Envíe este artículo por correo electrónico (Inicie sesión)
Enviar un correo electrónico al autor/a (Inicie sesión) Open Journal Systems
Respuesta inmune rápida contra la hepatitis B mediante esquema acelerado de vacunación intradérmica
Resumen
Objetivo: evaluar los niveles séricos de anticuerpos contra el virus de la hepatitis B en personal de salud que recibió un esquema acelerado por vía intradérmica con microdosis de la vacuna recombinante.
Métodos: estudio cuasiexperimental sin grupo control en trabajadores de la salud sanos no inmunizados contra el virus de la hepatitis B. Se aplicaron tres dosis de 5 µg (0.25 mL) de vacuna intradérmica a las semanas 0, 2 y 4. Se tomó una muestra sérica de 5 mL al ingreso, 2 y 8 semanas después de iniciado el esquema. Los anticuerpos contra el antígeno de superficie del virus de la hepatitis B (antiHB) se cuantificaron por el método de ELISA.
Resultados: se estudiaron 51 individuos negativos para antiHB, 61 % de sexo femenino, edad promedio de 33.5 años. Después de la primera dosis 29 % mostró seroprotección (mediana de 312 mUI/mL), al final del esquema 93 % tuvo antiHB y 78 % alcanzó niveles > 10 mUI/mL.
Conclusiones: con el esquema acelerado de vacunación se alcanza seroconversión en 90 % de los individuos inmunizados. Este esquema induce una inmunidad rápida por lo que podría ser útil en posexposición.
Palabras clave
Texto completo:
PDFReferencias
Lemon SM, Thomas DL. Vaccines to prevent viral hepatitis. N Engl J Med. 1997;336:196-204.
Centers for Disease Control and Prevention. Global progress toward universal childhood hepatitis B vaccination, 2003. MMWR 2003;52(36): 868-870. Disponible en http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5236a5.htm
Román S, Panduro A, Aguilar-Gutiérrez Y, Maldonado M, Vázquez-Vandyck M, Martínez-López E, et al. A low steady HBsAg seroprevalence is associated with a low incidence of HBV-related liver cirrhosis and hepatocellular carcinoma in Mexico: a systematic review. Hepatol Int. 2009;3 (2):343-355.
Chiquete E, Sánchez LV, Becerra G, Quintero A, Maldonado M, Panduro A. Performance of the serologic and molecular screening of blood donations for the hepatitis B and C viruses in a Mexican transfusion center. Ann Hepatol. 2005; 4(4):275-278.
Tanaka J. Hepatitis B epidemiology in Latin America. Vaccine. 2000;18(Supl 1): S17-S19.
Kershenobich D, Hurtado R, Collawn C, Bobadilla J, Cabrera G, Borovoy J, et al. Seroprevalence of viral markers of hepatitis B among health profe-ssionals. Multicenter study in Mexico. Rev Invest Clin. 1990;42(4):251-256.
Flores-Calderón J, Álvarez-Muñoz MT, Bustamante-Calvillo ME, Vázquez-Rosales G, Reyes-Morales H. Prevalencia de marcadores serológicos para el virus de la hepatitis B en el hospital pediátrico. Bol Med Hosp Infant Mex. 1994;51(2):99-104.
Roome AJ, Walsh SJ, Cartter ML , Hadler JL. Hepatitis B vaccine responsiveness in Connecticut public safety personnel. JAMA. 1993;270(24):2931-2934.
Navarrete-Navarro S, Álvarez-Muñoz MT, Bustamante-Calvillo ME, Vallejo-Aguilar OJ, Muñoz O, Santos-Preciado JI, Ávila-Figueroa C. Protection of health personnel against hepatitis B by DNA recombinant vaccine. Bol Med Hosp Infant Mex. 1992;49(1):739-742.
Playford EG, Hogan PG, Bansal AS, Harrison K, Drummond D, Looke DF, et al. Intradermal recombinant hepatitis B vaccine for healthcare workers who fail to respond to intramuscular vaccine. Infect Control Hosp Epidemiol. 2002;23(2):87-90.
Margolis HS, Presson AC. Host factors related to poor immunogenicity of hepatitis B vaccine in adults. JAMA. 1993;270(24):2971-2972.
Connor BA, Blatter MM, Beran J, Zou B, Trofa AF. Rapid and sustained immune response against hepatitis A and B achieved with combined vaccine using an accelerated administration schedule. J Travel Med. 2007;14:9-15.
Saltoglu N, Inal AS, Tasova Y, Kandemir O. Comparison of the accelerated and classic vaccination schedules against hepatitis B: three-week hepatitis B vaccination schedule provides immediate and protective immunity. Ann Clin Microbiol Antimicrob. 2003;2:10. Disponible en http://www.ncbi.nlm.nih. gov/pmc/articles/PMC293476/
Wahl M, Hermodsson S, Iwarson S. Hepatitis B vaccination with short dose intervals. A possible alternative for post-exposure prophylaxis? Infection. 1988; 16(4):229-232.
Leonardi S, Barone P, Musumeci S. Intradermal hepatitis B vaccination: five-year follow-up. Pediatr Infect Dis J. 1995;14(8):716-717.
Vázquez G, Mendoza-Guevara L, Álvarez T, Aguilar A, Morales A, Rodríguez F, et al. Comparison of the response to the recombinant vaccine against hepatitis B virus in dialyzed and nondialyzed children with CRF using different doses and routes of administration. Adv Perit Dial. 1997;13:291-296.
Miller KD, Gibbs RD, Mulligan MM, Nutman TB, Francis DP. Intradermal hepatitis B virus vaccine: immunogenicity and side-effects in adults. Lancet. 1983;2(8365-8366):1454-1456.
Zuckerman AJ. Appraisal of intradermal immunization against hepatitis B. Lancet. 1987;1(8530): 435-436.
Halsey NA, Reppert EJ, Margolis HS, Francis DP, Fields HA. Intradermal hepatitis B vaccination in an abbreviated schedule. Vaccine. 1986;4(4):228-232.
Henderson EA, Louie TJ, Ramotar K, Ledgerwood D, Hope KM, Kennedy A. Comparison of higher-dose intradermal hepatitis B vaccination to standard intramuscular vaccination of healthcare workers. Infect Control Hosp Epidemiol. 2000;21 (4):264-269.
McMaster KR, Roper JK, Carter JB. Intradermal hepatitis B vaccination in a 300-bed primary care hospital: experience with a recombinant vaccine in a four-dose schedule. Am J Infect Control. 1993; 21(6):283-288.
Yamashiki M, Kosaka Y, Nishimura A. An effective intradermal hepatitis B vaccination. Vaccine. 1997;15(15):1618-1623.
Kyi KP, Oo KM, Htun MM, Tun WM, Aye KK, Oo SS, et al. Clinical trial of the intradermal adminis-tration of hepatitis B vaccine produced at the Department of Medical Research, Myanmar. Vaccine. 2002;20(11-12):1649-1652.
Kurugöl Z, Erensoy S, Aksit S, Egemen A, Bilgic A. Low-dose intradermal administration of recombi-nant hepatitis B vaccine in children: 5-year follow-up study. Vaccine. 2001;19(28-29):3936-3939.
Wiström J, Settergren B, Gustafsson A, Juto P, Norrby RS. Intradermal vs. intramuscular hepatitis B vaccinations. JAMA. 1990;264(2):181-182.
Ghabouli MJ, Sbouri AH, Shoeibi N, Bajestan SN, Baradaran H. High seroprotection rate induced by intradermal administration of a recombinant hepatitis B vaccine in young healthy adults: comparison with standard intramuscular vaccination. Eur J Epidemiol. 2004;19(9):871-875.
Osorio JE, Zuleger CL, Burger M, Chu Q, Payne LG, Chen D. Immune responses to hepatitis B surface antigen following epidermal powder immunization. Immunol Cell Biol. 2003;81(1):52-58.
Chau KF, Cheng YL, Tsang DN, Choi KS, Wong KM, Chak WL, et al. Efficacy and side effects of intradermal hepatitis B vaccination in CAPD patients: a comparison with the intramuscular vaccination. Am J Kidney Dis. 2004;43(5):910-917.
Elisbão Mdo C, Baldy JL, Bonametti AM, Reiche EM, Morimoto HK, Pontello R, et al. Intradermal vaccination of adults with three low doses (2 micrograms) of recombinant hepatitis B vaccine. II. Persistence of immunity and induction of immunologic memory. Mem Inst Oswaldo Cruz. 2003;98(8):1109-1113.
Baldy JL, Elisbao Mdo C, Anzai ET, Pontello R, Reiche EM, Zaha-Inouye MM, et al. Intradermal vaccination of adults with three low doses (2 micrograms) of recombinant hepatitis B vaccine. I. Seroconversion rate and adverse effects. Mem Inst Oswaldo Cruz. 2003;98(8):1101-1107.
Enlaces refback
- No hay ningún enlace refback.