[Vaccination against hepatitis B in children with chronic hematologic diseases treated with immunosuppression]. / Szczepienia przeciw wirusowemu zapaleniu watroby typu B u dzieci z przewleklymi chorobami krwi leczonych immunosupresyjnie.

Prevention of hepatitis B infection is an important factor in the successful management of cancer and aplastic anaemia cases. Our result suggested that children with Hodgkin's disease and solid tumors vaccinated during early stage of immunosuppressive therapy are good responders to hepatitis B vaccine. Active immunisation with hepatitis B vaccine (Engerix B), was also effective in children with leukaemia after completing immunosuppressive therapy. Protective levels of antibodies remained 6 years after vaccination. Vaccination according to shortened schedule (0-10-20 days) was not effective in these children. Passive immunisation is indicated in children with chronic neoplastic haematological diseases during immunosuppressive therapy. In 6 children the lack of seroconversion after vaccination was due to immune disorders.

Active immunization of children with leukemias and lymphomas against infection by hepatitis B virus.

Engerix B vaccine was administered to 54 children with leukemias and lymphomas aged from 2 to 15 years. In 36 cases chemotherapy was completely stopped, and 18 cases were receiving maintenance treatment. Engerix B was given at 0, 1, 2 and 6 months in a dose of 20 micrograms to children < 10 years, and 40 micrograms to older patients. The effectiveness of active immunization was demonstrated after complete therapy cessation in 88% of cases. The levels of antibodies determined 1 year after primary vaccination remained high, and in most of the vaccinated children they were > 1000 mIU/mL. In children vaccinated in the course of maintenance treatment the levels of antibodies did not give sufficient protection against infection.

[Interferon alfa in treatment of chronic hepatitis B in children with leukemias and lymphomas]. / Interferon alfa w leczeniu przewleklego zapalenia watroby typu B u dzieci choryech na bialaczki i chloniaki.

The course of the hepatitis B virus infection (HBV) in the majority of children with cancer who have undergone intensive chemotherapy is characterized by scanty symptoms and often leads to chronic hepatitis and prolonged carrier state. Twenty three children with chronic hepatitis B virus (HBV) were treated with interferon alfa after the completion of chemotherapy of leukemias and lymphomas. In the majority of cases a disproportion between symptomless clinical course of the hepatitis B virus and the rate of its active replication was observed. Presence of HBsAg and high activity of polymerase DNA HBV (pDNA) were found in all children. In the course of a 6-month treatment with interferon in a dose of 3 mil IU/m2 of the body surface a gradual decrease of pDNA activity was observed. A statistically significant difference of mean values of pDNA before and right after the treatment was determined (p < 0.05). Tests performed 3 months after the completion of the therapy showed a repeated increase of pDNA activity. Boundary values of pDNA were observed in 5 children. Complete elimination of HBs and HBe antigens has not been achieved in any of the children. While analyzing the obtained results it has to be taken into consideration that there were numerous unfavourable prognostic factors determined in the studied group of children such as: coexisting malignant disease, undergone intensive chemotherapy, long period which has passed from the moment of HBV infection until the administration of the treatment with interferon, high activity of pDNA, scanty symptoms of inflammation process. Coexisting HCV infection in 12 children, could also have a undesirable effect upon the treatment results.(ABSTRACT TRUNCATED AT 250 WORDS)

[Evaluation of screening and complementary tests for anti-HCV antibodies]. / Ocena testów przegladowych i uzupelniajacych, sluzacych do wykrywania przeciwcial anty-HCV.

Screening for antibodies to hepatitis C virus (HCV) in blood donors by second generation tests was started on May 1991. On July 1992 obligatory testing of every blood or plasma donation was implemented. The incidence of anti-HCV evaluated in the first period (236.590 sera) was 1.4%. In the second period (296,573 sera) the incidence dropped to 0.9%. 489 sera repeatedly positive in screening were examined by a complementary test, 4-RIBA. Compatible positive results were obtained in 72.8% of the sera. 9.4% of the sera were negative and 17.8% gave indeterminate results. Reactivity was most frequently (95.7%) encountered to the structural core HCV peptide. The value of 4-RIBA was discussed. In conclusion, it was pointed out, that blood donors deferral should be based on repeated screening.

[Prevention of hepatitis B by passive immunization of children with chronic hematologic disease immunoglobulin]. / Zapobieganie metoda biernej immunizacji zakazeniu wirusem zapalenia watroby typu B u dzieci chorych na przewlekle choroby krwi.

In order to prevent the hepatitis virus B (HBV) infection, in 66 children aged from 6 months to 14 years with acute and chronic leukaemias, Hodgkin's and non-Hodgkin's lymphomas, testicular tumours, and aplastic anaemia a specific immunoglobulin was used intravenously (Hepatect made by Biotest). Hepatect was given every month to children with proliferative diseases throughout the whole time of intensive chemotherapy, and to children with aplastic anaemias during the administration of antilymphocytic globulin, prednisone, and Anapoln. Fourteen children were excluded from the analysis due to lack of systematic follow-up. Among 52 studied children, in most cases considerable fluctuations were observed of antibody concentration, the maximal values of which were of 150 mIU/ml. In 35 children, with the exception of sporadic falls, the anti-HBs antibody level remained level was noted, in two cases the presence of antibodies was revealed only sporadically. One of these children was infected with HBV. In all, three children were infected (5.76% of all children in the studied group). Perhaps the use of higher doses of Hepatect and its more frequent administration in children showing low anti-HBs level after routine doses might reduce further the incidence of infection.

[Serological markers of hepatitis B virus and cytomegalovirus in patients with hemophilia]. / Serologiczne znaczniki wirusa zapalenia watroby typu B i wirusa cytomegalii u chorych na hemofilie.

In 100 adult patients with severe haemophilia A (78 patients) and B (22 patients) sera were screened for the presence of serological markers of hepatitis B virus (HBV) and of cytomegalovirus (CMV) and liver function tests were performed which included measurement of serum aminotransferase AST and ALT activities, total bilirubin concentration and plasma levels of factor VII and X. In all the patients at least one out of five determined HBV markers (HBsAg. HBeAg, anti-HBs, anti-HBc and anti-HBe) was detected. HBsAg was found in 10% of the patients, and its prevalence in haemophiliacs B was higher than than observed in haemophiliacs A (22.7% and 6.4%, respectively). HBsAg appeared more frequently in patients receiving factor VIII concentrates (16.7%) than in those treated with cryoprecipitate (4.5%). Anti-CMV antibody was detected in sera of 98% of the patients. In 1/3 samples of cryoprecipitate anti-HBc or anti-HBs were present, and in the half of samples anti-CMV occurred. Abnormal liver function tests indicating chronic hepatitis or liver cirrhosis were obtained in 8 patients. Raised ALT activity which could suggest chronic infection with non-A, non-B virus occurred in 6 cases. The present study indicates that haemophiliacs frequently transfused with plasma products are at high risk for viral infections leading to liver dysfunction.

[HIV-1 infection in blood donors and blood recipients]. / Zakazenia HIV-1 u krwiodawców i biorców krwi.

The results of the tests on HIV-1 infection in blood donors in the years 1985-1989 were presented. Out of 3.222.345 serum samples, in 66 donors HIV-1 antibodies were detected. In 1989 the significant raise of HIV-1 carriers, among whom there were 17 intravenous drug users, was noticed. The transmission of HIV-1 infection to 9 blood recipients was proved. Medical examination of 20 infected blood donors revealed in all of them the enlargement of peripheral lymph nodes. In 8 donors candidosis of oral cavity was diagnosed. The undertaken analysis showed the low efficacy of self deferral and pointed out that medical examination before blood donation should be more carefully done.

HIV antibody status and immunological abnormalities in Polish haemophiliacs.

Sera of 520 multitransfused haemophiliacs were examined for antibody to HIV; 447 patients had haemophilia A and 73 had haemophilia B. In 382 patients with haemophilia A and in 62 with haemophilia B solely Polish-made blood products were used for replacement therapy. The remaining haemophiliacs had also received imported clotting factor concentrates prior to the investigation. Only 8 patients (haemophilia A - 7, haemophilia B - 1) developed anti-HIV and all of them had been exposed to commercial concentrates. The analysis of T-cell subsets demonstrated an inverted T4/T8 ratio (less than 1.0) in 7 (30%) of the 23 haemophiliacs treated solely with domestic cryoprecipitate and in 3 (37%) of the 8 seropositive recipients of commercial concentrates. The most frequent alteration in both subgroups was a reduced ratio with either normal absolute numbers or an increase in T8 cells. Increased serum IgG levels were found in 82% of the users of cryoprecipitate and in 75% of the seropositive patients. Serum beta-2-microglobulin level was elevated in 69 and 62% of each subgroup, respectively. The observed immunological abnormalities, at least in the cryoprecipitate treated subgroup, may be causally related to factors other than HIV infection.

[Study of anti-Rh(D) immunoglobulin for the presence of antibodies with different properties]. / Badania preparatów immunoglobuliny anty-RH/D/ w kierunku obecnosci przeciwcial o innych swoistosciach.

Investigations of 24 series of anti-Rh(D) immunoglobulins showed presence of arythrocyte antibodies with properties: anti--A (8) and anti--B (9) reacting only in antiglobulin test and anti-C (23), anti-E (16) and anti-s (2). In 8 preparations antibodies of HLA system were found with reactions of lymphocytes. In 2 series antibodies of HLA system were found with reactions of lymphocytes. In 2 series antibodies of HLA system were demonstrated by the C fixation with platelets method. No antibodies were detected against specific antigens of platelets and against to immunoglobulins class IgA. No preparation contained HBs antigen and corresponding antibodies. In 19 series of immunoglobulins anti-HBs antibodies were present.

[Comparative studies of human and animal sera containin g anti-HB-8 antibodies]. / Badania porównawcze ludzkiej i zwierzecych surowic z przeciwcialami anty-HB

In a material of 768 sera obtained from blood donors and patients and 150 sera containing HBs antigen it was investigated whether the available animal sera (horse, swine, goat) with anti-HBs antibodies meet the requirements of diagnostic sera. It was found that none of these anti-HBs animal sera was better than the human serum used as yet. Only the specificity of horse anti-HBs antibodies was equal to the human serum, hence horse serum could be used for diagnostic purposes in routine investigations by the precipitation and complement fixation method. The swine and goat sera did not ensure detection of all HBs antigens which are detected using human or horse serum.