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Biomedical subjects

A Milne

Publications and source records attributed to A Milne.

At least 55 records · Page 3Linked to original sources
PubMed1989

Liver disease and hepatitis B infection in a large New Zealand family.

This study illustrates the relationship between the hepatitis B virus (HBV) carrier state and primary hepatocellular carcinoma in a large family of Maori (173 members) amongst whom four brothers have died of primary hepatocellular carcinoma. The brothers were from a generation of fourteen siblings, eleven of whom were tested for hepatitis B surface antigen (HBsAg) and all found to be positive. Amongst the offspring of this generation there were 13 HBsAg positives from 28 children (46%) born to female carriers but no HBsAg positives amongst the 28 offspring of male carriers. The study provides further evidence that the morbidity which often follows HBsAg carriage, may be associated with early (perinatal) infection. There was a marked decrease in HBV serologic markers in succeeding generations, from 100% in generation two, to 55% in generation three and 14% in generation four, unrelated to the use of hepatitis B vaccine.

Adult↗
PubMed1989

Modes of hepatitis B virus transmission in New Zealand.

We review some of the current literature on modes of transmission of hepatitis B virus (HBV) and report a descriptive study of lifestyle practices of children in the eastern Bay of Plenty and east coast of New Zealand. We also report a small case-control study of possible HBV infection risk factors in a group of central North Island school children, with a hepatitis B surface antigen (HBsAg) seroprevalence of 1.5%, and an HBV immune seroprevalence of 16%. Toothbrush, bathtowel and bed sharing were found to be risk factors for HBV infection in this group. The primary mode of HBV transmission in New Zealand is currently unknown, although it appears that direct contact by parenteral means (through blood and sores) may be the most likely route of spread. Direct contact by non parenteral means, including sharing food contaminated with blood, may also be important. Environment-mediated spread may play a role, particularly as a means of spread between cuts and sores. Avenues for further research are also suggested.

Carrier State↗
PubMed1989

Prevalence of hepatitis B in children in a high risk New Zealand community, and control using recombinant DNA vaccine.

Two hundred and sixty-six children aged 3-10 years were tested for hepatitis B virus (HBV) serologic markers. Thirty-eight were positive, including seven who were positive for hepatitis B surface antigen (HBsAg). Two hundred and fifteen healthy children were randomised to receive either 3 x 5 micrograms doses or 3 x 10 micrograms doses of Smith Kline Biologicals Engerix B recombinant DNA (rDNA) hepatitis B vaccine into the deltoid muscle at 0, 1 and 6 months. They were tested for seroconversion and levels of antibody to hepatitis B surface antigen (anti-HBs) one month after dose 3. Ninety-nine percent of children in each group seroconverted for anti-HBs. Geometric mean titres (GMT) or anti-HBs in IU/L were higher with 10 micrograms doses. Nevertheless, 3 x 5 micrograms is the appropriate regimen for protecting children in this age group, as long as cost of vaccine remains a major factor in immunisation programmes.

Child↗
PubMed1989

Comparison of the immunogenicity of reduced doses of two recombinant DNA hepatitis B vaccines in New Zealand children.

A group of 201 hepatitis B virus (HBV) sero-negative children 1-12 years of age received either three 2 micrograms doses of Merck Sharp and Dohme (MSD) or Smith Kline and French (SKF) recombinant DNA (rDNA) hepatitis B vaccine I.M. at monthly intervals. Each recipient was tested 4-6 weeks later for antibody to hepatitis B surface antigen (anti-HBs) by enzyme immunoassay (EIA) and radioimmunoassay (RIA). Ninety-six 4-5-year-old children, given 2 micrograms doses of a plasma-derived vaccine (MSD, H-B-Vax) I.M. at 0, 1, 2 months, were tested at the same time with the same assays for comparison. Anti-HBs responses and geometric mean titres (GMT) were significantly higher with the MSDrDNA vaccine (96% and 338.9 IU/liter) than with the SKF/r DNA vaccine (82.3% and 69.4 IU/liter). We conclude that for the protection of young children, 2 micrograms doses of the MSD rDNA hepatitis B vaccine may be used under similar circumstances in which 2 micrograms of the MSD plasma-derived vaccine was used. Further studies are needed before the other rDNA hepatitis B vaccine may be used in lower than the 10 micrograms dose recommended in children.

Child↗
PubMed1988

Hepatitis B virus: the importance of age at infection.

Recent studies have demonstrated the importance of age at infection with hepatitis B virus (HBV). Age affects whether the infection is self-limited or results in the chronic carrier state, the severity of the acute infection, and the incidence of various sequelae of the chronic carrier state. In particular, although the acute infection is more severe in adults, infections in infants and preschool children carry much greater risks of chronic carriage which increases the risk of primary hepatocellular carcinoma and cirrhosis later in life. This has two important implications for areas where HBV is endemic. First, more impact can be gained by vaccinating infants and preschool children than by vaccinating healthy adults. Second, if funds are limited, greater impact will be gained by immunising a larger number of children with low doses of vaccine so that they are protected during the early years of life when the risk of chronic carriage is highest, rather than using the standard dose in a smaller number of children even though protection may be longer lasting with standard doses. These two considerations provide the basis for an efficient strategy for control in communities or countries where HBV is endemic or hyperendemic.

Adolescent↗
PubMed1988

Low dose hepatitis B vaccination in children: benefit of low dose boosters.

Fifty eight children aged 5-12 years (mean 9.3 years) who had received three x 2 micrograms of Merck Sharp and Dohme (MSD) H-B-Vax intramuscularly at time 0, 1, 6 months were given a further 2 micrograms dose 12 months after dose 3 and tested for immune response two weeks later. Fifty seven of 58 children were positive for antibody to hepatitis B surface antigen (anti-HBs) when tested by radioimmunoassay. In 56 of the 57, the response was anamnestic in nature. The geometric mean titre of anti-HBs rose from 106 IU/L before, to 15,759 IU/L after the booster dose. The latter figure was greater than that obtained in 20 adults given three x 20 micrograms of the same vaccine and also greater than that reported in children given three x 10 micrograms of MSD H-B-Vax. This study demonstrates that 8 micrograms of H-B-Vax given as four doses is at least as immunogenic in children as 30 micrograms of the same vaccine given as recommended and that the low dose strategy is appropriate for this expensive vaccine.

Adult↗
PubMed1988

Immunogenicity of a recombinant yeast-derived hepatitis B vaccine (Engerix B) in children.

Eighty-one children seronegative for markers of hepatitis B virus infection aged 0-10 years received 10 micrograms of a yeast-based hepatitis B vaccine (Engerix B) at 0, 1, and 6 months. Eighty subjects responded with a geometric mean titre of 7640 IU/L one month after the third dose. All seroconverters produced high level of antibodies regardless of age, race, or sex. It is concluded that Engerix B used in the dose and schedule described is highly immunogenic.

Antigens↗
PubMed1988

Antibody responses to recombinant, yeast-derived hepatitis B vaccine in teenage New Zealand children.

Three groups of healthy teenage New Zealand children were given 2.5 micrograms, 5 micrograms and 10 micrograms, which is the currently recommended dose, of Merck Sharp and Dohme recombinant yeast-derived hepatitis B vaccine at time 0, 1 and 6 months and tested for antibody responses to vaccine and for other hepatitis B virus markers. Seroconversion rates exceeded 98% in all three groups. Geometric mean titres (GMT) of the anti-HBs increased with higher doses. There was no significant differences in GMT between the sexes. Under the conditions of this study, 2.5 micrograms doses of this vaccine induced an excellent antibody response in children 12-14 years of age.

Adolescent↗
PubMed1988

Growth and survival of rumen fungi.

The life cycle and growth kinetics of an anaerobic rumen fungus (Neocallimastix R1) in liquid and solid media are described, together with its response to light, temperature and oxygen. These results are discussed in relation to the survival of rumen fungi in saliva and faeces of sheep, and the possible routes for the transfer of anaerobic fungi between ruminants. The thallus and life cycle of Neocallimastix R1 are compared with those of aerobic chytrids.

Anaerobiosis↗
PubMed1988

Failure of recombinant human granulocyte-macrophage colony-stimulating factor therapy in aplastic anemia patients with very severe neutropenia.

Four patients with very severe aplastic anemia refractory to antilymphocyte globulin were administered recombinant human granulocyte-macrophage--colony stimulating factor (GM-CSF). One patient with minimal residual myelopoiesis responded transiently to two separate courses of GM-CSF at 4 and 8 micrograms/kg/d administered intravenously and another course at 4 micrograms/kg/d administered subcutaneously. Septicemia and bilateral pneumonia that had been resistant to conventional therapy resolved. Three patients with no evidence of residual myelopoiesis did not respond to GM-CSF. In one patient, the dose was increased to 32 micrograms/kg/d with no effect on hematopoiesis. Immediate side effects were minimal at GM-CSF doses up to 16 micrograms/kg/d. GM-CSF may, however, have been involved in the pathophysiology of thrombosis of the inferior vena cava in the patient administered 32 micrograms/kg/d. We conclude that GM-CSF does not induce hematopoiesis in long-standing, severe, treatment-resistant aplastic anemia with complete myelopoietic failure. However, in patients with minimal residual myelopoiesis, GM-CSF could be a promising adjuvant therapy for severe infection.

Adult↗
PubMed1987

Very-low-dose hepatitis B vaccine in newborn infants: an economic option for control in endemic areas.

Three 1 microgram or 2 micrograms doses of Merck, Sharp and Dohme plasma vaccine were given to 119 infants of mothers negative for antibody to hepatitis B surface antigen (anti-HBs). Anti-HBs antibodies developed in 25/29 (86%) infants given 1 microgram and in 86/90 (96%) given 2 micrograms doses. Levels of anti-HBs achieved by three 2 micrograms doses were similar to those that have been reported for conventional 10 micrograms doses. Similar levels were recorded from infants of anti-HBs-positive mothers, which suggests that maternal antibody does not interfere with the infant's immune response to low doses of vaccine. Three 2 micrograms doses of vaccine in infancy produce satisfactory immunogenicity and make possible economic control of hepatitis B in endemic areas.

Carrier State↗
PubMed1987

Low-dose vaccination against hepatitis B in children: one-year follow-up.

Six hundred forty-three children, negative for markers of hepatitis B virus (HBV) infections, were given three X 2-micrograms doses of Merck, Sharp and Dohme (MSD) plasma derived hepatitis B vaccine (H-B-Vax) at monthly intervals. Twelve months after the first dose of vaccine, antibody to hepatitis B surface antigen (anti-HBs) was detected in 89% of children by radioimmunoassay (RIA) and in 83% by enzyme immunoassay (EIA). Seroconversion rates and anti-HBs titres were significantly greater in 1-4-year-olds than in older children (p less than 0.01). Eighteen children with no anti-HBs or other markers of HBV at this time were given 10 micrograms of vaccine and tested one month later. Seventeen developed anti-HBs, 12 at levels consistent with an anamnestic response. Forty-nine HBV-marker-negative children seroconverted for antibody to hepatitis B core antigen (anti-HBc) in the 8-month period before or the 12-month period following vaccination. Forty-six of these children were positive for anti-HBs, and one has been confirmed as a chronic carrier of hepatitis B surface antigen (HBsAg). Three cases of clinical hepatitis B in children have been seen in the community since the vaccination programme began. Two of these were amongst the estimated 5% of children who were not vaccinated. The third was in a vaccinee and occurred 4 1/2 months after the last dose of vaccine.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Immunogenicity of low doses of hepatitis B vaccine in children: a study in 650 New Zealand children.

Six hundred and fifty New Zealand children from 2-12 years of age were vaccinated three times with 2 mcg intramuscular (IM) doses of Merck Sharp and Dohme plasma-derived hepatitis B vaccine (H-B-Vax), at 0, 1, and 6 months, and tested 2-3 months later for antibody to hepatitis B surface antigen (anti-HBs) by radioimmunoassay (RIA). Overall, 96.5% of the children seroconverted for anti-HBs by RIA, having levels greater than 2.1 RIA S/N units, with 91.2% having values greater than 10 S/N units. Anti-HBs levels were also determined by enzyme immunoassay (EIA), by which method a significantly better response was demonstrated in 2-4-year-olds than in older children. This study demonstrated that a satisfactory anti-HBs response was obtained using one-fifth of the recommended doses of hepatitis B vaccine.

Child↗