HEPATITIS-A IMMUNIZATION IN HIV-INFECTED HEMOPHILIC PATIENTS

被引：4

作者：

WILDE, JT ^{[1
]}

RYMES, N ^{[1
]}

SKIDMORE, S ^{[1
]}

SWANN, M ^{[1
]}

LININ, J ^{[1
]}

机构：

[1] BIRMINGHAM HEARTLANDS HOSP,PUBL HLTH LAB,BIRMINGHAM,W MIDLANDS,ENGLAND

来源：

HAEMOPHILIA | 1995年 / 1卷 / 03期

关键词：

HEPATITIS A; HIV; HEMOPHILIA; IMMUNIZATION; HAVRIX;

D O I：

10.1111/j.1365-2516.1995.tb00068.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Forty-seven HIV-infected haemophilic patients were entered into a hepatitis A vaccination programme. 10 patients (21%) were IgG seropositive for hepatitis A consistent with past exposure. Of the 37 patients offered vaccination, one refused and 31 completed the vaccination course. 17/13 (55%) seroconverted, nine after the second and eight after the third injection, and 14 patients failed to seroconvert. The CD4 lymphocyte counts immediately prior to vaccination were significantly higher in the patients who developed immunity compared to the nonresponders (median CD4 count in the immune group 380 x 10(6)/l (range 170-1290), median CD4 count in nonimmune group 110 x 10(6)/l (range 10-590), P=0.003). No patient with a CD4 count < 170 x 10(6)/l seroconverted and five patients with well-preserved CD4 counts also failed to seroconvert. We conclude that HIV-infected haemophilic patients, especially those with more advanced disease, have an impaired response to hepatitis A vaccination. Due to the likely failure of response in patients with CD4 counts < 150 x 10(6)/l, it is reasonable not to include these patients in a hepatitis A vaccination programme.

引用

页码：196 / 199

页数：4

共 24 条

[1]

Geritzen A., Schneweis KE., Brackmann H.-H., Oldenburg J., Hanfland P., Gerlich WH., Caspari G., Acute hepatitis A in haemophiliacs, Lancet, 340, pp. 1231-1232, (1992)

[2]

Mannucci PM., Outbreak of hepatitis A among Italian patients with haemophilia, Lancet, 339, (1992)

[3]

Temperley IJ., Cotter KP., Walsh TJ., Power J., Hilary IB., Clotting factors and hepatitis A, Lancet, 340, (1992)

[4]

Peerlinck K., Vermylen J., Acute hepatitis A in patients with haemophilia A, Lancet, 341, (1993)

[5]

Lawlor E., Johnson Z., Thornton L., Temperely IJ., Investigation of an outbreak of hepatitis A in Irish haemophilia A patients, Vox Sang, 67, pp. 18-20, (1994)

[6]

Mannucci PM., Santagostino E., Di Bona E., Gentili G., Ghirardini A., Schiavoni M., Mele A., The outbreak of kepatitis A in Italian patients with hemophilia: facts and fancies, Vox Sang, 67, 1 Supplprefix, pp. 31-35, (1994)

[7]

Cohn RJ., Schwyzer R., Field SP., Fernandes-Costa F., Armstrong D., Acute hepatitis A in haemophiliacs, Thrombos Haemostas, 72, pp. 785-786, (1994)

[8]

Hollinger FB., Khan NC., Oefinger PE., Yawn DH., Schmulen AC., Dreesman GR., Melnick JL., Post transfusion hepatitis A in a neonatal intensive care unit, J Amer Med Assoc, 250, pp. 2313-2317, (1983)

[9]

Noble RC., Kane MA., Reeves SA., Roeckel I., Post transfusion hepatitis A in a neonatal intensive care unit, J Amer Med Assoc, 252, pp. 2711-2715, (1984)

[10]

Sheretz RJ., Russell BA., Reuman PD., Transmission of hepatitis A by transfusion of blood products, Arch Intern Med, 144, pp. 1579-1580, (1984)

← 1 2 3 →