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Biomedical subjects

A M Courouce

Publications and source records attributed to A M Courouce.

At least 91 records · Page 5Linked to original sources
PubMed1984

Hepatitis B vaccine: randomized trial of immunogenicity in hemodialysis patients.

In order to determine whether reinforced vaccinations improve the immune response among uremic patients, three vaccination schedules with hepatitis B surface antigen vaccine (Institut Pasteur Production) were compared. A total of 215 hemodialysis patients treated in HBV free units were randomly allocated to Group I (3 injections of 1 ml), Group II (3 injections of 2 ml) and Group III (4 injections of 1 ml). Immune response was evaluated in 204 patients. The percentages of responders within 12 months after the first injection (greater than = 10 mIU/ml on 2 successive blood specimens) were: 45.6%, 75.0% and 69.4% in Group I, Group II and Group III respectively. The geometric mean peak values of anti-HBs observed 6 months after the first injection among the responders were: 60, 192 and 268 mIU/ml respectively. One month after a booster dose given to 182 patients 14 months after the first injection, anti-HBs levels were 144, 1123, 524 mIU/ml respectively, and the frequency of patients with an anti-HBs titer greater than = 50 mIU/ml was 68%, 82% and 75% respectively. These results led us to discard the use of Protocol I for these immuno-depressed patients while it is quite satisfactory in healthy subjects; they also show that Protocol II and III give better results than Protocol I, but that they cannot be statistically differentiated. We conclude that response rates and anti HBs antibody titers can be significantly improved in chronic hemodialysis patients with reinforced vaccination protocols.

Antibodies, Viral↗
PubMed1983

Relationship between liver histopathological changes and HBsAg in 111 patients treated by long-term hemodialysis.

We studied liver biopsies performed between January 1972 and June 1980 in 111 patients receiving regular dialysis treatment. Biopsies were performed either because of suspected liver disease (61 patients) or routinely during abdominal surgery or kidney transplantation (50 patients). Repeat biopsies were done in 14 cases. Hepatitis B virus markers, assayed every 3 months during the observation period, were detected at some time in 71 patients (64%); 51 remained persistently positive. Histological examination showed normal liver in 39 cases, lobular hepatitis in 15, chronic persistent hepatitis in 36 and chronic active hepatitis in 21. All patients with chronic active hepatitis were chronic HBsAg carriers, and repeated biopsies showed aggravation only in these patients. The course was remarkably asymptomatic, with lesions leading to fibrosis despite the lack of histopathological patterns of severe necrosis and/or inflammation, which were conspicuously absent in this series.

Biopsy↗
PubMed1982

[Use of hepatitis B virus vaccine in volunteer donors already immunized against this virus].

Forty nine blood donors immune to HBV have been volunteers to receive a single dose of hepatitis B vaccine (Hevac B from Pasteur Institute Production). The initial mean level of anti-HBs was 20 IU/ml (from 5 to 75 IU/ml). The maximum level was observed at the consecutive plasma donation usually 1 month and a half after the vaccine injection. The mean maximum level was 188 IU/ml (from 7 to 800 IU/ml). i.e. an increase of 9 times the initial level. Six donors have developed a very weak immune response (inferior to twice the initial level). In the 43 others, anti-HBs levels remained higher than initial level 6 months after the vaccine injection. One year later (study conducted in 25 subjects), 56% had anti-HBs levels superior to 3.6 to 16 times the original level. Such booster responses are of considerable practical importance for increasing anti-HBs titers in human donors for producing HBIG.

Adult↗
PubMed1978

[The "e" antigen system in HBs antigen carriers (author's transl)].

Antigen e and its antibody were sought by radial immunodiffusion in 86 carriers of HBs antigen observed over a period of one year. The antigen was found in 3 cases out of 30 with acute viral hepatitis, 11 cases out of 33 with chronic active hepatitis, 1 case out of 6 with chronic persistent hepatitis and 1 out of 6 healthy carriers. It was not found in the serum of 6 patients with fulminating hepatitis. The presence of antigen e is associated with high titers of circulating HBs antigens (p less than 0,001). In this group, no difference in the course of the disease was found in cases of chronic active hepatitis with HBs antigen, according to the presence or absence of antigen e or its antibody.

Acute Disease↗
PubMed1978

[Anti hepatitis A antibodies in the French population and in polyvalent plasma immunoglobulins at a transfusion center (Gamma TS)].

A search for antibodies directed specifically against hepatitis virus A was carried out in 600 blood donors in the Paris region (354 men and 246 women) by a radio-immunological technic in solid phase. 75.3% had a positive test, no difference was found as regards sex on country of origin (57 were not French). An increase in the frequency of carriers of anti-HAV carriers was observed in relation to age, for 48.4% were aged between 18 and 24 years and 85.9% had antibodies after age 40 years. An estimation of anti-HAV antibodies was made on 19 lots of immunoglobulins from French transfusion centers by the same technic. High and homogenous levels were observed (average 1/4 270). These data were discussed and compared with those in the literature. A better prophylaxis of hepatitis A and the determination of specific activity of polyvalent immunoglobulins with regard to this virus is then considered.

Adolescent↗
PubMed1977

Prevention of hepatitis B in hemodialysis patients using hepatitis B immunoglobulin. A controlled study.

In a controlled study, the protection effect of hepatitis B immune globulin (HBIG) was evaluated in patients hemodialyzed for less than one month in two collaborating units. Fifteen randomly selected patients received HBIG at five to eight week intervals throughout the study, and 13 other control patients received no immunoglobulin. During a follow-up period of 14 to 30 months, none of the HBIG-treated and 12 of the control patients developed evidence of exposure to virus B hepatitis, including 10 with HBs Ag antigenemia (p is less than 0.001): five of these remained persistently antigen positive. Evidence of non-B hepatitis was found in 8 HBIG-treated and in 3 non-treated patients. Only two HBIG-treated patients developed active antibodies against hepatitis B surface antigen. Thus, HBIG seems effective in preventing hepatitis B in hemodialysis patients, provided the interval between two injections is not greater than two months. However, prolonged administration of HBIG may impair passive-active immunization to hepatitis B virus.

Adult↗