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Biomedical subjects

J N Zuckerman

Publications and source records attributed to J N Zuckerman.

31 records · Page 2Linked to original sources
PubMed1997

Immune response to a new hepatitis B vaccine in healthcare workers who had not responded to standard vaccine: randomised double blind dose-response study.

OBJECTIVE: To evaluate the immunogenicity and reactogenicity of a new triple S recombinant hepatitis B vaccine in a cohort of healthy people in whom currently licensed hepatitis B vaccines had persistently not induced an immune response. DESIGN: Single centre, randomised, double blind, dose-response study. SETTING: Research vaccine evaluation centre at a teaching hospital. SUBJECTS: 100 healthcare workers aged 18-70 years with a history of failure to seroconvert after at least four doses of a licensed hepatitis B vaccine containing the S component. INTERVENTION: Each subject was randomly allocated two doses of 5, 10, 20, or 40 micrograms of a new hepatitis B vaccine two months apart. MAIN OUTCOME MEASURES: Immunogenicity of the four doses. Seroconversion and seroprotection were defined as an antibody tire > 10 IU/l and > 100 IU/l respectively against an international antibody standard. RESULTS: 69 subjects seroconverted after a single dose of the vaccine. After the booster vaccination one other subject seroconverted, bringing the overall seroconversion rate to 70%. Fifteen subjects given 5 micrograms of vaccine, 19 given 10 micrograms, 16 given 20 micrograms, and 20 given 40 micrograms seroconverted. Seroconversion rates in the four antigen dose groups were 60% (15/25), 76% (19/25), 64% (16/25), and 80% (20/25). After the booster dose there was no significant dose-response effect on the overall seroconversion rate, although the small sample size meant that a clinically important dose-response could not be ruled out. CONCLUSION: A single dose of 20 micrograms of the vaccine was as effective as two doses of either 40 micrograms or 20 micrograms of this vaccine formulation in terms of seroconversion, seroprotection, and geometric mean titres.

Adolescent↗
PubMed1997

Contribution of human leukocyte antigens to the antibody response to hepatitis B vaccination.

We present here the analysis of 86 individuals who were true antibody nonresponders to a vaccine containing hepatitis B surface antigen. The HLA type of these individuals and of 248 controls were determined by serology for HLA class I and by molecular typing for the HLA class II loci DRB1 and DQB1. Subsequent analysis of the results revealed that HLA-DRB1*0701 and HLA-DQB1*02 were significantly associated with antibody non-response to the "S"-containing vaccine compared with the HLA control population. Further, we found that the antibody non-response was also significantly associated with the above antigens when found in linkage disequilibrium on the HLA haplotype DRB1*0701; DQB1*0202. The hepatitis B surface antigen vaccine antibody nonresponder group, comprising 86 individuals, were revaccinated with a novel vaccine Hep B-3, containing both preS1- and preS2-derived proteins in addition to hepatitis B surface antigen, to circumvent their previous nonresponsiveness. The hepatitis B surface antigen antibody results from this group of patients show that 30 of the 86 individuals remained antibody non-responders and that 24 individuals (80%) expressed the HLA-DQB1*02 and that 21 individuals (70%) expressed HLA-DRB1*0701. Our results indicate that antibody nonresponse to the Hep B-3 vaccine is significantly associated with an extended HLA haplotype B44; DRB1*0701; DQB1*0202. A possible indication of these results is that antibody nonresponse to Hep B-3 vaccine is linked with the HLA allele DQB1*0202. These findings may have an important impact on future vaccine design.

Adult↗
PubMed1996

Nonresponse to hepatitis B vaccines and the kinetics of anti-HBs production.

No empirical data are available for the anti-HBs title required for protection against infection with the hepatitis B virus (HBV), but nonresponders to hepatitis B vaccines remain susceptible to infection. There may be an unexplained qualitative difference between hyporesponders and true nonresponders, but there is a clear association with HLA haplotypes. There is no evidence for silent infection with HBV in nonresponders.

Adjuvants, Immunologic↗
PubMed1996

Determination of hepatitis A antibody response to vaccination by an enzyme immunoassay.

The quantitative responses to vaccination with hepatitis A vaccine was determined in 113 volunteers using a commercially available enzyme-linked immunosorbent assay for total antibodies to hepatitis A. Administration of vaccine or control preparation was carried out according to two regimens; at 0, 1 and 12 months (regimen I) and at 0, 0.5 and 12 months (regimen II). Seroconversion rates (concentrations of HAV antibodies > 50 IU/l) were between 94 and 97% at month 1 for regimen I and regimen II, respectively. The geometric mean titres (GMTs) fell gradually by month 12, and increased rapidly 10-100 fold 1 month after the booster dose at month 12. The GMTs of the groups receiving the control preparation remained below 50 IU/l. No significant differences were found between the antibody responses after regimen I or regimen II. It is concluded that the antibody test (Hepanostika HAV Antibody) can be used safely and adequately for quantitation of responses to hepatitis A immunisation.

Adult↗
PubMed1995

Prospects for hepatitis C vaccine.

The genetic and serological heterogeneity of hepatitis C virus and reinfections will make the development of a broad spectrum effective hepatitis C vaccine difficult. Important steps are identification of neutralising antibodies; reproducible techniques for tissue culture of HCV; the application of methods used for the development of vaccines against flaviviruses and pestiviruses, and the application of gene transfer techniques.

Animals↗
PubMedDate not supplied

Risks of hepatitis B in travelers as compared to immunization status.

BACKGROUND: Our objective was to determine the risks of infection with hepatitis B among European travelers and to compare this with the immunization status in various risk groups. METHODS: A cross-sectional telephone questionnaire survey of randomly selected subjects, in nine European study populations was used. A total of 9, 008 individuals were involved, with approximately 1,000 interviews conducted in each country in the native languages. Situations with a high risk of hepatitis B infection, such as invasive medical procedures, attending to a bleeding person, and skin perforating cosmetic practices, particularly when performed in countries with medium/high transmission risk, and vaccination status of travelers, were the main outcome measures. RESULTS: Depending upon the destination, 6.6-11.2% of travelers were classified as at high risk of hepatitis B, with 24.4% vaccinated; between 60.8-75.8% of travelers at potential risk, with 19.2% vaccinated; and 33.4% of travelers where no hepatitis B risk was identified. Significantly more travelers who only visited medium/high endemicity regions exposed themselves to a high risk of contracting hepatitis B, (40, 10.5%) compared to travelers who only visited low endemicity regions (225, 6.6%; p <.01). CONCLUSIONS: A significant proportion of travelers surveyed unwittingly exposed themselves to the risk of hepatitis B infection while at medium/high risk destinations. The majority of at-risk travelers had not been vaccinated, regardless of their destination. Improved advice and clear recommendations to avoid transmission are needed.

Adolescent↗
PubMedDate not supplied

A study of the incidence of accidents occurring during an Arctic expedition: another important aspect of travel medicine?

The number of expeditioners and independent adventure travelers to remote and physically demanding areas is increasing. Recent evidence suggests that trauma and accidents (resulting mainly from road traffic accidents and drowning) are the primary cause of mortality in travelers rather than infectious diseases.1,2 The risks and potential hazards faced on an expedition are likely to be different from those encountered by other travelers. An extensive literature search revealed little data concerning the incidence and nature of accidents on expeditions, or concerning the young adventure traveler. The objective of this study was to determine the frequency and type of accidents that occurred on a 6-week summer arctic expedition, undertaken by "young explorers" and their leaders. This information will be valuable in order to identify potential risks as part of the pretravel risk assessment, and consequently improve the medical briefing and training of expeditioners and adventure travelers.

Accidents↗