Hepatitis: Van Damme P

FitzSimons D, François G, De Carli G, Shouval D, Prüss-Ustün A, Puro V, Williams I, Lavanchy D, De Schryver A, Kopka A, Ncube F, Ippolito G, Van Damme P. · World Health Organization, Geneva, Switzerland. · Occup Environ Med. · Pubmed #18562683 No free full text.

Abstract: The Viral Hepatitis Prevention Board (VHPB) convened a meeting of international experts from the public and private sectors in order to review and evaluate the epidemiology of blood-borne infections in healthcare workers, to evaluate the transmission of hepatitis B and C viruses as an occupational risk, to discuss primary and secondary prevention measures and to review recommendations for infected healthcare workers and (para)medical students. This VHPB meeting outlined a number of recommendations for the prevention and control of viral hepatitis in the following domains: application of standard precautions, panels for counselling infected healthcare workers and patients, hepatitis B vaccination, restrictions on the practice of exposure-prone procedures by infected healthcare workers, ethical and legal issues, assessment of risk and costs, priority setting by individual countries and the role of the VHPB. Participants also identified a number of terms that need harmonization or standardisation in order to facilitate communication between experts.

Colle I, Adler M, Brenard R, Henrion J, Langlet P, Michielsen P, Orlent H, Reynaert H, Sprengers D, Stärkel P, Van Damme P, Verslype C, Delwaide J, Anonymous00199. · Department of Hepatology and Gastroenterology, Ghent University Hospital, Ghent, De Pintelaan 185, 9000 Gent, Belgium. · Acta Gastroenterol Belg. · Pubmed #18330099 No free full text.

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Robaeys G, Buntinx F, Bottieau E, Bourgeois S, Brenard R, Colle I, De Bie J, Matheï C, Mulkay JP, Van Damme P, Van Ranst M, Verrando R, Michielsen P, Bourgeois N, Brenard R, de Galocsy Ch, Delwaide J, Henrion J, Horsmans Y, Michielsen P, Reynaert H, Robaeys G, Sprengers D, Anonymous00401. · Department of Gastroenterology and Hepatology, Ziekenhuis Oost Limburg, Genk, Schiepse Bos, 6, B-3600 Genk, Belgium. · Acta Gastroenterol Belg. · Pubmed #15832586 No free full text.

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Vorsters A, Van Herck K, Van Damme P. · No affiliation provided · Vaccine. · Pubmed #19428900 No free full text.

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Banatvala J, Van Damme P, Emiroglu N. · No affiliation provided · BMJ. · Pubmed #16601018 links to  free full text

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Van Damme P, Van Herck K. · No affiliation provided · JAMA. · Pubmed #16014600 No free full text.

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Van Herck K, Vorsters A, Van Damme P. · Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium. · Best Pract Res Clin Gastroenterol. · Pubmed #19187864 No free full text.

Abstract: As hepatitis B and C share modes of transmission, their combined occurrence is not uncommon, particularly in areas where both viruses are endemic and in individuals at high-risk of parenteral infection. Both viral hepatitis infections form an important global public health problem, responsible for over half a billion chronic infections worldwide. Their distinctive characteristics impact upon their epidemiology, transmission, and the success of the different prevention strategies. Since several decades a safe and effective vaccine has been available to prevent hepatitis B virus (HBV) infection. Universal vaccination is the cornerstone of global HBV control. Despite major success, vaccine uptake is hampered, and increasing efforts are required to eliminate acute and chronic hepatitis B. Unlike hepatitis C and HIV, HBV has not captured sufficient attention from policymakers, advocacy groups, or the general public: a major challenge for the future. Although progress has been made in the development of an hepatitis C vaccine, short-term successes are not expected. Even without a vaccine, successes can be reported in the field of hepatitis C due to e.g. implementation of universal precautionary measures in health-care settings, screening of blood and blood products, and identification and counselling of infected people. Despite important efforts, transmission in injecting drug users is increasing.

Zanetti AR, Van Damme P, Shouval D. · Department of Public Health-Microbiology-Virology, Faculty of Medicine, University of Milan, Via C. Pascal 36, 20133 Milan, Italy. · Vaccine. · Pubmed #18848855 No free full text.

Abstract: Hepatitis B virus (HBV) infection is a world wide public health problem of major concern. HBV infection may lead to chronic liver disease, including cirrhosis and hepatocellular carcinoma (HCC). Vaccination is the most effective measure to control and prevent hepatitis B and its long-term serious sequelae on global scale, both in terms of cost-effectiveness and benefit-cost ratios. According to the WHO recommendations, universal vaccination has been currently implemented in 168 countries world wide with an outstanding record of safety and efficacy. The effective implementation of such programmes of vaccination has resulted in a substantial decrease in disease burden, in the carrier rate and in hepatitis B-related morbidity and mortality. A future challenge is to overcome the social and economic hurdles which still hamper the introduction of hepatitis B vaccination on a global scale.

Hollinger FB, Bell B, Levy-Bruhl D, Shouval D, Wiersma S, Van Damme P. · Baylor College of Medicine, Houston, TX 77030, USA. · J Viral Hepat. · Pubmed #17958635 No free full text.

Abstract: The introduction and implementation of hepatitis B vaccination programmes in areas of high endemicity has been very stressful. However, this initial accomplishment has led to the reassessment of priorities in some countries which could undermine these early successes. Work still remains to be done to support and implement interventions that will bring us closer to the WHO goal and to the control of hepatitis B in the community at large. Hepatitis A vaccine strategy for immunizing toddlers is shifting to those countries with intermediate endemicity where increasing morbidity in adults is being observed. Accumulating evidence indicates that such programmes can result in impressive reductions in the incidence of hepatitis A by herd immunity. Monitoring of these populations to determine durability of protection will be important to avoid shifting the infection to the older age population, when symptoms are more likely to occur. National policies need to consider hepatitis A vaccination in the context of other public health priorities.

Van Herck K, Leuridan E, Van Damme P. · Centre for the Evaluation of Vaccination, WHO Collaborating Centre for Prevention and Control of Viral Hepatitis, Department Epidemiology and Social Medicine, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium. · Sex Transm Infect. · Pubmed #17911142 No free full text.

Abstract: INTRODUCTION: Vaccination is an important tool in hepatitis B prevention. However, several vaccine doses are required to induce long-term protection. Several at-risk groups have difficulties in adhering to the standard vaccination schedule. OBJECTIVES: This paper aims to review the use of accelerated hepatitis B vaccination schedules, in terms of immunogenicity and compliance. RESULTS: Accelerated schedules (0.1.2.12 months) or super-accelerated schedules (0.7.21.360 days) have been shown to result in higher proportions of healthy vaccinees reaching anti-HBs antibody levels >or=10 IU/l more rapidly. A fourth completing dose is required to lift antibody levels to an equal height, as does a standard (0.1.6 months) schedule. Accelerated schedules do also increase the uptake of hepatitis B vaccine, that is the proportion of vaccinees who receive three doses. However, completing the schedule with a fourth dose is usually more difficult than completing a standard 0.1.6-month schedule. Several additional tools can help to increase the compliance (eg, reminder systems, outreach services and incentive schemes). CONCLUSION: For rapid seroconversion and almost immediate protection in the short term, a (super)accelerated schedule could be used in at-risk groups. As long-term protection data with these (super) accelerated schedules have not been documented yet, a fourth dose at month 12 is still required. A shortened schedule (0.1.4 months) might be an alternative worth considering compared with the standard 0.1.6, as it convenes to internationally accepted minimum dose intervals and offers earlier protection. There is a clear need to study the long-term protection and effectiveness of the primary part of (super)accelerated schedules.

Van Damme P, Van Herck K. · Centre for the Evaluation of Vaccination, WHO Collaborating Centre for Prevention and Control of Viral Hepatitis, Department of Epidemiology and Social Medicine, University of Antwerp, Belgium. · Travel Med Infect Dis. · Pubmed #17298912 No free full text.

Abstract: Vaccine-preventable viral hepatitis continues to be a cause of considerable morbidity and mortality: on worldwide basis, approximately 1.4 million cases of hepatitis A are reported every year. The true incidence, however, has been estimated to be 3-10 times higher. Regarding hepatitis B, more than a third of the world's population has been infected. The World Health Organization has estimated (2000) that there are 367 million chronic carriers of hepatitis B worldwide, and approximately 1 million deaths per year as a consequence of chronic complications and acute fulminant disease. Hepatitis B vaccines have been licensed since 1982, and hepatitis A vaccines since 1992. In 1996, a combined hepatitis A and B vaccine became available. An update on the long-term protection conferred by hepatitis A and hepatitis B vaccines as well as the combined hepatitis A and B vaccine is offered in this paper. Long-term efficacy and booster policy for hepatitis B vaccines have often been a topic of discussion. Based on current data and field experience there is, in general, no necessity for booster doses for fully vaccinated immunocompetent individuals. Long-term protection has been demonstrated by the rapid (5-7 days) development of anamnestic antibody responses among vaccinees who no longer have detectable anti-HBs. Anamnestic responses correlate with lymphoproliferative T-cell responses following challenge with hepatitis B vaccine. Furthermore, employing Spot-ELISA techniques, circulating B-cells were shown to be able to produce anti-HBs in vaccinees who lost their detectable antibodies. The accumulated data from a large number of studies indicate that despite antibody decline or loss, immune memory exhibits long-term persistence. There is somewhat less information available for hepatitis A vaccines, yet an increasing number of studies indicate that the findings for hepatitis B vaccines are also applicable to hepatitis A vaccines. The necessity to provide a booster dose was based on early projections of observed antibody levels. However, recent follow-up studies with up to 12 year observation, as well as studies employing mathematical models predict that following primary vaccination, antibodies will persist for at least 25 years. In addition, experimental studies confirm that vaccination against hepatitis A induces immunological memory. Therefore hepatitis A booster vaccination is presently considered as unnecessary in fully vaccinated individuals. The above findings are of importance in the context of administering combined hepatitis A and B vaccine for which similar long-term data have been observed. All available data on monovalent and combined hepatitis A and hepatitis B vaccines indicates that there is no support for a hepatitis A or hepatitis B booster when a complete primary vaccination course is offered to immunocompetent individuals.

François G, Duclos P, Margolis H, Lavanchy D, Siegrist CA, Meheus A, Lambert PH, Emiroğlu N, Badur S, Van Damme P. · Viral Hepatitis Prevention Board, WHO Collaborating Centre for Prevention and Control of Viral Hepatitis, Department of Epidemiology and Social Medicine, University of Antwerpen, Antwerp, Belgium. · Pediatr Infect Dis J. · Pubmed #16282928 No free full text.

Abstract: In the years following the hepatitis B vaccination/multiple sclerosis controversy, a number of new issues regarding vaccine safety have been raised, in some cases leading to more debate and confusion. Against this background, an international group of experts was convened to review the current points of view concerning the use of thimerosal as a preservative and its potential risks; the suggested link between thimerosal-containing vaccines and acute lymphoblastic leukemia; the alleged association between aluminum-containing vaccines/macrophagic myofasciitis and general systemic complaints; a possible link between vaccination and autoimmune pathology; and a hypothetical link between measles-mumps-rubella vaccination and autism. At present, there are no data to conclude that childhood vaccines, and in particular hepatitis B vaccine, pose a serious health risk or justify a change in current immunization practice. However, vaccine "scares" continue to have an international impact on immunization coverage. Creating a positive environment for immunization can be achieved by repositioning the value of vaccines and vaccination, supported by evidence-based information. The role of international organizations, the media, and the industry in the implementation of communication strategies was discussed and the impact of litigation issues on vaccination was evaluated. The Viral Hepatitis Prevention Board confirms its commitment to current recommendations for universal and risk group hepatitis B vaccination and further encourages the conduct of vaccine safety studies and the dissemination of their results.

Van Herck K, Van Damme P. · Centre for the Evaluation of Vaccination, WHO Collaborating Centre for the Prevention and Control of Viral Hepatitis, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium. · Expert Rev Vaccines. · Pubmed #16117704 No free full text.

Abstract: Hepatitis A is one of the most common vaccine-preventable infectious diseases in the world. With at least 1.5 million cases of hepatitis A worldwide each year, disease management constitutes a substantial economic burden. The first effective vaccine against hepatitis A, Havrix was introduced in 1992. This review summarizes data accumulated following more than a decade of clinical experience with this vaccine and compares clinical data with other currently available hepatitis A vaccines. Based on this data and on the current immunological knowledge, a recent consensus concluded that hepatitis A vaccines induce lifelong protection, and thus booster vaccinations against hepatitis A are unnecessary in fully immunized, healthy people. In view of this, current regulatory recommendations for the use of hepatitis A vaccines are reviewed and possible future strategies identified.

Matheï C, Robaeys G, Van Ranst M, Van Damme P, Buntinx F. · Department of General Practice, Katholieke Universiteit Leuven, Leuven, Belgium. · Acta Gastroenterol Belg. · Pubmed #15832588 No free full text.

Abstract: In industrialised countries, injecting drug use is currently the most important risk factor for infection with hepatitis C, resulting in high prevalence rates of hepatitis C among injecting drug users. To contain the hepatitis C epidemic major efforts should be done to prevent new infection among injecting drug users. Monitoring infection rates are crucial as it may provide feedback on the effectiveness of interventions. In this article the epidemiology of hepatitis C among injecting drug users in Belgium is briefly reviewed. More specifically the prevalence of anti-HCV antibodies, the prevalence of co-infections, the proportion of chronic HCV carriers, the distribution of genotypes and preventive measures among injecting drug users in Belgium are discussed and compared to the situation elsewhere in Western Europe.

Nothdurft HD, Zuckerman J, Stoffel M, Dieussaert I, Van Damme P. · Department of Infectious Diseases and Tropical Medicine, Ludwig-Maximilians University, Munich, Germany. · J Travel Med. · Pubmed #15541232 No free full text.

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Van Damme P, Van Herck K. · Unit of Epidemiology and Social Medicine, Centre for the Evaluation of Vaccination, WHO Collaborating Centre for the Prevention and Control of Viral Hepatitis, University of Antwerp, Campus 3 Eiken, Wilrijk, Belgium. · Expert Rev Vaccines. · Pubmed #15176942 No free full text.

Abstract: Hepatitis A and B are two of the most common vaccine-preventable liver diseases and continue to be a significant cause of morbidity and mortality worldwide, with their severity related to the individual's age upon initial infection. Twinrix (GlaxoSmithKline), a combined vaccine providing protection against both hepatitis A and B, has been available in more than 72 countries worldwide since 1997. This paper provides a critical review of clinical data on the efficacy, immunogenicity and tolerability of the combined vaccine, with particular focus on the clinical benefits of dual vaccination.

Kew M, François G, Lavanchy D, Margolis H, Van Damme P, Grob P, Hallauer J, Shouval D, Leroux-Roels G, Meheus A, Anonymous00087. · South African Medical Research Council/Cancer Association of South Africa/University Molecular Hepatology Research Unit, Department of Medicine, University of the Witwatersrand, and Johannesburg Hospital, Johannesburg, South Africa. · J Viral Hepat. · Pubmed #15117321 No free full text.

Abstract: In spite of advances made in our understanding of the biology of the hepatitis C virus (HCV), the epidemiology and natural history of HCV infection, and the treatment of chronic hepatitis C, the development and worldwide implementation of a comprehensive prevention and control strategy remains necessary. A World Health Organization informal consultation with the Viral Hepatitis Prevention Board was convened and met in Geneva, Switzerland, 13-14 May 2002, to review epidemiological and public health aspects of HCV infection, and the various prevention and control strategies that are currently in place. Based on the presentations and discussions, a number of specific recommendations were made, which should be considered in conjunction with previously published recommendations.

Van Damme P, Banatvala J, Fay O, Iwarson S, McMahon B, Van Herck K, Shouval D, Bonanni P, Connor B, Cooksley G, Leroux-Roels G, Von Sonnenburg F, Anonymous00297. · Centre for the Evaluation of Vaccination, WHO Collaborating Centre for Control and Prevention of Viral Hepatitis, Unit of Epidemiology and Social Medicine, University of Antwerp, 2610 , Antwerp, Belgium. · Lancet. · Pubmed #14522539 No free full text.

Abstract: Hepatitis A is one of the most common vaccine-preventable infectious diseases in the world. Effective vaccines against hepatitis A have been available since 1992, and they provide long-term immunity against the infection. However, there is no worldwide consensus on how long protection will last or whether there will be a need for hepatitis A virus (HAV) booster vaccinations in the future. In most countries, booster-vaccination policy is guided by manufacturers' recommendations, national authorities, or both. In June, 2002, a panel of international experts met to review the long-term immunogenicity and protection conferred by HAV vaccine in different population groups. Data have shown that after a full primary vaccination course, protective antibody amounts persist beyond 10 years in healthy individuals, and underlying immune memory provides protection far beyond the duration of anti-HAV antibodies. The group concluded that there is no evidence to lend support to HAV booster vaccination after a full primary vaccination course in a healthy individual. However, further investigations are needed before deciding if boosters can be omitted in special patient-groups.

André F, Van Damme P, Safary A, Banatvala J. · GlaxoSmithKline Biologicals, Rixensart, Belgium. · Expert Rev Vaccines. · Pubmed #12908508 No free full text.

Abstract: There is 10 years of marketing experience with the hepatitis A vaccine Havrix. It is highly immunogenic, provides lasting protection in healthy individuals and generates protective levels of antibodies in patients with chronic liver disease or impaired immunity. Postmarketing surveillance data have confirmed the outstanding safety profile of the vaccine. The timing of the booster dose is not critical to effectiveness, which has advantages for the protection of travelers to regions of high endemicity. The vaccine is effective in curbing outbreaks of hepatitis A and also when administered postexposure, due to rapid seroconversion and the long incubation period of the disease. In intermediate endemic regions, an epidemiological shift in hepatitis A infection has driven the development of universal preventive strategies to be added to the targeting of at-risk groups. Existing official recommendations and future directions for vaccine use are reviewed.

Connor BA, Van Herck K, Van Damme P. · The New York Center for Travel and Tropical Medicine, New York, NY 10021, USA. · BioDrugs. · Pubmed #12785874 No free full text.

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Banatvala JE, Van Damme P. · Clinical Virology, Guys Kings and St Thomas' School of Medicine and Dentistry, Clinical Virology, London, UK. · J Viral Hepat. · Pubmed #12558904 No free full text.

Abstract: This review analyses the cumulated data from a number of long-term follow-up studies among infants, children and adults vaccinated against hepatitis B in industrialised and developing countries. Despite low or undetectable antibody responses years after vaccination, the development of HBsAg was a rarity and, if present, only transient. Some vaccinees developed anti-HBc responses but none developed an HB carrier state or clinical manifestations of disease. Studies demonstrating anamnestic responses among those with low or undetectable anti-HBs levels following challenge with HB vaccine, together with the production of anti-HBs in circulating B-cells by spot ELISA, confirmed the presence of immune memory among vaccinees. Anamnestic anti-HBs responses all correlate close in kinetics and magnitude with proliferative T-cell responses. The accumulated data from studies assessed in this Review indicate that protection is dependent on immune memory, rather than declining anti-HBs responses and add additional weight to the European Consensus recommendations (12) that following a complete course of vaccination, booster doses are unnecessary in immunocompetent persons. If implemented, this recommendation will have considerable cost benefits world-wide.

Van Damme P, Thyssen A, Van Loock F. · Epidemiologie en Sociale Geneeskunde, Centrum voor de Evaluatie van Vaccinaties, Universitaire Instelling Antwerpen. · Acta Gastroenterol Belg. · Pubmed #12148442 No free full text.

Abstract: Based on currently available epidemiological data, Belgium appears to belong to the low endemicity countries for hepatitis C, with an estimated annual incidence of 3/100,000 clinical cases; a survey among the Flemish population showed an overall seroprevalence of 0.87% (1993-1994). There was no statistically significant difference in anti-HCV prevalence between men and women. A significant increase of the anti-HCV prevalence with increasing age was observed. In the French Community there was an overall seroprevalence of 0.6%. Developing surveillance for hepatitis C has proven to be difficult, since it requires confirmation tests. Techniques detecting hepatitis C antibodies in saliva will replace the need for serum samples, making prevalence studies more accessible.

Van Damme P, Vorsters A. · Centre for the Evaluation of Vaccination, WHO Collaborating Centre for Prevention and Control of Viral Hepatitis, Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium. · J Med Virol. · Pubmed #12116040 No free full text.

Abstract: In the nine years since the Global Advisory Group of the Expanded Programme on Immunisation (WHO) set 1997 as the target for integrating hepatitis B vaccination into national immunisation programmes worldwide, 129 countries have included hepatitis B vaccine as part of their routine infant or adolescent immunisation programmes (June 2001). By the end of 2002, 41 out of the 51 countries of the WHO European Region will be implementing universal hepatitis B immunisation. The rewards of effective implementation of the programmes in countries that started 10 years ago are becoming apparent; and their success offers an exemplary model for other countries. Some other countries, however, have difficulties to incorporate hepatitis B vaccine into universal childhood immunisation programmes, because of major economic constrains and the inability to procure a constant vaccine supply. The next decade will be characterised by expanded use of hepatitis B vaccines and the increasing efforts to sustain vaccine programmes and make the vaccine available to those countries and regions that cannot afford it. In Europe, as well as in the rest of the world, work still remains to be done to support and implement interventions that will bring us closer to the WHO goal and to eradicate hepatitis B.

François G, Kew M, Van Damme P, Mphahlele MJ, Meheus A. · WHO Collaborating Centre for Prevention and Control of Viral Hepatitis, Department of Epidemiology and Social Medicine, Universiteit Antwerpen, Universiteitsplein 1, B-2610 Antwerpen, Belgium. · Vaccine. · Pubmed #11427251 No free full text.

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Van Damme P, Van der Wielen M. · Center for the Evaluation of Vaccination, WHO Collaborating Centre, Department of Epidemiology and Social Medicine, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium. · Vaccine. · Pubmed #11257370 No free full text.

Abstract: Hepatitis A and B are common infections worldwide and their severity is related to the individual's age upon initial infection. Furthermore, when hepatitis B infection occurs in infants, the risk of becoming a chronic carrier is 90%. For hepatitis A, the lower incidence of disease arising from an improvement in living conditions leaves a greater number of children, adolescents and young adults susceptible to residual circulating virus. Consequently, initial infection occurs later in life when clinical illness is more frequent and the rate of morbidity and mortality higher. Although both viruses differ greatly, including their modes of transmission, the overlap in their epidemiology warrants the combination of hepatitis A and B vaccination. The immune response elicited by the combined hepatitis A and B vaccine following a three-dose schedule compares well with the anti-hepatitis A virus (HAV) and anti-hepatitis B sero-responses obtained with monovalent vaccines. In addition, it was shown that the seroprotection rate for anti-hepatitis B increased more rapidly with the administration of the combined vaccine, with values of more than 80% within 1 month after the first two doses (schedule, 0, 1 and 6 months). Currently, according to the World Health Organization recommendations, more than 116 countries are vaccinating their infants and/or adolescents against hepatitis B. Recently, several countries were considering or have decided to begin mass vaccination against HAV (more than fifteen states in the US, Spain (Catalonia), Italy (Puglia)). For these countries, the combination of hepatitis A and B antigens in one single vaccine offers the following advantages: fewer injections for protection against two infections, better compliance, lower implementation costs, and fewer missed vaccination opportunities. Further simplification of the schedule, by reducing the number of doses, would improve the compliance rate as well as being more convenient for the vaccinee. This should translate into a reduction in costs associated with vaccine administration. In some recent vaccine studies, the immunogenicity and safety profile of a two-dose schedule (0 and 6 months) of the adult formulation of the combined hepatitis A and B vaccine was investigated in children aged 1-11 years, as well as in adolescents aged 12-15 years. Current results indicate that this two-dose schedule of the adult formulation could be considered a viable alternative for immunization of children and adolescents.