Immune response to hepatitis B vaccine in haemodialysis patients.

Widespread vaccination of haemodialysis patients had occurred during the year 1999 as a result of the promulgation of the Ministry of Health & Population. To our knowledge, this might be the first study in Egypt concerning post-vaccination response in haemodialysis patients and possible risk factors influencing this response. Eighty-three haemodialysis patients vaccinated with 10 microg dose of recombinant hepatitis B Merck Sharp vaccine at 0, 1 and 6 months were enrolled in the study. Blood samples were withdrawn one month after the third dose and sera were tested for anti-HBc to exclude those who had previous HBV exposure and for quantitative determination of antibodies to hepatitis B surface antigen (anti-HBs) using commercial enzyme immunoassay kits. Routine analysis for anti-HIV, anti-HCV and HBsAg every 3 months is done for all haemodialysis patients in the governmental sector. Only 65 patients negative for both anti-HBc and HBsAg were considered eligible for evaluating the immunogenicity of the vaccine. Seroconversion rate (anti-HBs>10 mlU/ml) was detected in 64.6% and adequate response (anti-HBs>100 mlU/ml) was achieved in 38% only. Non-responders were 35.4% reflecting the profound immune suppression in haemodialysis patients. Seroconversion rate was 84.2% in patients below 40 years of age and dropped to 33.3% in those 60 years or above. Seroconversion was significantly higher in females than males (76.5% vs. 51.6%). HCV infection was strikingly high among dialyzed patients (78.5%). Seroconversion rate was 58.8% in HCV-infected and 85.7% in non HCV-infected haemodialysis patients. Neither the duration of haemodialysis nor the frequency of blood transfusions had any significant association with seroconversion rate.

Health status assessment of drug addicts in Alexandria.

The case-control study was conducted among addicts in Alexandria to determine the different health problems among them, as well as to study the correlation between addiction and these problems. One hundred drug addicts and eighty apparently healthy controls were included in this study. The whole sample was subjected to the following: filling a predesigned questionnaire sheet, clinical and electrocardiogram (ECG) examination, measurements of Body Mass Index (BMI), complete blood picture and antistreptolysin O titre (ASO), testing for hepatitis B surface antigen (HBsAg) and antibody to hepatitis B core antigen (anti HBc), skin scrapings from superficial fungal lesions in addition to complete urine and stool examination. The results revealed that chest rhonchi, hepatomegaly, central nervous system (CNS) abnormalities, skin lesions lymphadenopathy, underweight and anaemia were significantly higher among addicts than the controls. Hepatitis B virus (HBV) exposure and HBsAg seropositivity were found 48.0% and 21.0%, respectively among addicts compared to 26.3% and 5.0%, respectively among the controls. The intravenous injections and tattooing were the most risky routes for HBV infection among addicts. A positive correlation was revealed between HBV exposure and both the duration and the number of daily injections. Chest X-ray suggestive of pulmonary tuberculosis were found in 7.0% of the addicts. Addiction potentiated the risk of fungal infection among low social class, but it had no effect on the relationship between anaemia and social class nor on that between loss of appetite and underweight.

Hepatitis B surface antigen in Cimex lectularius.

Bedbug (Cimex lectularius) samples adult and nymphs either engorged or starved from Central Security Forces sleeping wards, laboratory animal house and control samples from laboratory reared colonies were ground and subjected to ELISA test of hepatitis B surface antigen together with 276 serum samples from the recruits slept in those wards. In the camp 7 out of 30 samples of engorged adult bedbugs were positive to HBSAg and 5 out of 30 samples of starved bedbugs were positive. Regarding nymphs 4 out of 30 engorged samples showed positive results. One of five samples of engorged adult bedbugs from the laboratory animal farm was positive. The control samples were negative. Serum samples of 276 recruits showed 3.6% positive results of HBSAg.

Study of the sensitivity of blood spotted on filter paper in the detection of HBsAg and anticore using ELISA technique.

The sensitivity of the filter paper method was compared with that of whole serum in the detection of HBsAg and antic using ELISA technique. It was found that analysis of eluates of blood spotted on filter paper should be recommended in field surveys and of HBsAg screening prior to an immunization campaign. On the other hand, in the detection of anti HBc the eluted technique is less sensitive and should not be performed if accurate epidemiological data are to be collected.