Wykazano, że podanie szczepionki przeciw WZW A w profilaktyce poekspozycyjnej ma przewagę nad zastosowaniem immunoglobulin pod względem zapewnienia odporności, dłuższego czasu ochrony, łatwości podawania oraz większej akceptowalności i dostępności.

ABSTRACT

Hepatitis A vaccinations

Viral hepatitis A (HEP-A) is an acute and self-limiting contagious disease caused by hepatitis A virus (HAV). The World Health Organization (WHO) estimates that there are about 1,400,000 cases of HEP-A each year. The incidence of HEP-A varies according to geographic area. In 2017, Poland saw a sudden increase in the number of HEP-A cases: there were 87 times more cases as compared to the preceding year. Given the multi-annual period of medium and low endemism, and the small number of people vaccinated against HEP-A, it is estimated that a majority of the Polish population is sensitive to HAV infection. The low prevalence of anti-HAV IgG antibodies in the general population and the current epidemiological situation in Poland support the legitimacy of HEP-A vaccinations which are highly effective in terms of both pre- and post-exposure prevention. HEP-A vaccines contain an inactivated HAV and are given in 2 doses at months 0, 6-12. Pregnancy and breast-feeding are not contraindications to vaccination. HEP-A vaccines are considered safe and their effectiveness in immunocompetent people is estimated at 98-99%. Post-vaccination immunity is a long-lasting and most likely life-long effect.

Zalecane piśmiennictwo

1. Baumann-Popczyk A. Wirusowe zapalenie wątroby typu A w Polsce w 2009 roku. Przegląd Epidemiologiczny 2011;65:255-8

2. Baumannn-Popczyk A. Wirusowe zapalenie wątroby typu A w Polsce w 2010 roku. Przegląd Epidemiologiczny 2012;66:273-76

3. Bura M, Bura A, Adamek A, et al. Seroprevalence of hepatitis A virus antibodies (anti–HAV) in adult inhabitants of Wielkopolska region, Poland – the role of simple demographic factors. Annals of Agricultural and Environmental Medicine 2012;19(4):738-41

4. Beaute J, Westrell T, Schmid D, et al. Travel-associated hepatitis A in Europe, 2009 to 2015. Eyro Sutveill 2018;23(22). doi.org/10.2807/1560-7917.ES.2018.23.22.1700583

5. Dagan R. Leventhal A, Anis E, et al. Incidence of hepatitis A in Israel following universal immunization of toddlers. JAMA: the Journal of the American Medical Association 2005;294:202-10

6. Dhankhar P, Nwankwo C, Pillsbury M, et al. Public Health Impact and Cost-Effectiveness of Hepatitis A Vaccination in the United States: A Disease Transmission Dynamic Modeling Approach. Value In Health 2015;18:358-67

7. Doshani M, Weng M, Moore KL, et al. Recommendations of the Advisory Committee on Immunization Practices for Use of Hepatitis A Vaccine for Persons Experiencing Homelessness. MMWR 2019;68(6):53-156

8. Fritzsche C, Bergmann L, Loebermann M, et al. Immune response to hepatitis A vaccine in patients with HIV. Vaccine 2019;37:2278-83

9. Garrido HMG, Veurink AM, Leeflang M, et al. Hepatitis A vaccine immunogenicity in patients using immunosuppressive drugs: A systematic review and meta-analysis. Travel Medicine & Infectious Diseases 2019. doi.org/10.1016/j.tmaid.2019.101479

10. Groom H, Smith N, Irving SA, et al. Uptake and safety wsp. Uptake and safety of hepatitis A vaccination during pregnancy: A Vaccine Safety Datalink study. Vaccine 2019. doi.org/10.1016/j.vaccine.2019.09.043

11. Juszczyk G, Czerw AI, Walewska-Zielecka B, et al. Immunity to hepatitis A virus among working professionals in Poland – Result of 3 – year serological survey 2013 – 2015. Annals of Agricultural and Environmental Medicine 2018;25(3):572-5

12. Koenig KL, Shastry S, Burns MJ. Hepatitis A Virus: Essential Knowledge and a Novel Identify-Isolate-Inform Tool for Frontline Healthcare Providers. West J Emerg Med 2017;18(6):1000-7

13. Lin KY, Hsieh SM, Sun HY, et al. Serologic Responses and Effectiveness of Hepatitis A Vaccination Among Human immunodeficiency Virus-Positive Individuals During the Outbreak of Acute Hepatitis A. Hepatology 2018;68:22-31

14. Lin KY, Sun HY, Chen YH, et al. Effect of a Hepatitis A Vaccination Campaign During a Hepatitis A Outbreak in Taiwan, 2015-2017: A Modeling Study. Clin Infect Dis 2019. https://doi.org/10.1093/cid/ciz471

15. Magdzik W, Czarkowski M. Zmiany w endemiczności wirusowego zapalenia wątroby typu A (WZW A) w Polsce. Przegląd Epidemiologiczny 2004;58:355-60

16. Moppert J, Zieniewicz-Cieslik K, Tyczyno M, et al. The frequency of occurrence anti-HAV antibodies to health employees – own observations. Przegl Epidemiol 2018;72(4):453-7

17. Nelson NP, Link-Gelles R, Hofmeister MG, et al. Update: Recommendations of the Advisory Committee on Immunization Practices for Use of Hepatitis A Vaccine for Postexposure Prophylaxis and for Preexposure Prophylaxis for International Travel. Morb Mortal Wkly Rep 2018;68(9):1216-20

18. Polański P. Wirusowe zapalenie wątroby typu A w Polsce w 2015 roku. Przegląd Epidemiologiczny 2017;71(3):345-9

19. Severi E, Verhoef L, Thornton L, et al. Large and prolonged food-borne multistate hepatitis A outbreak in Europe associated with consumption of frozen berries, 2013 to 2014. Euro Surveill 2015;20(29):pii=21192

20. Stan zachorowań na wirusowe zapalenie wątroby typu A w województwie mazowieckim. http://wsse.waw.pl/aktualnosci-i-komunikaty/komunikaty/stan-zachorowan-na-wirusowe-zapalenie-watroby-typu-a-w-wojewodztwie-mazowieckim

21. Stuurman AL, Marano C, Bunge EM. Impact of universal mass vaccination with monovalent inactivated hepatitis A vaccines – A systematic review. Human Vaccines & Immunotherapeutics 2017;13(3):724-36

22. Tavoschi L, Severi E, Carillo Santisteve P. Hepatitis A in the EU/EEA: The case for scaling up prevention. Vaccine 2018;36:2501-3

23. Van Damme P, Leroux-Roels G, Suryakiran P, et al. Persistence of antibodies 20 y after vaccination with a combined hepatitis A and B vaccine. Human Vaccines & Immunotherapeutics 2017;13(5):972-80

24. Van Der Meeren O, Crasta P, de Ridder M. A retrospective pooled analysis assessing the effect of age on the immunogenicity of Havrixin healthy adults. Hum Vaccin Immunother 2015;11:1729-34

25. WHO position paper on hepatitis A vaccines (June 2012). Weekly Epidemiological Record 2012;87(28/29):261-76

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