Pre-exposure prophylaxis of viral hepatitis with immune serum globulin in an endemic area. A trial in field units of the Israel Defence Forces

Scandinavian Journal of Infectious Diseases
J D Kark

Abstract

Field units in the Israel Defence Forces represent a high risk group for type A infectious hepatitis. Very large scale post-exposure prophylaxis with immune serum globulin (ISG) has been successfully employed for the past decade with a reduction in incidence and an elimination of overt epidemic cycles. The use of pre-exposure prophylaxis in an indigenous population in whom approximately 70% have antibody to HAV at age 18 was compared in a field trial with the routine post-exposure method. Units were randomized into an intervention group (A) in which all subjects were to receive ISG (79% were in fact immunized), a second group (B) in which 50% of subjects were to be immunized (36% were actually immunized) and a non-immunized control group (C). During the trial incidence rates in the non-immunized study population dropped well below predicted levels. The incidence rates were zero in group A, 1.31/1000 in group B (0.61/1000 among the immunized and 1.72/1000 among the non-immunized) and 2.49/1000 in group C over the 6-month follow-up. Pre-exposure ISG afforded excellent protection and even at the low rate of incidence was cost-effective. The possibility of herd immunity is discussed.

References

Jan 1, 1976·Scandinavian Journal of Infectious Diseases·S Iwarson, K Stenqvist
Aug 1, 1978·American Journal of Epidemiology·J Cornfield
Jan 1, 1981·Journal of Medical Virology·J D Kark, S Bar-Shani

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Citations

Jan 14, 2005·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·E BiancoT Jefferson
Nov 1, 1987·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·H Matzkin
Jun 1, 1992·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·S FujiyamaT Sato
Apr 17, 2009·The Cochrane Database of Systematic Reviews·Jian Ping LiuYutong Fei
May 10, 2017·Expert Review of Anti-infective Therapy·Jordi Bozzo, Juan I Jorquera
Mar 29, 2000·Archives of Environmental Health·M LevinY Lerman

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