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Biomedical subjects

Jane N Zuckerman

Publications and source records attributed to Jane N Zuckerman.

14 recordsLinked to original sources
PubMed2006

HIV and travel.

There is a high demand for travel among HIV-positive individual. This demand arises partly from those who have benefited from advances in antiretroviral therapy as well as those with disease progression. The key to a successful and uneventful holiday lies in careful pre-trip planning, yet many patients fail to obtain advice before travelling. Travel advice for HIV patients is becoming increasingly specialized. In addition to advice on common travel-related infectious diseases, HIV-positive travellers are strongly advised to carry information with them and they need specific advice regarding country entry restrictions, HIV inclusive travel insurance, safety of travel vaccinations and highly active antiretroviral therapy-related issues. A wide range of relevant issues for the HIV-positive traveller are discussed in this review and useful websites can be found at the end.

AIDS-Related Opportunistic Infections↗
PubMed2006

Protective efficacy, immunotherapeutic potential, and safety of hepatitis B vaccines.

Hepatitis B vaccines are highly effective and safe and have been incorporated into national immunization programs in over 150 countries. The major humoral immune response is to the common a determinant of the surface antigen protein of the virus. Approximately 5-10% of healthy immunocompetent subjects do not mount an antibody response (anti-HBs). Non-response is associated with different HLA-DR alleles and impaired Th cell response, among other factors such as route of injection, age, gender, body mass, and other factors. Important hepatitis B surface antigen variants have also been identified, which may have a potential impact on immunization and routine screening of blood, blood products and tissues, and organs for transplantation. Strategies for hepatitis B immunization are reviewed. Over 1,000 million doses of hepatitis B vaccine have been used with an outstanding record of safety. There is no evidence of an association between hepatitis B vaccines and the sudden infant death syndrome, chronic fatigue syndrome, and multiple sclerosis (MS). Several studies are in progress on treatment of chronic hepatitis B infection by immunization with multiple antigenic components, combination of vaccine with antiviral drugs and cytokines, T cell vaccines, DNA vaccines alone or with DNA encoded immunomodulatory cytokines, and direct genetic manipulation of antigen presenting cells.

Age Factors↗
PubMed2006

Immunogenicity and safety of an experimental adjuvanted hepatitis B candidate vaccine in liver transplant patients.

Patients with chronic liver disease are at higher risk of hepatitis B (HB) virus infection before and after liver transplantation, and they commonly have a suboptimal immune response to HB vaccines. In this randomized trial, we compared the immunogenicity of primary vaccination with 2 doses of an experimental adjuvanted HB vaccine (adjuvant system 04 containing aluminium and monophosphoryl lipid A [HB-AS04]) to that of 3 double doses of a licensed HB vaccine in 93 liver transplant candidates. Depending on the waiting list for liver transplantation, a booster dose of HB-AS04 or double booster dose of the licensed HB vaccine was given before or after surgery, at 6 to 12 months after initiation of the vaccination course. The percentage of subjects with seroprotective anti-HB surface antibody concentrations 1 month after booster was twice as high in the HB-AS04 group (60.0%), vs. patients in the comparator group (32.0%) (P = 0.035). In subjects who did not undergo liver transplantation before administration of the booster, better immunogenicity results were obtained: 80% of subjects were seroprotected after HB-AS04 vaccination vs. 60% with the comparator (P = 0.2302). Despite a slightly higher reactogenicity, the safety profile of the HB-AS04 vaccine was clinically acceptable. In conclusion, an improved antibody response was observed in liver transplant candidates with 3 doses of HB-AS04, as compared to 4 double doses of a comparator. Liver transplant candidates could benefit from the use of this experimental adjuvanted HB vaccine to further increase their protection against HB infection.

Adjuvants, Immunologic↗
PubMed2006

Vaccination against hepatitis A and B: developments, deployment and delusions.

PURPOSE OF REVIEW: Current issues in immunization against hepatitis A and B are discussed, including the need to abandon risk-based approaches in favour of universal vaccination, the use of combined hepatitis A and B vaccines and multivalent vaccines, the development of third-generation triple antigen hepatitis B vaccines and polyvalent vaccines. RECENT FINDINGS: The emergence of hepatitis B surface antigen mutants remains a concern in diagnostic work and immunoprophylaxis and horizontal transmission of the G145R variant stresses the need for surveillance programmes. The more recent and unfounded concerns about the safety of hepatitis B vaccines are noted. Innovative approaches to vaccine production including DNA vaccines and the expression of hepatitis B antigen components in plants (edible vaccines) are reviewed. SUMMARY: This review describes further evidence to support the introduction of universal immunization against hepatitis B in those countries where this has yet to be implemented. Immunization programmes will continue to evolve to include the administration of polyvalent vaccines in order to best protect populations against infectious diseases.

Drug Design↗
PubMed2005

Hepatitis A and B booster recommendations: implications for travelers.

Hepatitis A and B are serious vaccine-preventable diseases with a predominantly overlapping epidemiological distribution. Travelers, a term encompassing a range of individuals, are at risk of contracting these diseases if they are unvaccinated. Although the benefits of the primary vaccination course of hepatitis A and B vaccines are clear, the administration of hepatitis A and B boosters varies worldwide. Recommendations on the need for booster vaccinations have recently been published, and the implications of these recommendations for travelers are discussed in this review. Until a greater understanding is reached on the immunogenicity of hepatitis A and B vaccines in certain special groups (e.g., immunocompromised persons), there will be a need to monitor antibody levels to assess whether booster vaccinations are required. However, for the majority of immunocompetent travelers, the full primary vaccination course will provide protection from both hepatitis A and B infection in the long term, without the need for boosters.

Hepatitis A↗
PubMed2003

Enhancement of humoral immune responses to a human cytomegalovirus DNA vaccine: adjuvant effects of aluminum phosphate and CpG oligodeoxynucleotides.

A human cytomegalovirus (HCMV) glycoprotein B (gpUL55) DNA vaccine has been evaluated in BALB/c mice. Intramuscular immunization of these mice with pRc/CMV2-gB resulted in the generation of high levels of gpUL55-specific antibody (geometric mean titer [GMT] 1:8900) and neutralizing antibody (GMT 1:74) after 2 booster doses given 5 and 10 weeks after primary inoculation. Emulsifying the construct with the aluminum phosphate gel adjuvant Adju-Phos before immunization enhanced gpUL55-specific antibody responses (GMT 1:17800, P = 0.04). Co-immunization with CpG oligodeoxynucleotides was shown to enhance levels of neutralizing antibodies generated by immunization of mice with a pRc/CMV2-gB/Adju-Phos emulsion (P = 0.04). The results provide a rationale for evaluating combinations of other HCMV proteins for incorporation into a multi-target DNA vaccine, and for the optimization of adjuvant usage, to elicit enhanced levels of neutralizing antibodies. 2003.

Adjuvants, Immunologic↗
PubMed2003

Mutations of the surface protein of hepatitis B virus.

Neutralizing antibodies induced by immunization against hepatitis B infection are targeted to the conformational epitopes of the common a determinant of the surface antigen. However, amino acid substitutions within this region of the surface protein of the virus, particularly in the region of amino acid 137-147 allow replication of hepatitis B virus in vaccinated subjects, since antibodies induced by current vaccines do not recognize crucial changes in the surface antigen domain. The G145R mutant is replication competent and is stable, and it appears to be the most common variant. There is evidence that these mutants may not be detected by current screening tests and diagnostic reagents. Epidemiological monitoring of hepatitis B virus surface mutants is essential.

Amino Acid Sequence↗
PubMed2002

Recombinant hepatitis B triple antigen vaccine: Hepacare.

Infection with hepatitis B virus is a public health problem throughout the world. Hepatitis B vaccines are now included in national immunization programmes of infants and/or adolescents in 129 countries. Current single antigen vaccines, that are plasma-derived or produced by recombinant DNA technology are highly effective, but between 5-10% or more of healthy immunocompetent subjects do not mount an antihepatitis B surface antibody protective response and others respond poorly (hyporesponders). The inclusion of pre-S1 and -S2 components of hepatitis B surface antigen in addition to the single antigen (triple antigen) in a novel vaccine, Hepacare, Medeva Pharma Plc, Speke, UK, overcomes nonresponsiveness and hyporesponsiveness in a significant number of individuals. The triple antigen is indicated for vaccination of nonresponders (and hyporesponders) to the current single antigen vaccines and for persons who require rapid protection against hepatitis B infection.

Animals↗
PubMedDate not supplied

Impact of the insect biting nuisance on a British youth expedition to Alaska.

BACKGROUND: The morbidity and nuisance factor associated with bites from mosquitoes and other insects are one of the many hazards faced by travelers, including those to the Arctic. A predeparture literature review suggested that insect bites were such a large problem in the area to be visited that they would probably have a significant impact on expedition activities. Therefore, we set out to assess the extent of the insect biting nuisance, focussing particularly on interference with expedition activities, in order to make recommendations for future expeditions to this area. The number of bites and their effects was examined on a 6-week British youth expedition to Alaska in July/August 1999. METHODS: A weekly "Insect Biting Nuisance Questionnaire" was distributed to each expedition member (total 72) to record the number of bites received over the previous week, a subjective grading of severity and itchiness, the extent of interference with expedition activities, any complications from the bites, and details about prevention and treatment. RESULTS: The questionnaire response rate was 64%, which was a representative sample. The median number of bites per person over the entire 6-week period was 33, with females and younger expeditioners tending to receive more bites. Multivariate analysis suggested that younger age was associated with more severe and itchier bites. Sleep was disturbed by itching on only 4% (68/1918) of nights. Generally, the bites were thought not to interfere with expedition activities (median score for interference 0; range 0-10). CONCLUSION: The number of bites and their impact on expedition activities were both lower than expected. Thus, it is recommended that expeditions and independent travelers to this area do not need to increase time spent in the field to compensate for expedition man days lost due to problems associated with the insect biting nuisance.

Adolescent↗