Systemic immunosuppressive therapy (IS) renders patients with inflammatory bowel disease (IBD) vulnerable to fulminant hepatitis B virus (HBV) infection. Seroprotection against HBV through a full... Show moreSystemic immunosuppressive therapy (IS) renders patients with inflammatory bowel disease (IBD) vulnerable to fulminant hepatitis B virus (HBV) infection. Seroprotection against HBV through a full vaccination scheme is preferably obtained before IS is initiated, but often conflicts with the clinical need to initiate therapy rapidly. Consequently, the vast majority of patients will use IS during booster vaccinations. In this retrospective cohort study, we examined the serological response after a modified vaccination schedule which includes an initial double dose of Fendrix in patients with IBD and compared the results with the serological responses of patients with IBD who received the standard schedule. Seroprotection rates were 86.2 % and 88.9 % in the modified and standard schedule groups respectively. One-third of patients obtained seroprotection after only one double dose vaccine. A double dose may be considered in patients with IBD at high short-term risk of HBV infection when a rapid protective response is warranted. (c) 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/). Show less
Hamdiui, N.; Stein, M.L.; Timen, A.; Timmermans, D.; Wong, A.; Muijsenbergh, M.E.T.C. van den; Steenbergen, J.E. van 2018
In an epoch where every generation travels more frequently and at longer distances than the previous generation, with a mean increase of 30 million travellers per year from 1995 until today,... Show moreIn an epoch where every generation travels more frequently and at longer distances than the previous generation, with a mean increase of 30 million travellers per year from 1995 until today, physicians throughout the world are confronted with new diseases. In absolute numbers, this implies that each year, roughly 4 million travellers appeal to specialised health care, either abroad or at home, because of systemic febrile illness, diarrhoea or dermatologic disorders. During the last decades, travel medicine has evolved into a distinct discipline of Infectious Diseases, eventhough transmission of infectious agents into vulnerable populations through travel has been well know for centuries. Improvement of of protection against travel-related diseases can be achieved through knowledge on the following topics; 1. Epidemiology of travel-related diseases, 2. Morbidity and mortality of these illnesses in specific groups of travellers, 3. Adherence to travel health precautions, 4. Responsivity against vaccination, and 5. Availability of preventive measures, such as vaccines. The research described in this thesis addresses these various topics. Show less
