Pere Plans

Seroepidemiology of varicella-zoster virus infection in Catalonia (Spain). Rationale for universal vaccination programmes

With the aim of designing a strategy for vaccination against varicella-zoster virus (VZV), the results of a seroepidemiological survey on VZV infection carried out in a sample of the population of Catalonia are presented. Representative samples from schoolchildren (30 schools) and adults (97 municipal areas) were obtained by random cluster sampling. In the study, 883 children and 1253 adults were included. Age, gender, place of birth, place of residence, educational level and occupation were investigated in the study subjects. An ELISA test was used to measure varicella antibodies. The prevalence of varicella antibodies increased with age, being 85% in the 5-9 years age group, 92% in the 10-14 years age group, 94% in the 15-34 years age group and almost 100% in people over 35. No association was found between sociodemographic variables studied and prevalence levels of antibodies. These results suggest that the best vaccination strategy in Catalonia would be to add a temporary vaccination programme of pre-adolescents at 12 years to routine vaccination at 15 months.

Community-Based Seroepidemiological Survey of Hepatitis E Virus Infection in Catalonia, Spain

ABSTRACT The objective of the study was to investigate the prevalence of immunoglobulin G (IgG) antibodies to hepatitis E virus (HEV) infection in a population sample from Catalonia and to analyze the demographic and clinical variables associated with the presence of these antibodies. A total of 1,280 subjects between 15 and 74 years of age were selected randomly from urban and rural areas. Data for sociodemographic and clinical variables were collected by using a questionnaire. IgG antibodies to HEV were determined by an immunoenzymatic method. The odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated for studied variables. Multiple logistic regression analysis was used to determine which variables were independently associated with the prevalence of HEV infection. Anti-HEV antibodies were detected in 96 (7.3%) of the 1,280 samples analyzed. The prevalence of antibodies was greater among males (7.8%) than among women (7%) and increased with age for both sexes, from 3% among subjects 15 to 24 years of age to 12% among subjects ≥65 years of age. Bivariate analysis of the sociodemographic and clinical variables showed an association between the prevalence of hepatitis E virus infection and minor surgery (OR, 1.96; 95% CI, 1.24 to 3.11), abdominal surgery (OR, 1.74; 95% CI, 1.12 to 2.73), and, for women, being uniparous or multiparous (OR, 2.84; 95% CI, 1.19 to 6.79). The multivariate analysis showed an association with minor surgery only (OR, 1.68; 95% CI, 1.03 to 2.70). In conclusion, anti-HEV antibodies were detected in 7.3% of the Catalan population. The seroprevalence of anti-HEV antibodies increased with age and was associated with previous minor surgery.

Importance of sexual transmission of hepatitis C virus in seropositive pregnant women: A case‐control study

The mode of hepatitis C virus (HCV) transmission in patients who deny parenteral exposure is still not understood. Seroprevalence studies of anti‐HCV in sexually promiscuous populations and in spouses of infected patients have given contradictory results. We investigated the role of sexual transmission of HCV in a case‐control study of risk factors for infection in a series of 43 anti‐HCV positive pregnant women and 172 matched controls (4 for each case). In the univariate analysis, the following factors were associated significantly with anti‐HCV seropositivity: low social class, unmarried, history of abortion, wounds which were sutured, tattooes, sharing toiletries with the partner, sexual contact outside the partnership without condom use, blood transfusion, and intravenous drug abuse, but only the last 3 factors remained significantly associated with HCV infection in multiple logistic regression analysis. The relative risk of HCV infection increased according to the increased number of sexual partners. Thus sexual transmission must be considered a possible mode of infection in HCV infected persons without parenteral exposures. J. Med. Virol. 52:164–167, 1997.

Changes in the seroepidemiology of hepatitis B infection in Catalonia 1989-1996

The objective of this study was to investigate the prevalence of hepatitis B markers in a representative sample of 2142 subjects in Catalonia, Spain, and to compare it with previous studies. Multiple logistical regression analysis was carried out to determine variables associated with the markers studied. The prevalence of anti-HBc and HBsAg was 9.1% and 1.2%, respectively. Male gender, urban habitat, birth place outside Catalonia and lower social class were associated with the presence of anti-HBc. Carrier status was only associated with male gender. Between 1989 and 1996 there was a decrease of 46% in the prevalence of serum HBV markers mainly in the 25-44 (P<0.0001) and 35-64 year (P=0.0002) age groups, in those born in Catalonia (P=0.003) and in those in the higher social classes (P<0.0001). These decreases can be explained by the improved socioeconomic conditions and, partially, by the routine pre-adolescent and risk group programmes of immunization.

Prevalence of Hepatitis E Virus Infection in Children in the Northeast of Spain

ABSTRACT The prevalence of immunoglobulin G (IgG) anti-hepatitis E virus (anti-HEV) antibodies was studied with a representative sample of 1,249 healthy children aged between 6 and 15 years. IgG anti-HEV antibodies were detected in 57 (4.6%) of the 1,249 samples analyzed, suggesting that some children are exposed to HEV in early childhood.

Declining hepatitis A seroprevalence in adults in Catalonia (Spain): a population-based study

BackgroundOne of the main uses of seroprevalence studies it to evaluate vaccination programmes. In 1998, a programme of universal vaccination of preadolescents in schools with the hepatitis A vaccine was begun in Catalonia. The objective of this study was to investigate the prevalence and risk factors of hepatitis A virus infection (HAV) in a sample of the adult population of Catalonia in 2002 and to evaluate the changes with respect to a survey carried out in 1996.MethodsThe prevalence of HAV antibodies was determined by a third generation competitive immunometric assay in a representative sample of 1292 people aged >15 years. The association between the prevalence and different sociodemographic variables was determined by multiple logistic regression analysis.ResultsThe standardized global prevalence of HAV antibodies in 2002 was 68.2%, increased with age (p < 0.0001) and was associated with being born outside Catalonia (OR: 1.75; 95% CI 1.11–2.76) and lower social class (OR: 1.14; 95% CI 1.05–1.25). Compared with the last survey carried out in 1996 the standardized global prevalence was lower (68.2% vs 77.8%; p < 0.0001) as was the prevalence in people under 45 years.ConclusionThe prevalence of the hepatitis A virus is decreasing in the adult population of Catalonia, especially in the younger age groups. The programme of vaccination of adolescents begun in 1998 to control the disease can provide indirect protection to the unvaccinated population.

Measles immunity and vaccination policy in Catalonia

The prevalence of antibodies against measles in a representative sample of the school population in Catalonia was established and the results compared with previous studies. The study was carried out in 1996 using blood samples obtained from schoolchildren aged 6-7 years, 10-11 years, 13 14 years and 15-16 years. 1231 schoolchildren were studied. The global prevalence of antibodies was 96.3%, and a considerable increase was observed with respect to the prevalence in 1986 (89.4%). The level of antibodies was 94% at 6-7 years and 10-11 years, 99.7% at 13-14 years and 98.3% at 15 16 years. These data would suggest the advancement of the administration of the second dose of measles-mumps rubella vaccine to 4 6 years instead of at 11 years.

Prevalence of varicella-zoster antibodies in pregnant women in Catalonia (Spain). Rationale for varicella vaccination of women of childbearing age.

Objective  The objective of this study was to determine the prevalence of antibodies against varicella‐zoster virus (VZV) in pregnant women in Catalonia (Spain).

Seroepidemiología del tétanos en la población adulta de Cataluña, 1989-1996

Objetivo Investigar el estado inmunitario frente al tetanos de la poblacion adulta de Cataluna y comparar los resultados obtenidos con los de anteriores encuestas seroepidemiologicas. Metodos Se ha determinado la presencia de anticuerpos antitetanicos en una muestra representativa (n = 1.258) de este grupo po-blacional (> 15 anos). La tecnica utilizada ha sido la de ELISA. Resultados El 29% de varones y el 15% de mujeres (p Conclusiones Los resultados del presente estudio indican que la poblacion adulta de Cataluna presenta un bajo nivel de inmunidad frente al tetanos y que las medidas de vacunacion antitetanica llevadas a cabo hasta el presente no han sido suficientes para asegurar una adecuada proteccion de este grupo de poblacion.

Infrequent detection of hepatitis E virus RNA in pregnant women with hepatitis E virus antibodies in Spain

Targeted therapy for HCC has been the focus of study in recent years. To this end, targeted therapy for HCC has focused on EGFR and vascular endothelial growth factor receptors (1, 2). In a phase II trial, it was found that patients with advanced HCC treated with combined bevacizumab and erlotinib had a median progress-free survival of 39 weeks (95% CI, 26–45 weeks; 9.0 months), and the median overall survival was 68 weeks (95% CI, 48–78 weeks; 15.65 months). This study highlighted the potential beneficial effect of bevacizumab and erlotinib for treating HCC. Gefitinib is another EGFR–tyrosine kinase inhibitor with the same mechanism of action as erlotinib. Previous studies concerning gefitinib as a targeted therapy for HCC were performed using animal or in vitro models (3–8). Findings from these studies suggested that gefitinib may inhibit HCC growth by blocking several pathways, including the PTEN/Akt signalling pathway (8), and inhibit HCC metastasis by blocking the fibronectininduced activation of ERK, p38, Akt, cell proliferation and invasion (7). We have described the case of a patient with advanced HCC and lung metastasis who received gefitinib treatment. The clinical response to this treatment was positive, as indicated by a prolonged duration of survival and shrunken tumour.