G. Mena

Bio: G. Mena is an academic researcher. The author has contributed to research in topics: Viral load & Vaccination. The author has an hindex of 2, co-authored 2 publications receiving 56 citations.

Hepatitis B and A vaccination in HIV-infected adults: A review

Abstract: Hepatitis B and A account for considerable morbidity and mortality worldwide. Immunization is the most effective means of preventing hepatitis B and A. However, the immune response to both hepatitis vaccines seems to be reduced in HIV-infected subjects. The aim of this review was to analyze the immunogenicity, safety, long-term protection and current recommendations of hepatitis B and A vaccination among HIV-infected adults. The factors most frequently associated with a deficient level of anti-HBs or IgG anti-HAV after vaccination are those related to immunosuppression (CD4 level and HIV RNA viral load) and to the frequency of administration and/or the amount of antigenic load per dose. The duration of the response to both HBV and HAV vaccines is associated with suppression of the viral load at vaccination and, in the case of HBV vaccination, with a higher level of antibodies after vaccination. In terms of safety, there is no evidence of more, or different, adverse effects compared with HIV-free individuals. Despite literature-based advice on the administration of alternative schedules, revaccination after the failure of primary vaccination, and the need for periodic re-evaluation of antibody levels, few firm recommendations are found in the leading guidelines.

Primary Care Guidance for Persons With Human Immunodeficiency Virus: 2020 Update by the HIV Medicine Association of the Infectious Diseases Society of America.

Abstract: Advances in antiretroviral therapy (ART) have made it possible for persons with human immunodeficiency virus (HIV) to live a near expected life span, without progressing to AIDS or transmitting HIV to sexual partners or infants. There is, therefore, increasing emphasis on maintaining health throughout the life span. To receive optimal medical care and achieve desired outcomes, persons with HIV must be consistently engaged in care and able to access uninterrupted treatment, including ART. Comprehensive evidence-based HIV primary care guidance is, therefore, more important than ever. Creating a patient-centered, stigma-free care environment is essential for care engagement. Barriers to care must be decreased at the societal, health system, clinic, and individual levels. As the population ages and noncommunicable diseases arise, providing comprehensive healthcare for persons with HIV becomes increasingly complex, including management of multiple comorbidities and the associated challenges of polypharmacy, while not neglecting HIV-related health concerns. Clinicians must address issues specific to persons of childbearing potential, including care during preconception and pregnancy, and to children, adolescents, and transgender and gender-diverse individuals. This guidance from an expert panel of the HIV Medicine Association of the Infectious Diseases Society of America updates previous 2013 primary care guidelines.

Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020.

Abstract: HEPATITIS A IS A VACCINE-PREVENTABLE, COMMUNICABLE DISEASE OF THE LIVER CAUSED BY THE HEPATITIS A VIRUS (HAV). THE INFECTION IS TRANSMITTED VIA THE FECAL-ORAL ROUTE, USUALLY FROM DIRECT PERSON-TO-PERSON CONTACT OR CONSUMPTION OF CONTAMINATED FOOD OR WATER. HEPATITIS A IS AN ACUTE, SELF-LIMITED DISEASE THAT DOES NOT RESULT IN CHRONIC INFECTION. HAV ANTIBODIES (IMMUNOGLOBULIN G [IGG] ANTI-HAV) PRODUCED IN RESPONSE TO HAV INFECTION PERSIST FOR LIFE AND PROTECT AGAINST REINFECTION; IGG ANTI-HAV PRODUCED AFTER VACCINATION CONFER LONG-TERM IMMUNITY. THIS REPORT SUPPLANTS AND SUMMARIZES PREVIOUSLY PUBLISHED RECOMMENDATIONS FROM THE ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES (ACIP) REGARDING THE PREVENTION OF HAV INFECTION IN THE UNITED STATES. ACIP RECOMMENDS ROUTINE VACCINATION OF CHILDREN AGED 12-23 MONTHS AND CATCH-UP VACCINATION FOR CHILDREN AND ADOLESCENTS AGED 2-18 YEARS WHO HAVE NOT PREVIOUSLY RECEIVED HEPATITIS A (HEPA) VACCINE AT ANY AGE. ACIP RECOMMENDS HEPA VACCINATION FOR ADULTS AT RISK FOR HAV INFECTION OR SEVERE DISEASE FROM HAV INFECTION AND FOR ADULTS REQUESTING PROTECTION AGAINST HAV WITHOUT ACKNOWLEDGMENT OF A RISK FACTOR. THESE RECOMMENDATIONS ALSO PROVIDE GUIDANCE FOR VACCINATION BEFORE TRAVEL, FOR POSTEXPOSURE PROPHYLAXIS, IN SETTINGS PROVIDING SERVICES TO ADULTS, AND DURING OUTBREAKS.

Hepatitis A virus infection and hepatitis A vaccination in human immunodeficiency virus-positive patients: A review.

Abstract: Hepatitis A virus (HAV) is one of the most common infectious etiologies of acute hepatitis worldwide. The virus is known to be transmitted fecal-orally, resulting in symptoms ranging from asymptomatic infection to fulminant hepatitis. HAV can also be transmitted through oral-anal sex. Residents from regions of low endemicity for HAV infection often remain susceptible in their adulthood. Therefore, clustered HAV infections or outbreaks of acute hepatitis A among men who have sex with men and injecting drug users have been reported in countries of low endemicity for HAV infection. The duration of HAV viremia and stool shedding of HAV may be longer in human immunodeficiency virus (HIV)-positive individuals compared to HIV-negative individuals with acute hepatitis A. Current guidelines recommend HAV vaccination for individuals with increased risks of exposure to HAV (such as from injecting drug use, oral-anal sex, travel to or residence in endemic areas, frequent clotting factor or blood transfusions) or with increased risks of fulminant disease (such as those with chronic hepatitis). The seroconversion rates following the recommended standard adult dosing schedule (2 doses of HAVRIX 1440 U or VAQTA 50 U administered 6-12 mo apart) are lower among HIV-positive individuals compared to HIV-negative individuals. While the response rates may be augmented by adding a booster dose at week 4 sandwiched between the first dose and the 6-mo dose, the need of booster vaccination remain less clear among HIV-positive individuals who have lost anti-HAV antibodies.

Impfen bei Immundefizienz

Abstract: Auf Initiative der Ständigen Impfkommission (STIKO) hat eine Arbeitsgruppe aus ExpertInnen der zuständigen Fachgesellschaften, MitarbeiterInnen des Robert Koch-Instituts und STIKOMitgliedern die hier vorliegenden Anwendungshinweise für das Impfen bei hämatologischen und onkologischen Erkrankungen, Stammzelltransplantation, Organtransplantation und Asplenie erarbeitet. Das methodische Vorgehen wurde im Grundlagenpapier „Impfen bei Immundefizienz“ beschrieben (siehe https://link.springer.com/content/ pdf/10.1007%2Fs00103-017-2555-4.pdf). Diese Anwendungshinweise sind keine STIKO-Empfehlungen nach § 20 Abs. 2 IfSG und haben damit keine leistungsrechtlichen Implikationen. Sie sollen als Hilfestellung für ÄrztInnen zu Impfungen bei PatientInnen mit hämatologischen und onkologischen Erkrankungen (antineoplastische Therapie, Stammzelltransplantation), Organtransplantation und Asplenie dienen. Dabei sind die Fachinformationen der Impfstoffe und immunmodulatorischen Arzneistoffe zu beachten. Insbesondere die Anwendungshinweise zur Verabreichung von Lebendimpfstoffen entbinden Impfende nicht von der Pflicht einer genauen ärztlichen Prüfung des Einzelfalls unter Berücksichtigung impfstoff-, PatientInnenund arzneimittelspezifischer Faktoren und einer entsprechenden Aufklärung von PatientInnen bzw. Sorgeberechtigten sowie einer Dokumentation im Falle eines Off-LabelGebrauchs [327]. In den jeweiligen Abschnitten wird auf bestehende Empfehlungen der STIKO Bezug genommen. Anwendungshinweise, die von den aktuell gültigen Empfehlungen der STIKO (Epidemiologisches Bulletin 34/2019) abweichen, sind im folgenden Dokument dunkelrot gekennzeichnet. Die STIKO prüft aktuell, ob ihre Empfehlungen nach § 20 Abs. 2 IfSG u. a. auf Grundlage der Anwendungshinweise entsprechend angepasst bzw. erweitert Hans-Jürgen Laws · Ulrich Baumann · Christian Bogdan 4 · Gerd Burchard 5 · Maximilian Christopeit · Jane Hecht · Ulrich Heininger 8 · Inken Hilgendorf · Winfried Kern · Kerstin Kling · Guido Kobbe · Wiebe Külper · Thomas Lehrnbecher · Roland Meisel · Arne Simon · Andrew Ullmann · Maike de Wit 17 · Fred Zepp 18 Klinik für Kinder-Onkologie, -Hämatologie und Klinische Immunologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland; Klinik für Pädiatrische Pneumologie, Allergologie und Neonatologie, Medizinische Hochschule Hannover, Hannover, Deutschland; Mikrobiologisches Institut – Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander Universität FAU ErlangenNürnberg, Erlangen, Deutschland; Ständige Impfkommission (STIKO), Robert Koch-Institut, Berlin, Deutschland; Bernhard-Nocht-Institut für Tropenmedizin, Hamburg, Deutschland; Interdisziplinäre Klinik für Stammzelltransplantation, Universitätsklinikum Eppendorf, Hamburg, Deutschland; Abteilung für Infektionsepidemiologie, Fachgebiet Nosokomiale Infektionen, Surveillance von Antibiotikaresistenz und -verbrauch, Robert Koch-Institut, Berlin, Deutschland; Universitäts-Kinderspital beider Basel, Basel, Schweiz; Klinik für Innere Medizin II, Abteilung für Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Jena, Deutschland; Klinik für Innere Medizin II, Abteilung Infektiologie, Universitätsklinikum Freiburg, Freiburg, Deutschland; Abteilung für Infektionsepidemiologie, Fachgebiet Impfprävention, Robert Koch-Institut, Berlin, Deutschland; Klinik für Hämatologie, Onkologie und Klinische Immunologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland; Klinik für Kinderund Jugendmedizin, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland; Klinik für Pädiatrische Onkologie und Hämatologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland; Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Deutschland; Klinik für Innere Medizin – Hämatologie, Onkologie und Palliativmedizin, Vivantes Klinikum Neukölln, Berlin, Deutschland; Klinik für Innere Medizin – Onkologie, Vivantes Auguste-Viktoria-Klinikum, Berlin, Deutschland; Zentrum für Kinderund Jugendmedizin, Universitätsmedizin Mainz, Mainz, Deutschland

Recommended immunization schedules for adults: Clinical practice guidelines by the Escmid Vaccine Study Group (EVASG), European Geriatric Medicine Society (EUGMS) and the World Association for Infectious Diseases and Immunological Disorders (WAidid).

Abstract: Rapid population aging has become a major challenge in the industrialized world and progressive aging is a key reason for making improvement in vaccination a cornerstone of public health strategy. An increase in age-related disorders and conditions is likely to be seen in the near future, and these are risk factors for the occurrence of a number of vaccine-preventable diseases. An improvement in infectious diseases prevention specifically aimed at adults and the elderly can therefore also decrease the burden of these chronic conditions by reducing morbidity, disability, hospital admissions, health costs, mortality rates and, perhaps most importantly, by improving the quality of life. Among adults, it is necessary to identify groups at increased risk of vaccine-preventable diseases and highlight the epidemiological impact and benefits of vaccinations using an evidence-based approach. This document provides clinical practice guidance on immunization for adults in order to provide recommendations for...