Agterhuis, R. (Rolf) (2012) Gebruik van Fendrix® bij non-responders voor hepatitis B vaccinatie. thesis, Medicine.
Full text available on request.Abstract
Background: Hepatitis B is an infectious disease which in many parts of the world is endemic and can cause acute liver inflammation. But the infection may remain chronic without acute symptoms and can cause in later life health damage. The hepatitis B virus (HBV) may be incurred by both blood-blood contact and through sexual contact. To protect clients against HBV there are safe and effective vaccines available. To evaluate the effect of these vaccinations on clients it is possible to use a widely available blood test (anti-HBs). This is both recommended for travelers who are at increased risk for hepatitis B and who have a possible lesser response to the vaccine, and healthcare professionals whose work may implie that he is more easily infected with HBV. Clients with insufficient anti-HBs levels after vaccination, are being categoized as non-responders and are not protected agains HBV. Non-responders receive a second serie of 3 vaccinations to protect them once more. The risk of non-response increases with age, particularly after the 40th year. The male sex, smoking, obesity, certain HLA types and other characteristics of the immune system are also risk factors. The current guidelines indicate that after 6 vaccinations in two series there is no need to continue vaccination because the probability of seroconversion is small. In this study, I examined whether the new vaccine Fendrix, which is successfully used in dialysis practice, can give the group of persistent non-responders still a change of protect against HBV. Materials and methods: For this retrospective study I selected all persistent non-responders, with vaccina-tions against HBV, in the years 2000 to 2011 at the database of the the publical Health Service of the region IJsselland which contains data of travelers and health workers. Of this group a number of clients has had the new vaccine Fendrix and a number has had no additional vaccinations. Excluded were clients who were hepatitis B infected in the past or are chronic carriers of HBV, immunocompromised and pregnant women at the time of vaccination. Also I looked at the occurrence of primary non-responders in 2010 within the Health Service database and the infulence of the known risk factors age and gender. The blood tests for anti-HBs and anti-HBc have been processed by the laboratories of the hospitals in Deventer and Zwolle in The Netherlands. The GE-statistic is dismissed with SPSS 16.0. The tests used were the Chi-kwadraadtest and logistical regression analysis. Results: About 2010, the overall seroconversion rate (anti-HBs <10 to over 10), after correc-tion for an additional group of older men is 95.4%, with 36 non-responders on 835 blood tests. The male-female difference in this group was significant (p> 0.001) as well as age (p> 0.001). About 2000 to 2012 there were 226 nonreponders, 135 of them have finished the second series of vaccinations. From 6 clients the bloodresults was untraceable, 35 were persistent non-responder. Of them, 23 obtained an additional vaccination of Fendrix. 60.9% after Fendrix had a bloodlevel of 10 IU / l anti-HBs or more, a significant difference compared with no vaccination (p> 0.001). In the 35 persistent non-responders, age and sex are not significant (p 0.331 and 0.192). Conclusion: The use of Fendrix in persistent non-responders has been proven effective in this study population of travelers and healthcare workers
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Nijholt, Ingrid Isala Klinieken Zwolle |
| Supervisor name: | Extern begeleider: and Hanna Bos, Infectieziektebestreiding and Lokatie: and GGD IJsselland, afdelingen Infectieziektebestreiding |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:03 |
| Last Modified: | 25 Jun 2020 11:03 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2302 |
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