Suboptimal response to hepatitis B vaccine in drug users

Article Abstract:

Intravenous (IV) drug users are at risk of acquiring hepatitis B infection, which affects the liver. A vaccine against hepatitis B has recently been developed, and it may be the only means of protecting IV drug users. This is especially true since many IV drug users are infected with human immunodeficiency virus (HIV, the virus that causes AIDS). This can make them even more susceptible to hepatitis B, since HIV weakens the immune system. Fifty-five IV drug users enrolled in a drug detoxification program were vaccinated with the hepatitis B vaccine known as Engerix B. Forty-one healthy individuals from the community were also vaccinated and served as controls. Seventeen of the drug users had no evidence of previous hepatitis B, while 15 had evidence of a past infection, and 23 had evidence of a recent infection. Each group received three injections, one at the beginning of the study, one a month later, and one six months later. One month after the third vaccination, 76 percent of the drug users with no history of hepatitis B had responded to the vaccine (by producing antibodies), 6 percent with past infection had responded, and 69 percent with recent infection had responded. In contrast, 97 percent of the healthy individuals had responded. The drug users had lower levels of protective antibodies against hepatitis B virus. Two years after the first vaccination, only 43 percent of drug users with no history of hepatitis B infection had protective antibodies, compared with 86 percent of the controls. Among the IV drug users who had a prior infection with hepatitis B, none of those with past a infection had protective antibodies, and only 31 percent of those with a recent infection had them. Drug users who exhibited anergy (a decreased immune response to foreign substances) were less likely to respond to the vaccine. The vaccine used in this study may not be able to stimulate the immune system to produce protective antibodies as well as other forms of hepatitis B vaccine; other studies of hepatitis vaccination in IV drug users have shown response rates of 90 to 100 percent. The fact that many nonresponders were anergic indicates that their immune systems might be weakened. However, since many of the drug users responded to the vaccine, vaccination of IV drug users against hepatitis B may still be effective. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Prevention, Drug addicts, Drug abusers, Hepatitis B vaccine, Hepatitis B vaccines, Intravenous drug abuse

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High prevalence of antibody to hepatitis C virus in multitransfused hemophiliacs with normal transaminase levels

Article Abstract:

Non-A, non-B hepatitis is the inflammation of the liver that occurs most often after blood transfusion. Studies have shown that anywhere from 20 to 77 percent of hemophiliacs have been infected with non-A, non-B hepatitis. Almost 20 percent of these patients develop cirrhosis, abnormal structural changes in liver tissue, and liver cancer. A new blood test for detecting infection with hepatitis C virus (HCV), the major cause of non-A, non-B hepatitis, makes possible a more accurate estimation of the incidence of long-term infection among hemophiliacs. The new test detects antibodies, or specialized proteins, that specifically bind to HCV, and these anti-HCV antibodies serve as markers of active infection. In addition, the ribonucleic acid of the virus can be identified in liver biopsies from infected patients using the polymerase chain reaction technique. With the new antibody test, the prevalence of anti-HCV in hemophiliacs who have had many blood transfusions was shown to be 82 percent, indicating that chronic HCV infection is more common than previously thought. Detection of HCV allows for identification and treatment of those patients at risk for developing cirrhosis. The study also showed that blood concentrates subjected to dry heat in order to kill the virus can still transmit hepatitis viruses. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Testing, Statistics, Diseases, Blood-borne diseases, Bloodborne diseases, Hemophiliacs, Hepatitis C virus, Hepatitis E, Chronic active hepatitis

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The natural history of asymptomatic hepatitis B surface antigen carriers

Article Abstract:

Individuals who test positive for hepatitis B surface antigen (HBsAg) but who have normal liver function appear to have a low, long-term risk for developing severe liver disease. Between 70% and 90% of patients with chronic hepatitis B virus infection who have normal liver function still test positive for HBsAg. Of 92 HbsAg carriers with normal liver function, 69 initially had no or mild liver abnormalities, 18 had chronic persistent hepatitis and 5 had mild chronic active hepatitis. Of 68 patients who then had regular follow-up, only three showed biochemical signs of HBV infection and of them, only one developed chronic active hepatitis. No patient developed hepatitis C or D infections, no patient developed liver cancer and there were no liver-related deaths. Another 22 patients were interviewed by telephone and none had liver disease.

Hepatitis associated antigen, Hepatitis B e-antigen

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