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Biomedical subjects

G Papaevangelou

Publications and source records attributed to G Papaevangelou.

At least 19 recordsLinked to original sources
PubMed1992

Knowledge, attitudes and practices of Greek health professionals, in relation to AIDS.

In order to improve educational programmes directed at health care workers we investigated their knowledge, attitudes and practices in relation to HIV/AIDS. An anonymous self-administered questionnaires was distributed to 609 health care workers. Of these, 59.6% agreed to participate (42.4% of the medical doctors, 74.3% of the nurses and 79.6% of the laboratory technicians, health visitors and other health care workers). All studied groups believed that their knowledge of HIV modes of transmission (84.3%) was sufficient. In contrast, a relatively small percentage reported knowledge of the clinical spectrum of HIV infection (48.8%) and the diagnostic assays (57.6%). Nearly all the study participants believe (92.8%) that there is a risk of acquiring HIV infection during the hospitalization of HIV/AIDS patients. Obligatory screening of all patients was reported by nearly all participants (90.6%) as a chance to minimize their occupational risk. Although health care workers reported satisfactory knowledge of safety measures (87.0%), only 56.7% used gloves and 38.8% accept the hospitalization of HIV/AIDS patients. In spite of the educational programmes for AIDS in Greece, this study demonstrates that health professionals' knowledge and precautionary measures are not sufficient. As a result, a small percentage of them treat AIDS patients without discrimination. There is an urgent need to implement specific educational programmes for health professionals so that they will safely provide high quality care to people affected by HIV/AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Epidemiology of hepatitis A in Mediterranean countries.

Infection with hepatitis A virus (HAV) is still endemic in some Mediterranean areas. In most Northern Mediterranean countries, the incidence of acute icteric hepatitis in adults is increasing. This is due to the shifting of HAV infection to adulthood as a result of the decline of its overall prevalence due to improvements in socioeconomic, sanitary and hygienic conditions. The majority of adults remain susceptible and develop overt disease when infected, since the severity of disease is highly associated with age. Epidemics are now rare, but are more extensive when they do occur. They may sometimes be caused by accidental contamination of the water supply, but are usually due to contamination of food by diseased food-handlers or result from contaminated frozen foods. Outbreaks still may occur in day-care centres and in schools. Thus travelling to endemic areas is becoming the main source of HAV infection. Intrafamilial person-to-person spread also is an important source of infection. Transmission from children to parents and other adults may occur due to lack of immunity in the adult population. Selective immunization would further reduce the incidence of the disease. However, only inclusion of the vaccine in the routine programme of childhood immunization would guarantee the disappearance of hepatitis A.

Adolescent↗
PubMed1991

HIV infection in Greek intravenous drug users.

In order to investigate the prevalence of HIV infection among Greek intravenous drug users (IVDU), its trend during years recent and possible risk factors, we studied 893 inmates recently admitted to the main prisons of Greece from 1986 to 1989. Screening and counselling was offered to all of them. The acceptance rate was 98%. One thousand one hundred and two IVDUs voluntarily attending the AIDS Reference Centre in Athens for counselling and screening were also included in the study. Anti-HIV were determined by commercially available radioimmunoassays, and positive results were confirmed by Western Blot. Our results showed that the prevalence of HIV infection remained very low in both groups during the study period; it was similar to the prevalence found (2.1%) in stored sera drawn in 1982 from imprisoned IVDU. In the non-prisoner group, the prevalence among those who reported needle/syringe sharing (2.6%) was similar to that among those who denied sharing (2.5%). This lack of difference may be due to the fact that sharing is only an occasional practice and that cleaning of of the injection equipment is common. We conclude that the prevalence of anti-HIV in IVDU in Greece is considerably lower than that in neighbouring countries and that it has remained stable during the last eight years. Further studies are necessary to identify behavioral and other risk factors.

Adolescent↗
PubMed1988

Epidemiological characteristics of hepatitis B virus infection in Cyprus.

The prevalence of hepatitis B virus (HBV) infection in Cyprus was estimated in a sample of 795 blood donors, 388 armed forces recruits, 1872 hospital staff, 135 haemodialysis patients, 559 thalassaemic patients, 722 institutionalised adults, 98 mentally retarded children and 323 family contacts of HBsAg carriers. Commercially available radioimmunoassays were used for screening. Merck Sharpe and Dohme hepatitis B vaccine was used for a vaccination pilot program. Our results showed that the carrier rate of HBsAg in the blood donor and army recruit samples ranged between 0.77% and 1.01% and the prevalence of past infection between 11.1% and 13.6%. Among high risk groups the highest carrier rate was found in family contacts of HBsAg carriers (18.27%), in mentally retarded children (6.12%) and in institutionalized adult patients (5.40%). The frequency of immunes was found 28.5%, 12.2% and 33.2% respectively. The highest frequency of immunes was found in thalassaemic (82.9%) and haemodialysis (43.7%) patients. The carrier rate (2.94%) and the prevalence of immunes (22.5%) in hospital personnel was higher than in general population. Vaccination studies in a limited number of thalassaemic children and hospital personnel showed excellent acceptance of vaccination and excellent immunogenicity. We infer that HBV infection should be consider as a major public health problem in Cyprus. A National Vaccination program has to be implemented for containing its spread.

Adult↗
PubMed1988

Immunogenicity of low doses of recombinant hepatitis B vaccine in young males.

A trial of low doses (1.25 and 0.625 micrograms) of recombinant hepatitis B vaccine in 110 males aged 17-19 years is reported. Follow-up was extended to one year and further data are reported for participants from earlier trials of 10, 5 and 2.5 microgram doses for comparison. Seroconversion rates after the booster dose were 94% at 1.25 micrograms and 89% at 0.625 micrograms, compared to 100% at higher doses. Geometric mean titres (GMT) of antibody to hepatitis B surface antigen (anti-HBs) were significantly lower with the 0.625 microgram dose than with 1.25 micrograms at all times, reaching a GMT of 42.6 IU l-1 and 152.9 l-1, respectively, after the booster dose. GMT values at 12 months were 513.9, 510.0, 320.7, 46.5 and 13.3 IU l-1 in the 10, 5, 2.5, 1.25 and 0.625 microgram dose groups, respectively. Increases in GMT after the booster dose were parallelled in all groups. GMT decreased by approximately equal to 65% between 7 and 12 months in the three lowest dose groups, significantly less than the fall of 80% at 5 and 10 micrograms. However, to secure variability among vaccinees, the minimum effective dose for young adults should be greater than 5 micrograms per dose.

Adolescent↗
PubMed1988

Heterosexual transmission of HIV in Greece.

To provide further evidence for the heterosexual transmission of the acquired immunodeficiency syndrome (AIDS) in Greece we examined 53 Greek female steady heterosexual partners of 53 anti-HIV-positive men. Human immunodeficiency virus (HIV) transmission was estimated by the detection of anti-HIV antibodies. Our results showed that 27.8% (5 of 18) of the female partners of bisexuals, 33.3% (2 of 6) of intravenous drug abusers (IVDA), and 100% (4 of 4) of those who had lived for a long time in Africa were found anti-HIV positive. In contrast, only 4% (1 of 25) of the studied sexual partners of hemophiliac carriers were found to be HIV seropositive. The use of condoms seemed to be the most important factor in reducing HIV transmission. According to our results the duration of sexual relationships and the practice of anal intercourse did not increase the possibility of seroconversion. These results confirm the heterosexual transmission of HIV. However, further studies should be conducted to evaluate the relative role of various risk factors and the overall importance of heterosexual spread of HIV infections.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Education in preventing HIV infection in Greek registered prostitutes.

From March 1984 to November 1985, 350 Greek registered prostitutes were screened for anti-HIV. Twelve of them (3.4%) were found to be positive. To monitor and control the further spread of HIV infection, an intensive educational campaign was established and screening every 3 months was implemented. Until October 1986, two new seroconversions were detected out of 270 examined (seroconversion rate of 0.74% per year). Further HIV infections have not been detected among the 282 prostitutes followed to 1988. This should be attributed to avoidance of clients from Central Africa and mainly to almost universal use of condoms as a result of the intensive educational campaign.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Partial splenic embolisation for hypersplenism of thalassaemia major: five year follow up.

Six patients with thalassaemia major were treated by partial splenic embolisation as an alternative to splenectomy and followed up for five years. Results were compared with those in a matched control group of seven patients treated by splenectomy. All patients treated by partial splenic embolisation showed a reduction in blood transfusion requirements comparable with those in the controls and which remained unchanged over the five years. Serious infections that commonly occur in patients splenectomised for thalassaemia did not occur after embolisation, presumably owing to preservation of some immune function by the splenic remnant. By contrast with the change in platelet counts seen after splenectomy, platelet counts remained normal after partial splenic embolisation, so reducing the risk of thromboses. On the other hand, pre-existing leucopenia and thrombocytopenia were corrected after embolisation. It is concluded that partial splenic embolisation provides an alternative to splenectomy for thalassaemia major and is equally effective and much safer.

Adolescent↗
PubMed1987

Qualitative analysis of the humoral immune response to the "a" determinant of HBs antigen after inoculation with plasma-derived or recombinant vaccine.

Competitive inhibition assays using monoclonal antibodies reacting with defined sequence of the "a" determinant of hepatitis B surface antigen (HBsAg) indicate that the humoral response to plasma-derived and recombinant HBsAg vaccine is similar in quantitative and qualitative terms. Both vaccines evoke an antibody response to the RFHBs 1 epitope, which is known in animal experiments to be protective.

Adolescent↗
PubMed1987

New vaccines against hepatitis B.

The high cost and limited availability of the plasma-derived hepatitis B vaccines have prevented their widespread use, especially in the less developed areas where they are needed most. Hepatitis B vaccines produced by recombinant technology seem to offer a solution to these difficulties. Studies reported up to now confirmed the safety of this vaccine. Immunogenicity studies in various population groups showed that seroconversion rates and antibody titres are comparable to plasma vaccine. In assessing the efficacy of the vaccine, information concerning the quality of the anti-HBs induced should complement these data. Potential live vaccines using recombinant vaccinia viruses have been constructed for hepatitis B. Preliminary studies in rabbits and chimpanzees indicated the feasibility of future using a recombinant vaccinia virus. Chemically synthesized polypeptides corresponding to relevant epitopes of HBsAg may be useful as synthetic vaccines offering the advantages of a cheap viral immunogen free from irrelevant antigenic determinants. Finally preliminary studies for an idiotypic vaccine have already been reported.

Animals↗
PubMed1987

Prevalence of HBV, HDV and HIV infections among intravenous drug addicts in Greece.

The prevalence of HBV, HDV and HIV infection was studied in 288 imprisoned intravenous drug addicts (IVDA) and 329 controls. Commercially available radioimmunoassays for the detection of HBV and HDV serologic markers and enzyme-immunoassays for IgM anti-HBc and anti-HIV were used. Anti-HIV positive results were confirmed by Western Blot. The prevalence of HBV serologic markers among IVDA (77.1%) was found considerably higher than among controls (22.5%). An increased prevalence of HBsAg carriers (6.9%) and anti-HBc alone positives (9.7%) was also found. IVDA carriers were more frequently HBeAg positive (25.0%) and HDV serologic markers were detected in 35.0% (7/20) of them. Anti-HIV were detected in 6 (2.1%) IVDA but in none control. These data show the widespread HBV and HDV infections among Greek IVDA and suggest the need for continuation of the initiated hepatitis B vaccination program. Anti-HIV prevalence is yet low. However there is urgent need for an extensive campaign to limit the further spread of the HIV among this high risk group.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Immune status of Greek patients with beta-thalassemia major negative for anti-HIV.

Patients with thalassemia who receive multiple blood transfusions are at risk for the acquired immunodeficiency syndrome. Peripheral blood lymphocyte subpopulations were studied in 22 multitransfused thalassemic patients; 10 patients were without splenectomy and 12 were studied after splenectomy. Both groups were negative for anti-HIV. Four additional patients who were found positive for anti-HIV and ten healthy controls were also included in this study. Patients without splenectomy compared to controls and to patients after splenectomy showed a significant decrease of both percentage (p less than 0.001) and absolute numbers (p less than 0.001) of Leu-7+ cells without significant abnormalities of T4/T8 ratio (1.56 +/- 0.4). Patients after splenectomy compared to controls and to patients without splenectomy showed a significant increase of the absolute numbers of lymphocytes and lymphocytes subsets T11+, T3+, T4+, T8+ and SmIg+ cells. In the seropositive patients for HIV only a significant increase of the absolute number of T8+ cells was observed while the T4/T8 ratio was 1.24 +/- 0.73. The decrease in the percentage of Leu-7+ cells in patients without splenectomy correlated inversely to the total amount of blood transfused. In conclusion patients with thalassemia had normal T4/T8 ratio and did not show the abnormal immunologic profile that has been reported in haemophiliacs.

Adolescent↗
PubMed1987

An epidemic of hepatitis A in an institution for young children.

A common-source epidemic of hepatitis A occurred in an Athenian institution boarding 38 children (mean age 4.8 years). All children were examined, and blood was drawn from each at the onset of the study and repeatedly during the next three months. Only one child (2.6%) was initially immune to hepatitis A virus as a result of prior infection. The attack rate (62.2%) and the ratio of icteric to anicteric cases (1:1.3) were high despite the administration of immunoglobulin (IG). Assays for anti-HAV IgM and a rising titer of anti-HAV IgG identified 19 (82.6%) and 22 (95.7%) of the 23 hepatitis A infections, respectively. One case (4.3%) was detected only by the presence of hepatitis A virus antigen and hepatitis A virus RNA in a fecal specimen, but these assays were otherwise marginally useful in this study. Nevertheless, the use of all available tests for the detection of hepatitis A virus is mandatory for the most accurate estimation of an epidemic of hepatitis A. Prompt administration of immunoglobulin had no effect on the number of clinical cases that were in the late incubation period, but it may have diminished the clinical expression of the infection and thus made diagnosis of infection more difficult.

Child↗