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DOSIS DE REFUERZO Y MONITORIZACION SEROLOGICA TRAS LA VACUNACION DE LA HEPATITIS B
(especial para SIIC © Derechos reservados)
En individuos inmunocompetentes no parece necesario el control serológico para aplicar dosis de refuerzo de la vacunación de la hepatitis B, al menos en los primeros 5-10 años. El seguimiento posvacunación sólo es necesario en inmunodeprimidos y en pacientes con hepatitis crónica por virus C.
Autor:
José Ramón Pallás Álvarez
Columnista Experto de SIIC
Artículos publicados por José Ramón Pallás Álvarez
Coautor
Javier Llorca Díaz* 
Profesor Titular del Area de Medicina Preventiva y Salud Pública. Facultad de Medicina. Universidad de Cantabria*
Recepción del artículo
23 de Mayo, 2002
Primera edición
20 de Junio, 2002
Segunda edición, ampliada y corregida
23 de Julio, 2003

Resumen
La vacunación estándar (con 3 o 4 dosis) de la hepatitis B es efectiva en individuos inmunocompetentes, ya que permite en la gran mayoría de los casos un título de antiHBs protector ( >10 UI/l). Sin embargo, existen diversos grupos de riesgo en los que las tasas de seroconversión son menores (fundamentalmente en inmunodeprimidos). Pautas de vacunación con el doble de dosis y la administración intradérmica de la vacuna recombinante se han postulado como alternativas para asegurar una seroprotección vacunal. En todo caso, parece necesario realizar un seguimiento serológico posvacunación en grupos de riesgo, donde la dosis de refuerzo está indicada y generalmente es efectiva. Así, en los pacientes en hemodiálisis, HIV positivos y hepatitis crónica por virus C existen intentos de protocolización de la dosis de refuerzo, debido al alto riesgo de infección por HBV. No obstante, hacen falta estudios adicionales ya que no existe consenso unánime sobre el momento y la periodicidad para utilizarla.

Palabras clave
Vacuna de hepatitis B, hepatitis B/serología, hepatitis B/inmunología


Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página  www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Epidemiología
  Relacionadas: GastroenterologíaInfectologíaSalud Pública


Artículo completo

(castellano)
Extensión:  +/-4.32 páginas impresas en papel A4
Exclusivo para suscriptores/assinantes

Abstract
The standard hepatitis B vaccination (with 3 or 4 doses) is effective among immune-competent subjects, since elicit protective anti-HBs levels (above 10 UI/l) in most people. Nevertheless, there are various high-risk groups whose seroconvertion status is lower (especially to subjects with immunodeficiency). Schedule vaccination with double doses and intradermal administration of recombinant hepatitis B vaccine has been postulate as alternatives to make sure seroprotective vaccination. In any case, postvaccination antibody testing seems necessary among high-risk groups, in which the booster dose has been recommended and is generally effective. Like this, in patients receiving hemodialysis, anti-HIV-1 seropositives, and chronic hepatitis C there are purposes of planning booster doses, due to high risk to HBV infection. Additional studies are necessary and unanimous consensus does not exist about to the appropriate timing and periodicity for administration.

Key words
Hepatitis B vaccine, hepatitis B/serology, hepatitis B/immunology

Bibliografía del artículo
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