80 vs. 91%, respectively) or in the response to therapy (complete response in 82 vs. 95%, respectively). However, patients with cirrhosis had a significantly lower probability of remaining free of cirrhosis complications (49.1% at 102 months, 95%CI, 35.5-67.9% vs. 86.7%, 95%CI, 77.1%-97.5%, respectively) (p = 0.0000) and a significantly lower overall survival at 120 months (67.1%, 95%CI, 51.3-87.6 vs. 94.4%, 95%CI, 86.9-100%, respectively) (p = 0.003) than those without cirrhosis at presentation. CONCLUSION: Patients with type 1 autoimmune hepatitis and cirrhosis at presentation have a lower survival than those without cirrhosis despite a similar response to treatment.
