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Antibody levels and protection after hepatitis B vaccination: results of a 15-year follow-up.

https://arctichealth.org/en/permalink/ahliterature5632
Source
Ann Intern Med. 2005 Mar 1;142(5):333-41
Publication Type
Article
Date
Mar-1-2005
Author
Brian J McMahon
Dana L Bruden
Kenneth M Petersen
Lisa R Bulkow
Alan J Parkinson
Omana Nainan
Marina Khristova
Carolyn Zanis
Helen Peters
Harold S Margolis
Author Affiliation
Arctic Investigations Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, and the Alaska Native Medical Center, Anchorage, Alaska 99508, USA. bdm9@cdc.gov
Source
Ann Intern Med. 2005 Mar 1;142(5):333-41
Date
Mar-1-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Alaska - epidemiology
Antibodies, Viral - blood
Child
Child, Preschool
DNA, Viral - blood
Female
Follow-Up Studies
Hepatitis B - epidemiology - prevention & control
Hepatitis B Surface Antigens - immunology
Hepatitis B Vaccines - immunology
Hepatitis B virus - genetics - immunology
Humans
Infant
Male
Middle Aged
Prospective Studies
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Vaccination
Abstract
BACKGROUND: The duration of protection afforded by hepatitis B vaccination is unknown. OBJECTIVE: To determine antibody persistence and protection from hepatitis B virus (HBV) infection. DESIGN: Prospective cohort study. SETTING: 15 villages in southwest Alaska. PARTICIPANTS: 1578 Alaska Natives vaccinated at age 6 months or older. INTERVENTION: During 1981-1982, participants received 3 doses of plasma-derived hepatitis B vaccine. This cohort was followed annually over the first 11 years, and 841 (53%) persons were tested at 15 years. MEASUREMENTS: Antibody to hepatitis B surface antigen (anti-HBs), markers of HBV infection, and testing to identify HBV variants. RESULTS: Levels of anti-HBs in the cohort decreased from a geometric mean concentration of 822 mIU/mL after vaccination to 27 mIU/mL at 15 years. Initial anti-HBs level, older age at vaccination, and male sex were associated with persistence of higher anti-HBs levels at 15 years when analyzed by a longitudinal linear mixed model. After adjustment for initial anti-HBs level and sex, those vaccinated at age 6 months to 4 years had the lowest anti-HBs level at 15 years. Asymptomatic breakthrough infections were detected in 16 participants and occurred more frequently in persons who did not respond to vaccination than those who responded (P = 0.01). Among infected persons with viremia, 2 were infected with wild-type HBV and 4 had HBV surface glycoprotein variants, generally accompanied by wild-type HBV. LIMITATIONS: The loss of participants to follow-up at 15 years was 47%. However, characteristics of persons tested were similar to those of persons lost to follow-up. CONCLUSIONS: Hepatitis B vaccination strongly protected against infection for at least 15 years in all age groups. Antibody levels decreased the most among persons immunized at 4 years of age or younger.
Notes
Comment In: Ann Intern Med. 2005 Mar 1;142(5):384-515738458
Comment In: Ann Intern Med. 2005 Mar 1;142(5):I3415738447
PubMed ID
15738452 View in PubMed
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Antibody Levels and Protection After Hepatitis B Vaccine: Results of a 30-Year Follow-up Study and Response to a Booster Dose.

https://arctichealth.org/en/permalink/ahliterature282857
Source
J Infect Dis. 2016 Jul 01;214(1):16-22
Publication Type
Article
Date
Jul-01-2016
Author
Michael G Bruce
Dana Bruden
Debby Hurlburt
Carolyn Zanis
Gail Thompson
Lisa Rea
Michele Toomey
Lisa Townshend-Bulson
Karen Rudolph
Lisa Bulkow
Philip R Spradling
Richard Baum
Thomas Hennessy
Brian J McMahon
Source
J Infect Dis. 2016 Jul 01;214(1):16-22
Date
Jul-01-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Alaska
Child
Child, Preschool
Cohort Studies
Female
Follow-Up Studies
Hepatitis B - immunology - prevention & control
Hepatitis B Antibodies - blood - immunology
Hepatitis B Vaccines - immunology
Humans
Immunity, Active - immunology
Immunization, Secondary
Male
Middle Aged
Time Factors
Young Adult
Abstract
The duration of protection in children and adults resulting from hepatitis B vaccination is unknown. In 1981, we immunized a cohort of 1578 Alaska Native adults and children from 15 Alaska communities aged =6 months using 3 doses of plasma-derived hepatitis B vaccine.
Persons were tested for antibody to hepatitis B surface antigen (anti-HBs) levels 30 years after receiving the primary series. Those with levels
PubMed ID
26802139 View in PubMed
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Autoimmune hepatitis in the Alaska Native population: autoantibody profile and HLA associations.

https://arctichealth.org/en/permalink/ahliterature262772
Source
Liver Int. 2014 Sep;34(8):1241-9
Publication Type
Article
Date
Sep-2014
Author
Elizabeth D Ferucci
Tammy L Choromanski
Kathy J Hurlburt
Stephen Livingston
Julia Plotnik
Michael P Manns
Brian J McMahon
Judith A James
Source
Liver Int. 2014 Sep;34(8):1241-9
Date
Sep-2014
Language
English
Publication Type
Article
Keywords
Alaska - epidemiology
Antibodies, Antineutrophil Cytoplasmic - blood
Antibodies, Antinuclear - blood
Autoantibodies - blood
Cohort Studies
Enzyme-Linked Immunosorbent Assay
Fluorescent Antibody Technique
HLA-DR3 Antigen - blood
Hepatitis, Autoimmune - epidemiology - immunology
Humans
Indians, North American
Prevalence
Abstract
The Alaska Native population is one of few populations in the world with a high prevalence of autoimmune hepatitis. The objective of this study was to determine the frequency and HLA and clinical associations of autoantibodies in Alaska Native people with autoimmune hepatitis.
Alaska Native individuals with autoimmune hepatitis were recruited in clinics conducted statewide. Sera were tested for the presence of autoantibodies described in either autoimmune hepatitis or rheumatic disease. Associations between autoantibodies and HLA alleles and clinical features were assessed.
Seventy-one patients were included. At the study visit, 34 patients (47.9%) had antibodies to double-stranded DNA by immunofluorescence; 27 (38.0%) had anti-neutrophil cytoplasmic antibodies; and 11 (15.5%) had anti-Ro antibodies. Only one person had antibodies against soluble liver antigen, and in that person, anti-Ro was absent. Associations were found between autoantibodies and HLA alleles, including positive associations between HLA DR3 and anti-double-stranded DNA antibodies and between HLA DR14 and antineutrophil cytoplasmic antibodies. There was no association between autoantibodies and clinical outcomes.
As in other populations, the prevalence of anti-double-stranded DNA antibodies and antineutrophil cytoplasmic antibodies is high in Alaska Native people with autoimmune hepatitis. In contrast to data from other populations, there is a lower prevalence of anti-soluble liver antigen and a lack of association between anti-Ro and anti-soluble liver antigen. In addition, the HLA profile and associations with autoantibodies are unique. No clear prognostic implications of autoantibodies have emerged in this population.
PubMed ID
24939565 View in PubMed
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Cascade of Care for Alaska Native People With Chronic Hepatitis C Virus Infection: Statewide Program With High Linkage to Care.

https://arctichealth.org/en/permalink/ahliterature303078
Source
Clin Infect Dis. 2020 Apr 15; 70(9):2005-2007
Publication Type
Journal Article
Date
Apr-15-2020
Author
Brian J Mcmahon
Lisa Townshend-Bulson
Chriss Homan
Prabhu Gounder
Youssef Barbour
Annette Hewitt
Dana Bruden
Hannah Espera
Julia Plotnik
James Gove
Timothy J Stevenson
Sarah V Luna
Brenna C Simons
Author Affiliation
Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, Alaska.
Source
Clin Infect Dis. 2020 Apr 15; 70(9):2005-2007
Date
Apr-15-2020
Language
English
Publication Type
Journal Article
Abstract
Most persons with chronic hepatitis C virus (HCV) infection in the United States are undiagnosed or linked to care. We describe a program for the management of Alaska Native patients infection utilizing a computerized registry and statewide liver clinics resulting in higher linkage to care (86%) than national estimates (~25%).
PubMed ID
31504307 View in PubMed
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The changing epidemiology and aetiology of hepatocellular carcinoma from 1969 through 2013 in Alaska Native people.

https://arctichealth.org/en/permalink/ahliterature286938
Source
Liver Int. 2016 Dec;36(12):1829-1835
Publication Type
Article
Date
Dec-2016
Author
Marc Connelly
Michael G Bruce
Lisa Bulkow
Mary Snowball
Brian J McMahon
Source
Liver Int. 2016 Dec;36(12):1829-1835
Date
Dec-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Alaska Natives
Carcinoma, Hepatocellular - ethnology - etiology
Child
Female
Hepatitis B - complications
Hepatitis C - complications
Humans
Linear Models
Liver Neoplasms - ethnology - etiology
Longitudinal Studies
Male
Middle Aged
Risk factors
United States - epidemiology
Young Adult
Abstract
Alaska Native people have an increased rate of hepatocellular carcinoma compared to the United States population. Viral hepatitis is a risk factor for malignancy and the leading cause of hepatocellular carcinoma in Alaska. With the introduction of hepatitis B immunization in 1982, as well as the emergence of hepatitis C virus in this population, the epidemiology and aetiology of hepatocellular carcinoma in Alaska have changed.
Using the Alaska Native Tumor Registry, all cases of viral and non-viral hepatocellular carcinoma occurring from 1969 through 2013 were identified and reviewed. Incidence rates per 100 000 population were calculated for hepatocellular carcinoma overall and by aetiological category.
One hundred and fifty-two cases of hepatocellular carcinoma were identified in 148 Alaska Native persons. Overall tumour rate was 3.82 per 100 000 and did not change significantly over the study period. Hepatitis B-associated cases decreased significantly over the study period (P = 0.048) and were eliminated in persons under the age of 20. Hepatitis C-associated cases increased significantly (P
PubMed ID
27224493 View in PubMed
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Clearance of hepatitis B surface antigen and risk of hepatocellular carcinoma in a cohort chronically infected with hepatitis B virus.

https://arctichealth.org/en/permalink/ahliterature98313
Source
Hepatology. 2010 May;51(5):1531-7
Publication Type
Article
Date
May-2010
Author
Josephine Simonetti
Lisa Bulkow
Brian J McMahon
Chriss Homan
Mary Snowball
Susan Negus
James Williams
Stephen E Livingston
Author Affiliation
Liver Disease & Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK 99508, USA.
Source
Hepatology. 2010 May;51(5):1531-7
Date
May-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alaska - epidemiology
Carcinoma, Hepatocellular - etiology
Cohort Studies
Female
Hepatitis B Surface Antigens - blood - genetics
Hepatitis B, Chronic - immunology
Humans
Incidence
Indians, North American
Liver Neoplasms - etiology
Male
Middle Aged
Prospective Studies
Risk
Abstract
Some individuals who are chronically infected with hepatitis B virus (HBV) eventually lose hepatitis B surface antigen (HBsAg). Hepatocellular carcinoma (HCC) has been demonstrated to occur in a few patients after loss of HBsAg. Neither factors associated with loss of HBsAg nor the incidence of HCC thereafter have been clearly elucidated. We performed a prospective population-based cohort study in 1,271 Alaska Native persons with chronic HBV infection followed for an average of 19.6 years to determine factors associated with loss of HBsAg and risk of developing HCC thereafter. HBsAg loss occurred in 158 persons for a rate of HBsAg clearance of 0.7%/year. Older age, but not sex, was associated with clearance of HBsAg, and loss of HBsAg was not associated with any particular HBV genotypes (A, B, C, D, and F) found in this population. Participants were followed for an average of 108.9 months after HBsAg loss. Six patients, two with cirrhosis and four without, developed HCC a mean of 7.3 years after HBsAg clearance (range, 2.0-15.5 years). The incidence of HCC after clearance of HBsAg was 36.8 per 100,000 per year (95% CI 13.5-80.0) which was significantly lower than the rate in those who remained HBsAg-positive (195.7 cases per 100,000 person-years of follow-up [95% CI 141.1-264.5; P
PubMed ID
20087968 View in PubMed
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Clinical management of chronic hepatitis B infection in Alaska Native People: outcome and effectiveness of surveillance for early detection of hepatocellular carcinoma and antiviral therapy to prevent cirrhosis

https://arctichealth.org/en/permalink/ahliterature284367
Source
Pages 700-701 in N. Murphy and A. Parkinson, eds. Circumpolar Health 2012: Circumpolar Health Comes Full Circle. Proceedings of the 15th International Congress on Circumpolar Health, Fairbanks, Alaska, USA, August 5-10, 2012. International Journal of Circumpolar Health 2013;72 (Suppl 1):700-701
Publication Type
Article
Date
2013
, Bulkow L, Harpster A, Snowball M, Lanier A, Sacco F, et al. Screening for hepatocellular carcinoma in Alaska Natives infected with ch ronic hepatitis B: a 16-year population- based study. H epatology. 2000;32:842- 6. *Brian J. McMahon Email: bdm9@cdc.gov Citat ion: Int J Circumpd ar Health 2013
  1 document  
Author
Brian J. McMahon
Susan Negus
Mary Snowball
Chriss Homan
Lisa Bulkow
Michael Bruce
Brenna Simons
Stephen Livingston
Author Affiliation
Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
Arctic Investigations Program, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
Source
Pages 700-701 in N. Murphy and A. Parkinson, eds. Circumpolar Health 2012: Circumpolar Health Comes Full Circle. Proceedings of the 15th International Congress on Circumpolar Health, Fairbanks, Alaska, USA, August 5-10, 2012. International Journal of Circumpolar Health 2013;72 (Suppl 1):700-701
Date
2013
Language
English
Publication Type
Article
Digital File Format
Text - PDF
Physical Holding
University of Alaska Anchorage
Abstract
Alaska Native (AN) people were found to have high rates of acute and chronic hepatitis B virus (HBV) and hepatocellular carcinoma (HCC) in the 1970s. AN children and young adults had the highest rate of HBV-related HCC ever recorded, reaching 3/100,000 in the early 1980s.
Documents
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Cost-effectiveness analysis of hepatocellular carcinoma screening by combinations of ultrasound and alpha-fetoprotein among Alaska Native people, 1983-2012.

https://arctichealth.org/en/permalink/ahliterature289332
Source
Int J Circumpolar Health. 2016; 75:31115
Publication Type
Journal Article
Date
2016
Author
Prabhu P Gounder
Lisa R Bulkow
Martin I Meltzer
Michael G Bruce
Thomas W Hennessy
Mary Snowball
Philip R Spradling
Bishwa B Adhikari
Brian J McMahon
Author Affiliation
Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Disease, U.S. Centers for Disease Control and Prevention (CDC), Anchorage, AK, USA; pgounder@cdc.gov.
Source
Int J Circumpolar Health. 2016; 75:31115
Date
2016
Language
English
Publication Type
Journal Article
Keywords
Adult
Alaska Natives
Carcinoma, Hepatocellular - diagnosis - diagnostic imaging - economics - metabolism
Cost-Benefit Analysis
Female
Humans
Liver Neoplasms - diagnosis - diagnostic imaging - economics - metabolism
Male
Mass Screening - economics
Middle Aged
Ultrasonography - economics
alpha-Fetoproteins - analysis
Abstract
The American Association for the Study of Liver Diseases (AASLD) recommends semi-annual hepatocellular carcinoma (HCC) screening using ultrasound (US) in persons with chronic hepatitis B (CHB) virus infection at high risk for HCC such as Asian males aged =40 years and Asian females aged =50 years.
To analyse the cost-effectiveness of 2 HCC screening methods in the Alaska Native (AN) health system: US-alone, or screening by alpha-fetoprotein (AFP) initially and switching to US for subsequent screenings if AFP >10 ng/mL (AFP?US).
A spreadsheet-based model was developed for accounting the costs of 2 hypothetical HCC screening methods. We used epidemiologic data from a cohort of 839 AN persons with CHB who were offered HCC screening by AFP/US semi-annually during 1983-2012. We assumed that compared with AFP?US, US-alone identifies 33% more tumours at an early stage (defined as a single tumour =5 cm or =3 tumours =3 cm in diameter). Years of life gained (YLG) attributed to screening was estimated by comparing additional years of survival among persons with early- compared with late-stage tumours. Screening costs were calculated using Medicare reimbursement rates in 2012. Future screening costs and YLG were projected over a 30-year time horizon using a 3% discount rate.
The total cost of screening for the cohort by AFP?US would have been approximately $357,000 ($36,000/early-stage tumour detected) compared to $814,000 ($59,000/early-stage tumour detected) by US-alone. The AFP?US method would have yielded an additional 27.8 YLG ($13,000/YLG) compared with 38.9 YLG ($21,000/YLG) for US-alone. Screening by US-alone would incur an additional $114,000 per extra early-tumour detected compared with AFP?US and $41,000 per extra YLG.
Although US-alone HCC screening might have yielded more YLG than AFP?US, the reduced costs of the AFP?US method could expand access to HCC screening in resource constrained settings.
Notes
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PubMed ID
27197711 View in PubMed
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Diagnostic accuracy of tests for Helicobacter pylori in an Alaska Native population.

https://arctichealth.org/en/permalink/ahliterature128673
Source
World J Gastroenterol. 2011 Nov 14;17(42):4682-8
Publication Type
Article
Date
Nov-14-2011
Author
Dana L Bruden
Michael G Bruce
Karen M Miernyk
Julie Morris
Debby Hurlburt
Thomas W Hennessy
Helen Peters
Frank Sacco
Alan J Parkinson
Brian J McMahon
Author Affiliation
Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging Zoonoses and Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK 99508, United States. dbruden@cdc.gov
Source
World J Gastroenterol. 2011 Nov 14;17(42):4682-8
Date
Nov-14-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Alaska - epidemiology
Antibodies, Bacterial - blood
Breath Tests - methods
Diagnostic Tests, Routine - standards
Endoscopy, Gastrointestinal
Female
Helicobacter Infections - complications - diagnosis - epidemiology
Helicobacter pylori - immunology
Humans
Male
Middle Aged
Population Groups
Predictive value of tests
Sensitivity and specificity
Stomach Neoplasms - diagnosis - etiology
Urea - metabolism
Urease - metabolism
Young Adult
Abstract
To evaluate the accuracy of two non-invasive tests in a population of Alaska Native persons. High rates of Helicobacter pylori (H. pylori) infection, H. pylori treatment failure, and gastric cancer in this population necessitate documentation of infection status at multiple time points over a patient's life.
In 280 patients undergoing endoscopy, H. pylori was diagnosed by culture, histology, rapid urease test, (13)C urea breath test (UBT), and immunoglobulin G antibodies to H. pylori in serum. The performances of (13)C-UBT and antibody test were compared to a gold standard defined by a positive H. pylori test by culture or, in case of a negative culture result, by positive histology and a positive rapid urease test.
The sensitivity and specificity of the (13)C-UBT were 93% and 88%, respectively, relative to the gold standard. The antibody test had an equivalent sensitivity of 93% with a reduced specificity of 68%. The false positive results for the antibody test were associated with previous treatment for an H. pylori infection [relative risk (RR) = 2.8]. High levels of antibodies to H. pylori were associated with chronic gastritis and male gender, while high scores in the (13)C-UBT test were associated with older age and with the H. pylori bacteria load on histological examination (RR = 4.4).
The (13)C-UBT outperformed the antibody test for H. pylori and could be used when a non-invasive test is clinically necessary to document treatment outcome or when monitoring for reinfection.
Notes
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PubMed ID
22180710 View in PubMed
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Duration of hepatitis B immunity in low risk children receiving hepatitis B vaccinations from birth.

https://arctichealth.org/en/permalink/ahliterature5641
Source
Pediatr Infect Dis J. 2004 Jul;23(7):650-5
Publication Type
Article
Date
Jul-2004
Author
Kenneth M Petersen
Lisa R Bulkow
Brian J McMahon
Carolyn Zanis
Marilyn Getty
Helen Peters
Alan J Parkinson
Author Affiliation
Arctic Investigations Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Alaska Native Tribal Health Consortium, Anchorage, AK 99508, USA.
Source
Pediatr Infect Dis J. 2004 Jul;23(7):650-5
Date
Jul-2004
Language
English
Publication Type
Article
Keywords
Alaska
Chi-Square Distribution
Child
Child, Preschool
Female
Hepatitis B - prevention & control
Hepatitis B Antibodies - immunology
Hepatitis B Surface Antigens - immunology
Hepatitis B Vaccines - immunology
Humans
Immunization Schedule
Infant
Infant, Newborn
Longitudinal Studies
Male
Risk factors
Time Factors
Abstract
BACKGROUND: The duration of protection after hepatitis B vaccination of infants is unknown. METHODS: We determined antibody to hepatitis B surface antigen (anti-HBs) at 4-13 years of age in 363 low risk children who had been vaccinated starting at birth with hepatitis B vaccine. Those with nonprotective titers ( or = 10 mIU/mL) of anti-HBs at 9 and 13 years, respectively. Of those who did not have protective antibody titers, 61% (33 of 54) and 67% (8 of 12), respectively, responded to a booster dose. In children of HBsAg-positive mothers, 31% retained protective anti-HBs at 12 years, and 90% (9 of 10) with nonprotective titers responded to a booster. In low risk children initially receiving a recombinant vaccine, 12.5% (26 of 208) and none (0 of 36) retained protective anti-HBs titers at 5 and 7 years of age, respectively. Of those who did not have protective titers, 90% (120 of 134) and 91% (32 of 35), respectively, responded to a booster. CONCLUSIONS: Anti-HBs disappeared by 5 years of age in most children who were vaccinated with hepatitis B vaccine from birth. Although most children showed immunologic memory, one-third failed to demonstrate an anamnestic response to a booster dose. Additional long term studies of low risk infants are needed to determine duration of protection and the necessity for or timing of booster doses.
PubMed ID
15247604 View in PubMed
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52 records – page 1 of 6.