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Gepubliceerd in: Bijblijven 8/2005

01-08-2005 | Artikel

Reizigersvaccinatie tegen virale hepatitis

Auteurs: Prof. Dr. P. van Damme, Dr. K. van Herck, Dr. M. van der Wielen, Dr. H. Theeten, Prof. Dr. P. Michielsen

Gepubliceerd in: Bijblijven | Uitgave 8/2005

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Samenvatting

In deze bijdrage worden drie vaccins tegen virale hepatitis behandeld die voor reizigers van belang zijn: het hepatitis-A-vaccin, het hepatitis-B-vaccin en het gecombineerde hepatitis-A+B-vaccin.
Sinds 1992 beschikt men in België en Nederland over hepatitis-A-vaccins. Het preventiebeleid in beide landen bestaat uit de vaccinatie van een aantal risicogroepen. Dit vaccin wordt sterk aanbevolen voor elke reiziger naar landen waar hepatitis A endemisch is. Na een eerste dosis hepatitis-A-vaccin ontwikkelt men binnen twee weken beschermende antistoffen, wat belangrijk is voor wie kort voor vertrek nog ingeënt moet worden. Men schat dat de antistoffen na een volledige hepatitis-A-vaccinatie meer dan 25 jaar aanwezig blijven en dat de bescherming levenslang aanhoudt. Simultane toediening van andere vaccins doet de doeltreffendheid of veiligheid van het hepatitis-A-vaccin niet afnemen.
Recombinante hepatitis-B-vaccins zijn in België en Nederland sinds 1986 op de markt. Wie een volledige vaccinatie heeft gekregen en immunocompetent is, behoeft geen herhalingsvaccin. Zuigelingen, kinderen en adolescenten worden als immunocompetent beschouwd voor de hepatitis-B-vaccins, voor volwassenen wordt één tot drie maanden na de volledige basisvaccinatie een serologische controle op anti-hbs-antistoffen aanbevolen, want niet alle volwassenen kunnen als immunocompetent beschouwd worden. Men gaat ervan uit dat de gevaccineerde bij een anti-hbs-concentratie van 10 mIE/ml of meer levenslang beschermd is tegen klinische hepatitis B en dragerschap. In België wordt vaccinatie van een aantal risicogroepen aanbevolen en is men in 1999 gestart met de systematische vaccinatie van alle zuigelingen en adolescenten van 11 en 12 jaar. Ook in Nederland wordt hepatitis-B-vaccinatie aanbevolen voor een aantal risicogroepen. Een systematische hepatitis-B-vaccinatie van kinderen bestaat niet in Nederland. Wel worden kinderen gratis ingeënt die in of na 2003 geboren zijn en van wie één van de ouders geboren is in een hoog-risicoland voor hepatitis B.
Het gecombineerde vaccin tegen hepatitis A en B combineert zowel de werkzaamheid als het veiligheidsprofiel van de beide andere vaccins.vaccinatie reizigers preventie
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Metagegevens
Titel
Reizigersvaccinatie tegen virale hepatitis
Auteurs
Prof. Dr. P. van Damme
Dr. K. van Herck
Dr. M. van der Wielen
Dr. H. Theeten
Prof. Dr. P. Michielsen
Publicatiedatum
01-08-2005
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Bijblijven / Uitgave 8/2005
Print ISSN: 0168-9428
Elektronisch ISSN: 1876-4916
DOI
https://doi.org/10.1007/BF03059877

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