Twinrix® | Shim Clinic, STD CLINIC SINGAPORE™

Twinrix® | Shim Clinic, STD CLINIC SINGAPORE™: Combined hepatitis A & B vaccine jab/shot/injection, to vaccinate against hepatitis A & B viruses, to immunise against hepatitis A and B clinic, Singapore. Private and confidential service. Definitions, references, and latest news.

Description

Contents

• Hepatitis B
• Hepatitis Vaccine
• Hepatitis A Vaccine
• Hepatitis B Vaccine
• Twinrix® Vaccine

Vaccine	Against	Disease	Age	D o s e s	Dose schedule	Price per dose (SG$)
Havrix™ 1440 Adult Hepatitis A vaccine	Hepatitis A virus	Hepatitis A	≥19y	2	m 0 & 6-12	$90/=
Engerix™-B 20 μg Hepatitis B vaccine	Hepatitis B virus	Hepatitis B	11-15y	2	m 0, & 6	$50/=
			≥20y	3	m 0, 1, & 6
				4	m 0, 1, 2, & 12 or d 0, 7, 21 & m 12
Twinrix®	Hepatitis A virus Hepatitis B virus	Hepatitis A Hepatitis B	1-15y	2	m 0, 6-12	$120/=
			≥16y	3	m 0, 1, 6
				4	d 0, 7, 21 & m 12
Gardasil® - HPV vaccine	HPV types 6, 11, 16 and 18	Genital warts Cervical cancer	9-26y	3	m 0, 2, & 6 or m 0, 1, & 4	$195/=
Cervarix® - HPV vaccine	HPV types 16 and 18 (31, 33, and 45)	Genital warts Cervical cancer	10-25y	3	m 0, 1, & 6 m 0, 1, & 5 m 0, 2½, 12	$195/=
V503 - HPV vaccine	HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58	Genital warts Cervical cancer		3	m 0, 2, & 6 or m 0, 1, & 4	$???/=

Hepatitis Vaccine Schedule

Hepatitis B infection is caused by the Hepatitis B virus and is usually screened for by detecting HBsAg in the blood. Immunity may be discerned by detecting HBsAb, and if absent, the Hepatitis B vaccine or Twinrix® vaccine may be given.

• The hepatitis B virus is 100 times more infectious than HIV, the virus that causes AIDS, and infects about 10 times more people than HIV worldwide.
• Hepatitis B virus infects the liver, and more than 350 million people in the world are lifelong hepatitis B virus carriers.
• Long-term hepatitis B virus infection causes at least one million premature deaths every year from cirrhosis of the liver or liver cancer. It is second only to tobacco as the leading cause of cancer in humans.
• Among the Hepatitis B carriers, 25% will develop serious liver diseases, including chronic hepatitis, cirrhosis, and hepatocellular carcinoma.
• The hepatitis B virus can be passed from an infected mother to her baby during childbirth, 1 in 20 Singaporeans are chronically infected with hepatitis B virus.

Treatment

• Nucleoside analog reverse transcriptase inhibitors
  • Lamivudine (Epivir) - 40% resistance by 2 years. Also used to treat HIV
  • Telbivudine (Tyzeka)
  • Entecavir (Baraclude)
• Nucleotide analog reverse transcriptase inhibitors
  • Adefovir (Hepsera)
  • Tenofovir (Viread) - Also used to treat HIV

TORCH

References

• Twinrix - Wikipedia, the free encyclopedia
• Twinrix: Definition from Answers.com
• Twinrix - definition of Twinrix in the Medical dictionary - by the Free Online Medical Dictionary, Thesaurus and Encyclopedia.

Interferons and hepatitis C virus.
Tue, 15 May 2012 19:06:02 +0100 | Swiss Medical Weekly
Authors: Heim M Abstract Interferons are not only the first line of defence against viral infections such as hepatitis C virus infections, but they also have important roles during the chronic phase of viral infections. For over 20 years now, recombinant interferon alpha has been used for the treatment of chronic hepatitis C. The molecular mechanisms responsible for non-response to interferon are still not completely understood, but systematic analysis of liver biopsies revealed that the spontaneous activation of the endogenous interferon system in the liver of patients with chronic hepatitis C prevented response to interferon-based therapies. Moreover, recent genomewide association studies found a highly significant and strong association between genetic variants near the IFNλ3 g...

Many cancers caused by 'treatable infections'
Wed, 09 May 2012 16:30:00 +0100 | NHS News Feed
Conclusion This important study highlights the potential role played by certain infections in causing cancer. It uses the highest quality available evidence to calculate the proportion of cancer caused by infectious agents, worldwide and by region. However, as the authors point out, their calculations may be imprecise. For example, many countries have very sparse data on cancer incidence and the prevalence of risk factors for specific cancers. To obtain global estimates researchers had to extrapolate data from other areas. They also say they had to make certain assumptions, for example, that the risk of infection was constant across populations and sexes. They also point out that there was a lack of high quality data from some of the research sites in the studies. In the UK, a vaccine agai...

One in six cancers 'caused by treatable infections'
Wed, 09 May 2012 06:53:39 +0100 | Guardian Unlimited Science
Bacteria, viruses and parasites responsible for 2m cases of cancer each year, according to scientistsBacteria, viruses and parasites cause around 2m cases of cancer in the world each year, experts believe.Of the 7.5m global deaths from cancer in 2008, an estimated 1.5m may have been due to potentially preventable or treatable infections.Scientists carried out a statistical analysis of cancer incidence to calculate that around 16% of all cancers diagnosed in 2008 were infection-related. The proportion of cancers linked to infection was three times higher in developing countries than in developed ones.Key cancer-causing infectious agents include human papillomavirus (HPV), the gastric bug Helicobacter pylori and the hepatitis B (HBV) and C viruses.These four were together believed to be resp...

Underinsurance for Recently Recommended Vaccines in Private Health Plans
Sat, 05 May 2012 06:03:10 +0100 | Journal of Community Health
Abstract  Underinsurance for vaccines presents financial barriers to vaccination. Preventive services coverage is of interest in national healthcare reform. To assess vaccine benefits coverage in private health plans. Private health insurance carriers were surveyed December 2008–June 2009 on policies regarding vaccine coverage in fully insured plans. Carriers were identified as multi-state, state-specific Blue Cross or local-independent carriers. Plan types included HMO, PPO, POS and ‘other.’ Full benefits coverage was defined as having benefits without a copay or coinsurance for a recommended vaccine. Analyses were conducted to examine associations between carrier type, plan type, and full benefits coverage. Fifty-one carriers (response rate = 56 %) pro...

New Projects Dispel Myths and Spread the Truth About Vaccines
Fri, 04 May 2012 13:40:40 +0100 | IPS Inter Press Service - Health
In northern Pakistan, one in ten children dies before the age of five from diseases such as polio, measles or hepatitis, despite the availability of vaccines. And while health workers feared visiting this region, which includes the mountainous Swat district controlled by the Taliban until 2009, local people also fear the potentially life-saving vaccines. (Source: IPS Inter Press Service - Health)

Robust HCV 2a (J6cc) and 2b (J8cc) culture systems [Medical Sciences]
Tue, 01 May 2012 04:00:00 +0100 | Proceedings of the National Academy of Sciences
Hepatitis C virus (HCV) infection is a leading cause of chronic liver diseases worldwide, but treatment options are limited. Basic HCV research required for vaccine and drug development has been hampered by inability to culture patient isolates, and to date only the JFH1 (genotype 2a) recombinant replicates spontaneously in hepatoma cells and releases infectious virus. A JFH1 chimera with the 5′ end through NS2 from another genotype 2a strain, J6, had enhanced infectivity. However, the full-length J6 clone (J6CF), which we previously found to be fully functional in vivo, was replication incompetent in vitro. Through a systematic approach of culturing J6 with minimal JFH1 sequences, we identified three mutations in NS3, NS4A, and NS5B that permitted full-length J6 propagation and adaptati...

Occurrence of vaccine and non‐vaccine human papillomavirus types in adolescent Finnish females 4 years post‐vaccination
Mon, 30 Apr 2012 04:00:00 +0100 | International Journal of Cancer
AbstractControl of human papillomavirus (HPV)‐related cancers by inclusion of HPV vaccination into national vaccination programmes is likely. One open question is replacement of the vaccine types with other high‐risk (hr) HPV types in the vaccination era. We studied occurrence of HPV types in adolescent females participating in a population‐based vaccination trial. A total of 4,808 16‐ to 17‐year‐old females from Finland were enrolled in the 1:1 randomized phase III (PATRICIA) trial of the efficacy of vaccination with the AS04‐adjuvanted HPV‐16/18 virus‐like particle vaccine as compared to hepatitis A virus (HAV) vaccine. HPV infection was assessed from cervical samples taken every 6 months for 4 years post‐vaccination by polymerase chain reaction (PCR) for genital onco...

Tenofovir Disoproxil Fumarate for Prevention of Vertical Transmission of Hepatitis B Virus Infection by Highly Viremic Pregnant Women: A Case Series
Sun, 29 Apr 2012 05:56:44 +0100 | Digestive Diseases and Sciences
Conclusion  Our preliminary data suggest that TDF use in the third trimester is safe, and effectively prevents VT of HBV from high viremic HBeAg-positive mothers. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s10620-012-2187-3Authors Calvin Q. Pan, Division of Liver Diseases, Department of Medicine, Mount Sinai Medical Center, Mount Sinai School of Medicine, New York, NY, USALi-Jun Mi, Department of Internal Medicine, New York Downtown Hospital, New York, NY, USAChalermrat Bunchorntavakul, Division of Gastroenterology and Hepatology, Department of Medicine, University of Pennsylvania, 2 Dulles, 3400 Spruce Street, Philadelphia, PA 19104, USAJeffrey Karsdon, Division of Neonatology, Department of Pediatrics, New York Downtown Hospital, New Y...

Immunization and Bell's Palsy in Children: A Case-Centered Analysis
Sun, 29 Apr 2012 04:00:00 +0100 | American Journal of Epidemiology
Bell’s palsy (BP) is an acute and idiopathic paralysis of the facial nerve, with an estimated incidence ranging from 11.5 per 100,000 person-years to 53.3 per 100,000 person-years in different populations. BP has been reported following immunization with inactivated trivalent influenza vaccine (TIV) and hepatitis B virus (HBV) vaccine. Epidemiologic studies examining this association among children are lacking. From 2001 through 2006, all children aged ≤18 years diagnosed with BP within the Kaiser Permanente Northern California population were identified using International Classification of Diseases, Ninth Revision, code 351.0. All electronically identified cases were reviewed and adjudicated by an otolaryngologist (n = 233). Using a case-centered approach, the authors examined t...

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