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Biomedical subjects

H W Reesink

Publications and source records attributed to H W Reesink.

At least 145 records · Page 8Linked to original sources
PubMed1990

Infectivity of blood seropositive for hepatitis C virus antibodies.

Stored serum samples from 5150 blood product transfusions and 383 recipients were tested for antibodies to hepatitis C virus (anti-HCV) by a recombinant enzyme-linked immunosorbent assay (ELISA) as part of a prospective study on post-transfusion non-A, non-B hepatitis (NANBH). Donor cofactors associated with HCV infectivity of anti-HCV-positive blood products were raised alanine aminotransferase concentrations (6 of 9 infective vs 1 of 26 not infective); a mean ELISA optical density/cut-off ratio greater than or equal to 2 (7 of 9 vs 9 of 26); both preceding factors (together in 6 blood products, all of which transmitted infection); and persistent donor anti-HCV seropositivity. Use of anti-HCV screening to prevent post-transfusion NANBH was compared with measurement of alanine aminotransferase concentrations: a corrected efficacy of 63% and 65%, a specificity of 93% and 64%, and a positive predictive value of 16.2% and 3.6% were found, respectively; 0.7% or 3.8% of blood donations, respectively, would be discarded. Blood donor screening for anti-HCV is recommended to reduce the incidence of post-transfusion NANBH.

Alanine Transaminase↗
PubMed1990

[Treatment of AIDS patients with zidovudine].

During 20 months 49 AIDS patients treated with zidovudine were followed prospectively. The 12-month cumulative probability of survival was 73% and the 18-month probability of survival was 51%. The probability of survival was significantly higher when, at the start of therapy, the Karnofsky score was 70 or higher (p less than 0.001) or the CD4 cell count was 0.05 x 10(9)/l or higher (p less than 0.05). The general condition, Karnofsky score, body weight, number of CD4 positive cells and the lymphocyte stimulation in vitro improved during therapy, but the beneficial effects lasted only 6-9 months. Anaemia (Hb less than 6 mmol/l) developed in 21 (43%) of the patients. (Pan)cytopenia prompted dose reduction in 14 patients, in 5 patients with pancytopenia therapy was withdrawn. The length of stay in hospital was 885 days for the whole group of patients, equivalent to 20 days per patient year.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Platelet activation during preparation of platelet concentrates: a comparison of the platelet-rich plasma and the buffy coat methods.

The activation of platelets during the preparation of platelet concentrates (PCs) by two methods was compared. To eliminate interdonor differences, 2 units of whole blood were pooled and subsequently divided into two batches. From one batch, the platelets were harvested as pelleted platelets from platelet-rich plasma (PRP) and from the other as nonpelleted platelets from the buffy coat (BC). The activation of platelets in these PCs was studied immediately after preparation and during storage for up to 9 days at 22 degrees C with gentle agitation. The binding of monoclonal antibodies (MoAbs) against the GP IIb/IIIa complex and against activation-dependent antigens (GMP 140 from the alpha granules and a 53-kDa glycoprotein from the lysosomal granules) was measured. Beta-thromboglobulin (beta-TG) release was also determined. Disc-to-sphere transformation was quantitated by measuring on an aggregometer the difference in light transmission during stirring at different rates and also by light microscopy. Immediately after preparation, platelets derived from PRP had a more spheric morphology (p less than 0.01), had a higher beta-TG release (p less than 0.01), bound more MoAbs against GP IIb/IIIa (p less than 0.01), and expressed more GMP 140 and 53-kDa glycoprotein (p less than 0.01) than did BC-derived platelets. However, these differences had disappeared after 2 days of storage. It was concluded that, immediately after preparation, PRP-derived platelets are more activated than BC-derived platelets. This is most likely a result of the pelleting that follows the second high-speed centrifugation of the PRP.

Antibodies↗
PubMed1990

Comparison of a conventional quadruple-bag system with a 'top-and-bottom' system for blood processing.

'Top-and-bottom' bags have an outlet at the top and at the bottom of the collecting bag, allowing simultaneous expression of plasma and red cells, whereas the buffy coat remains in the collecting bag. The composition of blood components was investigated following manual separation of whole blood in a conventional 4-bag system (A) or automated separation in a 'top-and-bottom' system (B). To overcome inter-donor differences, two units of whole blood were pooled and redistributed into the original bags (A and B) prior to centrifugation. Leukocyte-poor platelet concentrates (LPPC) were manufactured from both types of buffy coat (A and B). The volumes of plasma, red cell concentrates (RCC) and buffy coat were similar in both methods. However, the residual leukocytes and platelets in the RCC from the top-and-bottom system were significantly lower than in the conventional system, 140 +/- 59 x 10(6) (mean +/- SD) versus 762 +/- 228 x 10(6), respectively (p less than 0.01). Both types of LPPC contained less than 10(7) leukocytes and could be stored for 7 days maintaining a pH above 6.5. We conclude that the top-and-bottom system enables automated and standardized preparation of RCC and plasma with a significantly better buffy-coat removal than with manual processing.

Automation↗
PubMed1990

[A new multiple blood bag system with top and bottom drainage. Comparison with the conventional multiple bag system].

Blood components were investigated following manual preparation in a conventional 4-bag system (A) or automatic preparation in a top and bottom system (B). To overcome inter donor differences two units of whole blood were pooled and subsequently split up into the original bags. Leukocyte-poor platelet concentrates (PC) were manufactured from both types of buffy-coat (A and B). The volumes of the various blood components were similar, whereas the residual leukocytes and platelets in the red cell concentrates from the top and bottom system were significantly lower (p less than 0.01). Both types of PC contained less than 10(7) leukocytes and could be stored for 7 days maintaining a pH above 6.5. We conclude that the top and bottom system enables automatic preparation of red cell concentrates and plasma with a significantly better buffy-coat removal than with manual processing.

Blood Banks↗
PubMed1989

Anti-hepatitis C antibodies and non-A, non-B post-transfusion hepatitis in The Netherlands.

In a prospective study carried out in the Netherlands (1984-86) to establish the incidence of post-transfusion hepatitis non-A, non-B (PTH-NANB) in patients undergoing open heart surgery, 393 patients received 5315 blood product transfusions. PTH-NANB developed in 9 patients (index cases); stored serum samples from these patients and from 9 control patients, matched for age, sex, and number of blood product transfusions, as well as serum samples of all implicated blood products, were selected retrospectively. Sera were tested under code with a radioimmunoassay for the detection of antibodies to hepatitis C virus (anti-HCV). PTH-NANB patients received 151 blood product transfusions and control patients 140. 4 of 9 PTH-NANB patients (3/5 chronic, 1/4 acute resolved hepatitis) and 0/9 controls seroconverted. 7 of the transfusions given to PTH-NANB patients but none of those given to control patients were anti-HCV positive. In 7 of 9 serum sets from PTH-NANB index cases plus implicated donors, either a donor or the recipient was anti-HCV positive. Among the donors implicated in transmission of PTH-NANB there was a strong correlation between raised alanine aminotransferase levels and the presence of anti-HCV antibodies.

Alanine Transaminase↗
PubMed1989

Prevention of hepatitis B virus carrier state in infants according to maternal serum levels of HBV DNA.

235 infants of HBeAg-carrier mothers in Hong Kong were assigned to four study groups. Groups I, II, and III received hepatitis-B (HB) vaccine at birth and at 1, 2, and 6 months. Group I also received seven monthly injections of HB immunoglobulin (HBIg), and group II received one HBIg injection at birth. Group III received vaccine only and group IV received placebo for both vaccine and HBIg. At the age of 3 years, all infants of the three treatment groups were significantly protected against the HB virus (HBV) carrier state compared with the placebo group (p less than 0.0001); the protective efficacy rates in groups I, II, and III were 87%, 80%, and 65%, respectively. At all times, group I was significantly better protected than group III. In groups III and IV, infants of mothers with serum HBV DNA levels of 5 pg/ml or above were at a significantly higher risk of acquiring the HBV carrier state than those whose mothers had HBV DNA levels below 5 pg/ml. This difference was not significant in groups given HBIg. Of the 183 infants who initially escaped HBV infection, 73 (40%) had transient and 8 (4%) chronic HBV infection between 6 and 36 months. Vaccinated infants who had actively formed anti-HBs remained well protected against the HBV carrier state. However, infants in groups I and II with no active anti-HBs response to vaccine became at risk for the HBV carrier state when the passively acquired anti-HBs antibodies had disappeared. HBIg should be included in HB vaccination schedules for all infants of HBeAg-positive mothers.

Age Factors↗
PubMed1989

Lack of immune potentiation by complexing HBsAg in a heat-inactivated hepatitis B vaccine with antibody in hepatitis B immunoglobulin.

In a randomized, dose-response study among 305 health care workers, we examined whether the immunogenicity of a heat-inactivated hepatitis B vaccine could be enhanced when HBsAg was complexed by anti-HBs contained in hepatitis B immunoglobulin either at equivalent proportions or at 10-fold antigen excess. The dose of HBsAg in the control vaccine as well as in the two complexed vaccine preparations could be reduced from the standard value (3 micrograms) to 0.6 micrograms per injection without affecting the antibody response in the vaccinees. Still lower dosages of HBsAg in the three vaccine preparations induced significantly lower but comparable anti-HBs responses. These results indicate that, in man, using a heat-inactivated plasma vaccine, addition of anti-HBs contained in hepatitis B immunoglobulin does not potentiate the immunogenicity of HBsAg.

Antibody Formation↗
PubMed1989

Blood transfusion and hepatitis: still a threat?

The incidence of post-transfusion hepatitis (PTH) in recipients of blood products is reviewed. PTH was observed in 10%-12% of recipients of blood products in the United States, 2%-4% in northern Europe and 15%-20% in southern Europe. All studies indicate that 80%-90% of all PTH cases are attributed to non-A/non-B. At least 40% of the patients with PTH non-A/non-B will develop chronic hepatitis or cirrhosis. No specific tests for the detection of the non-A/non-B agent(s) exist. However, several independent studies indicate that part of the donors carrying the infectious non-A/non-B agent have increased levels of alanine amino transferase (ALT). When donors are excluded with elevated ALT values, it is estimated that about 30% of the PTH non-A/non-B cases would be prevented. Some studies indicate that anti-hepatitis B core (anti-HBc) positive donors may carry an increased risk to transmit the non-A/non-B agent, but more recent studies do not confirm this. There is hope that a specific non-A/non-B test will be developed soon.

Hepatitis↗
PubMed1989

Diagnosis and prevalence of HIV-2 antibodies in different population subsets in The Netherlands.

A serum panel obtained from male homosexuals (n = 278); i.v. drug abusers (n = 99), patients attending a VD clinic (n = 390), blood donors who visited Central or West Africa (n = 573), blood donors who had sexual contact with natives from Central or West Africa (n = 38), blood donors from Surinam, South America (n = 481), individuals positive for anti-HIV-1 (n = 94), individuals with indeterminate HIV-1 western blot (WB) reactions (n = 73), African patients with AIDS or AIDS-related symptoms (n = 30), and random Dutch blood donors (n = 555), was tested with HIV-2 ELISA (ELAVIA-2). Of these 2,611 samples, 32 (1.2%) were repeatedly reactive. Antibodies to gp140/105env were found in 4/32 by HIV-2 WB, and in 1/4 by radioimmunoprecipitation (RIPA). These 4 HIV-2 WB-positive samples were also reactive with gp160/120env in HIV-1 WB, suggesting cross-reactivity. In a spot test with synthetic peptides of the transmembrane glycoprotein of both HIV types, 3/4 were only HIV-1 positive and 1/4 was strongly HIV-2 positive and weakly HIV-1 positive. In inhibition assays with soluble HIV-1 or HIV-2 synthetic peptides in HIV-1 and HIV-2 peptide ELISA, cross-reactivity was excluded, which indicates an HIV variant or HIV-1/HIV-2 double infection. It is concluded that for the moment HIV-2 infection is at low prevalence in risk groups in The Netherlands, and that in addition to WB and RIPA, synthetic peptide assays are useful for differentiation between HIV-1 and HIV-2 antibodies.

Blotting, Western↗
PubMed1989

Storage of whole blood for up to 24 hours at ambient temperature prior to component preparation.

The effect of rapid cooling to 20-24 degrees C of whole blood immediately after collection, using 'cooling units' with butane-1,4-diol and prolonged storage up to 24 h at ambient temperature was investigated in the whole blood and the subsequently prepared plasma, buffy coat and buffy-coat-poor red cell concentrate (BC-poor RCC) in saline-adenine-glucose-mannitol (SAG M) solution. Factor VIII:C content of the plasma (n = 10), after 24 h storage was 80 +/- 3% of the initial value. In routine procedures factor VIII:C content in the plasma (n = 129 pools of 20 donor units plasma) was 0.77 +/- 0.078 IU/ml, after storage of the whole blood for 16-20 h. In whole blood (n = 10), the 2,3-diphosphoglycerate (2,3-DPG) content of the red cells decreased from 4.36 +/- 0.55 to 1.47 +/- 0.6 mumol/ml red cells after 24 h storage at 20-24 degrees C. After storage of the BC-poor RCC (n = 10) at 2-6 degrees C for 1 week, the 2,3-DPG had dropped to 0.76 +/- 0.46 mumol/ml red cells. During the first 24 h of storage of whole blood, the adenine triphosphate (ATP) levels of the red cells remained stable. A mean increase of 20% of the initial value was observed after addition of SAG M solution. In the BC-poor RCC the ATP slowly decreased to 81 +/- 5% after 5 weeks and to 68 +/- 6.6% of the initial value after 6 weeks storage.(ABSTRACT TRUNCATED AT 250 WORDS)

2,3-Diphosphoglycerate↗
PubMed1989

Blood donors with indeterminate anti-p24gag reactivity in HIV-1 western blot: absence of infectivity to transfused patients and in virus culture.

During a follow-up period of 23-40 months, 7 regular blood donors had persistently, and 4 had intermittently indeterminate anti-p24gag reactivity in human immunodeficiency virus (HIV)-1 Western Blot. Serological testing and viral cultures revealed that these donors had no signs of infection for HIV-1, HIV-2, human T-cell lymphotropic virus (HTLV)-4, and HTLV-1. Extensive interviewing and physical examination of these donors revealed neither risk factors, nor signs of HIV infection in the tested donors. Ten recipients, who were transfused with blood products from 6 of these 11 anti-p24gag-positive donors, were traced back. Six months after transfusion, no serological or clinical signs of HIV-1, HIV-2, or HTLV-1 infection were observed in these patients. It is concluded that blood donors with persistent or intermittent anti-p24gag reactivity in HIV-1 Western Blot, without development of antibodies to other HIV-encoded proteins in later blood samples, do not transmit the described retroviruses to transfused patients.

Acquired Immunodeficiency Syndrome↗
PubMed1989

A new cellulose acetate filter to remove leukocytes from buffy-coat-poor red cell concentrates.

Transfusion of leukocyte-free red cell concentrates (RCC) prevents or delays HLA immunization in multitransfused patients. We investigated a new cellulose acetate filter which was recently introduced to remove leukocytes from buffy-coat-poor RCC. It was found that the filtration time was only 10 min with buffy-coat-poor RCC in saline-adenine-glucose-mannitol (SAG M; n = 23), hematocrit being 62 +/- 2% (SD). The red cell loss was 13.5 +/- 2.6% and leukocyte removal was more than 99%. Routine filtration in SAG M (n = 179) showed again that more than 99% of the leukocytes were removed from buffy-coat-poor RCC with an original leukocyte content of 804 +/- (SD)458 x 10(6). The red cell loss (12 +/- 8.6%) was not diminished by increasing the amount of saline (0.9% NaCl) from 100 to 300 ml in an attempt to remove the retained red cells from the filter. We conclude that the new filter is reliable in rapidly removing more than 99% of the leukocytes from buffy-coat-poor RCC in SAG M solution.

Cell Separation↗
PubMed1989

Storage of leukocyte-poor red cell concentrates: filtration in a closed system using a sterile connection device.

Storage of leukocyte-poor red cell concentrates (LP-RCC) was investigated after filtration in a closed system that was assembled using a Sterile Connection Device (SCD). The LP-RCC were stored for up to 6 weeks following filtration with either 0.9% saline solution (n = 14) or saline-adenine-glucose-mannitol (SAG M) solution (n = 15) to prime and rinse the cellulose acetate filter. The results were compared with the data of nonfiltered buffy-coat-poor red cell concentrates (BC-poor RCC) stored in SAG M solution (n = 10). All LP-RCC contained less than 10(6) leukocytes whereas the nonfiltered BC-poor RCC contained 675 +/- 286 X 10(6) leukocytes at day 1, decreasing to 83 +/- 49 x 10(6) at day 42. Although glucose consumption, lactic acid production and decrease in pH was similar from day 7 through 28 in both groups of LP-RCC, a significantly steeper decline of ATP values as well as a higher hemolysis and LDH release was observed in the LP-RCC filtered with saline. During storage of the nonfiltered BC-poor RCC in SAG M, significantly higher glucose consumption (p less than 0.01), LDH release (p less than 0.001), rate of hemolysis (p less than 0.001) and a lower pH (p less than 0.001) were found, compared to the filtered units. It is postulated that the leukocytes present in the nonfiltered BC-poor RCC were responsible for these differences. The ATP values in the SAG-M-filtered and nonfiltered BC-poor RCC in SAG M were comparable.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenine↗
PubMed1989

Hepatitis B infection in infants after neonatal immunization.

A double-blind randomized placebo-controlled study to prevent hepatitis B infection in 235 babies born to chronic hepatitis B, HBeAg carriers was carried out. Babies in three treatment groups all received heat-inactivated hepatitis B vaccine. In addition multiple doses of HBIG and a single dose of HBIG were given in groups I and II respectively. After three years of follow-up, 4/60 (Group I), 3/64 (Group II), and 1/64 (Group III) developed chronic infection. For those who escaped chronic infection, other hepatitis events also occurred. They were transient HBs-antigenaemia, anti-HBc conversion and significant rise in anti-HBs titre without seroconversion for anti-HBc. It was deduced that 30% of babies born to hepatitis carriers are naturally protected from chronic infection. Immunization, with vaccine only, protects another 46%. The addition of single and multiple doses of HBIG protects another 10% and 5%, respectively. 2% acquired intrauterine infection and 7% failed to respond to the most intensive immunization schedule.

Double-Blind Method↗
PubMed1988

Long-term follow-up of antiviral combination therapy in chronic hepatitis B.

For patients with chronic hepatitis B e (HBe)-positive hepatitis, long-term results of pilot studies with lymphoblastoid interferon-alpha, acyclovir, or a combination, and of a randomized controlled trial of interferon/desciclovir combination therapy are presented. HBe seroconversion was observed in more than 40 percent of patients treated with combination therapy, 30 percent with interferon therapy, 18 percent with acyclovir, and 0 percent with no treatment. HBe reactivation occurred in two patients with cirrhosis. Hepatitis B surface seroconversion followed HBe seroconversion in 11 to 30 percent of treated patients. HBe seroconversion was significantly related to initial low levels of viral replication and to transient aminotransferase elevation during the second half of the interferon treatment of 16 weeks. Clinical improvement and persistent normalization of aspartate aminotransferase was observed in all patients with HBe seroconversion. Conversion to a state of virus latency (HBe negative) mostly occurred after therapy, suggesting that the specific immunologic host response had been brought about by the suppression of virus replication through antiviral agents. Recommendations for selection of patients for antiviral combination therapy are made on the basis of these long-term results.

Acyclovir↗