Sten Iwarson | University of Gothenburg (original) (raw)
Papers by Sten Iwarson
Scandinavian Journal of Infectious Diseases, 1982
Scandinavian Journal of Infectious Diseases, 1990
Scandinavian Journal of Infectious Diseases, Feb 1, 1994
A decline in the incidence of notified hepatitis B cases has been observed in major parts of Euro... more A decline in the incidence of notified hepatitis B cases has been observed in major parts of Europe since the mid-1980s. Sweden may be taken as an example of a low prevalence area in the north where notifications of acute hepatitis B declined from 6 cases/100,000 inhabitants in 1985 to only 3/100,000 annually in 1988-91. Choosing W. Germany as an example from central Europe, the notification rate of acute hepatitis B declined from 11 cases/100,000 inhabitants in 1984 to 6-8/100,000 in 1988-91. In Italy, a dramatic decline in hepatitis B infections has occurred since 1985, according to the national hepatitis surveillance system (SEIEVA), from 12 cases/100,000 inhabitants in 1985 to 5/100,000 in 1988-91. A similar trend has also been observed in the USA which seems to be unrelated to vaccination, since only limited vaccination programs have been initiated in high-risk groups. Also in Europe, changed sexual and needle-usage practices in risk groups such as drug addicts and male homosexuals have probably contributed to the observed decline. In southern Europe, rapidly improving socio-economic conditions and improved medical precautions against hepatitis B have probably also been important factors.
Vaccine, 1991
Available data on the immunogenicity, safety and efficacy of Hib conjugate vaccines are encouragi... more Available data on the immunogenicity, safety and efficacy of Hib conjugate vaccines are encouraging and the prospects for having a means to control invasive Hib disease are good. Most of the third generation Hib vaccines seem to prevent invasive Hib disease at a level of efficacy that motivates worldwide mass immunization of infants. The peak incidence of Hib meningitis occurs before the age of 1 year in most industrialized countries and the most desirable time to start vaccination against Hib is at 2-3 months of age. In many countries a Hib conjugate vaccine may ideally be coordinated with the DTP immunization programme. In non-industrialized countries the peak incidence of Hib meningitis occurs earlier than in industrialized countries, which means that in these areas immunization against Hib meningitis should start earlier, for instance at 6 weeks when the first DTP vaccine injection is given in many countries.
Journal of Antimicrobial Chemotherapy, 1978
Vaccine, 1993
In western Europe there has been a striking decline in the incidence of hepatitis B virus infecti... more In western Europe there has been a striking decline in the incidence of hepatitis B virus infection during the second half of the 1980s. Only a minor part of this decrease is the effect of vaccination, since rather limited vaccination programmes have been introduced in most west European countries. The policies for recommendation of hepatitis B vaccination have differed from north to south in Europe due to different risks of exposure to hepatitis B virus. In Scandinavia, vaccination has mainly been recommended for health-care workers with frequent blood contact, while in Germany and in France vaccination has been recommended for all health-care workers with patient contact. Further south, as in Italy, all health-care workers have been considered a risk group, and vaccination is recommended for all newly recruited workers and students.
Vaccine, 1998
The Czech Republic, Denmark, Finland, Norway, the Netherlands, Slovakia, Sweden and the UK all ha... more The Czech Republic, Denmark, Finland, Norway, the Netherlands, Slovakia, Sweden and the UK all have very low HBsAg carrier rates; in the Scandinavian countries, for instance, carrier rates are on the order of 0.05%. Most countries in this group are unconvinced that the carrier rates and the burden of disease caused by new hepatitis infections warrant the expense of universal childhood immunization. In Scandinavia and the UK hepatitis B prevention programmes are based on immunization of high-risk groups. In Scandinavia (excepting Denmark), the UK and the Netherlands, pregnant women are screened and newborns of carrier mothers vaccinated. Only the Czech Republic and Slovakia Ð both of which now employ high-risk group strategies of hepatitis B prevention Ð have expressed interest in implementing programmes of universal hepatitis B vaccination of infants and/or adolescents. #
Vaccine, 1993
Data available on the immunogenicity, safety and efficacy of Haemophilus influenzae type b (Hib) ... more Data available on the immunogenicity, safety and efficacy of Haemophilus influenzae type b (Hib) conjugate vaccines are encouraging and the prospects for controlling invasive Hib disease are good. The incidence of Hib meningitis in many industrialized countries increases sharply between 6 and 12 months of age and the first two doses of a Hib vaccine should ideally be given before that. In non-industrialized countries, the incidence peak is seen very early in life, which would require a very early start for Hib vaccination in such areas.
Journal of Antimicrobial Chemotherapy, 1979
Journal of Antimicrobial Chemotherapy, 1982
... British Medical Journal i, 124-6. Charlton, CA C , Crowther, A., Davies, JG, Dines, J., Jacks... more ... British Medical Journal i, 124-6. Charlton, CA C , Crowther, A., Davies, JG, Dines, J., Jackson, GE, Mann, PG, Rye, S., Valentine, JP & White, DG (1981). ... Abstract 232. Hansen, PH, Kristensen, K. H, Lender-Eriksen, H.-A., Pagh, J. & 0stergard, JE (1981). ...
APMIS, 1995
Plasma-derived vaccines and yeast-derived recombinant vaccines against hepatitis B virus (HBV) in... more Plasma-derived vaccines and yeast-derived recombinant vaccines against hepatitis B virus (HBV) infection have gained an acceptable record of efficacy. However, non- or hyporesponsiveness to immunization does not only occur in cases of obesity, renal failure or immune suppression, but also in healthy individuals. There is therefore a rationale for developing more immunogenic vaccines against HBV, especially for those populations who are potential non- or hyporesponders. Currently used recombinant hepatitis B vaccines consist of antigen particles assembled with the product of 226 amino acids encoded in the S gene. Since proteins encoded in the pre-S gene are also incorporated in the HBV envelope, pre-S gene products should, at least in theory, be useful in improving protection with hepatitis B vaccines. Inactivated hepatitis A vaccines are more potent than currently used hepatitis B vaccines. Two injections of a standard dose of HAVRIX (SB) by the intramuscular route, or even a single injection using a higher dose (HAVRIX 1440), will achieve protective levels of antibodies. Therefore, increased potency is not essential with inactivated hepatitis A vaccines. New hepatitis A vaccines are likely to be recombinant or attenuated live types. Another aspect of the improvement of existing hepatitis A and B vaccines is unification into a combined form.
Upsala Journal of Medical Sciences, 1988
The level of 21 plasma proteins was followed in Hepatitis A for two months after onset of icterus... more The level of 21 plasma proteins was followed in Hepatitis A for two months after onset of icterus. The mean concentration of alpha 1-antitrypsin, orosomucoid, haptoglobin, C-reactive protein (CRP) and alpha 1-antichymotrypsin increased uniformely during the first week of hepatitis A. Thus, they differ from that of inoculation hepatitis earlier described. The mean curve for IgM was higher in hepatitis A than the corresponding results for inoculation hepatitis during the first week of illness, but because of great inter-individual differences in concentrations IgM determinations can not be used to discriminate between the two diseases in a given case. IgA levels were slightly increased early in hepatitis A but no change in IgG levels was observed. Prealbumin was the best mirror of the patients' recovery or deterioration.
The first plasma Factor II-VII-X value after admission to the hospital was higher than 90% in 29%... more The first plasma Factor II-VII-X value after admission to the hospital was higher than 90% in 29% of 38 common duct stone patients, in 9% of 33 patients with bile duct obstruction due to pancreatic carcinoma, and in 3 of 5 patients with cholestatic drug reaction. In contrast, the admission value was above 90% in only one of 89 patients with acute hepatitis and in none of 8 patients with a hepatocellular drug reaction. Therefore, a high plasma Factor II-VII-X activity in a patient with liver or biliary tract disease seems to be a rellained by an increased protein synthesis in the liver.
Serodiagnosis and Immunotherapy in Infectious Disease, 1987
The immune response after vaccination with a plasma-derived hepatitis B vaccine (MSD) was studied... more The immune response after vaccination with a plasma-derived hepatitis B vaccine (MSD) was studied in 32 patients with Down's syndrome during a follow-up period of 24 months. An equal number of staff members served as age-matched controls. Two vaccine dosage regimens were used, 20 or 40 ug, respectively, and these doses were given i.m. at 0, 1 and 6 months.
Scandinavian Journal of Infectious Diseases, 1982
Scandinavian Journal of Infectious Diseases, 1990
Scandinavian Journal of Infectious Diseases, Feb 1, 1994
A decline in the incidence of notified hepatitis B cases has been observed in major parts of Euro... more A decline in the incidence of notified hepatitis B cases has been observed in major parts of Europe since the mid-1980s. Sweden may be taken as an example of a low prevalence area in the north where notifications of acute hepatitis B declined from 6 cases/100,000 inhabitants in 1985 to only 3/100,000 annually in 1988-91. Choosing W. Germany as an example from central Europe, the notification rate of acute hepatitis B declined from 11 cases/100,000 inhabitants in 1984 to 6-8/100,000 in 1988-91. In Italy, a dramatic decline in hepatitis B infections has occurred since 1985, according to the national hepatitis surveillance system (SEIEVA), from 12 cases/100,000 inhabitants in 1985 to 5/100,000 in 1988-91. A similar trend has also been observed in the USA which seems to be unrelated to vaccination, since only limited vaccination programs have been initiated in high-risk groups. Also in Europe, changed sexual and needle-usage practices in risk groups such as drug addicts and male homosexuals have probably contributed to the observed decline. In southern Europe, rapidly improving socio-economic conditions and improved medical precautions against hepatitis B have probably also been important factors.
Vaccine, 1991
Available data on the immunogenicity, safety and efficacy of Hib conjugate vaccines are encouragi... more Available data on the immunogenicity, safety and efficacy of Hib conjugate vaccines are encouraging and the prospects for having a means to control invasive Hib disease are good. Most of the third generation Hib vaccines seem to prevent invasive Hib disease at a level of efficacy that motivates worldwide mass immunization of infants. The peak incidence of Hib meningitis occurs before the age of 1 year in most industrialized countries and the most desirable time to start vaccination against Hib is at 2-3 months of age. In many countries a Hib conjugate vaccine may ideally be coordinated with the DTP immunization programme. In non-industrialized countries the peak incidence of Hib meningitis occurs earlier than in industrialized countries, which means that in these areas immunization against Hib meningitis should start earlier, for instance at 6 weeks when the first DTP vaccine injection is given in many countries.
Journal of Antimicrobial Chemotherapy, 1978
Vaccine, 1993
In western Europe there has been a striking decline in the incidence of hepatitis B virus infecti... more In western Europe there has been a striking decline in the incidence of hepatitis B virus infection during the second half of the 1980s. Only a minor part of this decrease is the effect of vaccination, since rather limited vaccination programmes have been introduced in most west European countries. The policies for recommendation of hepatitis B vaccination have differed from north to south in Europe due to different risks of exposure to hepatitis B virus. In Scandinavia, vaccination has mainly been recommended for health-care workers with frequent blood contact, while in Germany and in France vaccination has been recommended for all health-care workers with patient contact. Further south, as in Italy, all health-care workers have been considered a risk group, and vaccination is recommended for all newly recruited workers and students.
Vaccine, 1998
The Czech Republic, Denmark, Finland, Norway, the Netherlands, Slovakia, Sweden and the UK all ha... more The Czech Republic, Denmark, Finland, Norway, the Netherlands, Slovakia, Sweden and the UK all have very low HBsAg carrier rates; in the Scandinavian countries, for instance, carrier rates are on the order of 0.05%. Most countries in this group are unconvinced that the carrier rates and the burden of disease caused by new hepatitis infections warrant the expense of universal childhood immunization. In Scandinavia and the UK hepatitis B prevention programmes are based on immunization of high-risk groups. In Scandinavia (excepting Denmark), the UK and the Netherlands, pregnant women are screened and newborns of carrier mothers vaccinated. Only the Czech Republic and Slovakia Ð both of which now employ high-risk group strategies of hepatitis B prevention Ð have expressed interest in implementing programmes of universal hepatitis B vaccination of infants and/or adolescents. #
Vaccine, 1993
Data available on the immunogenicity, safety and efficacy of Haemophilus influenzae type b (Hib) ... more Data available on the immunogenicity, safety and efficacy of Haemophilus influenzae type b (Hib) conjugate vaccines are encouraging and the prospects for controlling invasive Hib disease are good. The incidence of Hib meningitis in many industrialized countries increases sharply between 6 and 12 months of age and the first two doses of a Hib vaccine should ideally be given before that. In non-industrialized countries, the incidence peak is seen very early in life, which would require a very early start for Hib vaccination in such areas.
Journal of Antimicrobial Chemotherapy, 1979
Journal of Antimicrobial Chemotherapy, 1982
... British Medical Journal i, 124-6. Charlton, CA C , Crowther, A., Davies, JG, Dines, J., Jacks... more ... British Medical Journal i, 124-6. Charlton, CA C , Crowther, A., Davies, JG, Dines, J., Jackson, GE, Mann, PG, Rye, S., Valentine, JP & White, DG (1981). ... Abstract 232. Hansen, PH, Kristensen, K. H, Lender-Eriksen, H.-A., Pagh, J. & 0stergard, JE (1981). ...
APMIS, 1995
Plasma-derived vaccines and yeast-derived recombinant vaccines against hepatitis B virus (HBV) in... more Plasma-derived vaccines and yeast-derived recombinant vaccines against hepatitis B virus (HBV) infection have gained an acceptable record of efficacy. However, non- or hyporesponsiveness to immunization does not only occur in cases of obesity, renal failure or immune suppression, but also in healthy individuals. There is therefore a rationale for developing more immunogenic vaccines against HBV, especially for those populations who are potential non- or hyporesponders. Currently used recombinant hepatitis B vaccines consist of antigen particles assembled with the product of 226 amino acids encoded in the S gene. Since proteins encoded in the pre-S gene are also incorporated in the HBV envelope, pre-S gene products should, at least in theory, be useful in improving protection with hepatitis B vaccines. Inactivated hepatitis A vaccines are more potent than currently used hepatitis B vaccines. Two injections of a standard dose of HAVRIX (SB) by the intramuscular route, or even a single injection using a higher dose (HAVRIX 1440), will achieve protective levels of antibodies. Therefore, increased potency is not essential with inactivated hepatitis A vaccines. New hepatitis A vaccines are likely to be recombinant or attenuated live types. Another aspect of the improvement of existing hepatitis A and B vaccines is unification into a combined form.
Upsala Journal of Medical Sciences, 1988
The level of 21 plasma proteins was followed in Hepatitis A for two months after onset of icterus... more The level of 21 plasma proteins was followed in Hepatitis A for two months after onset of icterus. The mean concentration of alpha 1-antitrypsin, orosomucoid, haptoglobin, C-reactive protein (CRP) and alpha 1-antichymotrypsin increased uniformely during the first week of hepatitis A. Thus, they differ from that of inoculation hepatitis earlier described. The mean curve for IgM was higher in hepatitis A than the corresponding results for inoculation hepatitis during the first week of illness, but because of great inter-individual differences in concentrations IgM determinations can not be used to discriminate between the two diseases in a given case. IgA levels were slightly increased early in hepatitis A but no change in IgG levels was observed. Prealbumin was the best mirror of the patients' recovery or deterioration.
The first plasma Factor II-VII-X value after admission to the hospital was higher than 90% in 29%... more The first plasma Factor II-VII-X value after admission to the hospital was higher than 90% in 29% of 38 common duct stone patients, in 9% of 33 patients with bile duct obstruction due to pancreatic carcinoma, and in 3 of 5 patients with cholestatic drug reaction. In contrast, the admission value was above 90% in only one of 89 patients with acute hepatitis and in none of 8 patients with a hepatocellular drug reaction. Therefore, a high plasma Factor II-VII-X activity in a patient with liver or biliary tract disease seems to be a rellained by an increased protein synthesis in the liver.
Serodiagnosis and Immunotherapy in Infectious Disease, 1987
The immune response after vaccination with a plasma-derived hepatitis B vaccine (MSD) was studied... more The immune response after vaccination with a plasma-derived hepatitis B vaccine (MSD) was studied in 32 patients with Down's syndrome during a follow-up period of 24 months. An equal number of staff members served as age-matched controls. Two vaccine dosage regimens were used, 20 or 40 ug, respectively, and these doses were given i.m. at 0, 1 and 6 months.