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Factors influencing postexposure immunoprophylaxis of hepatitis b virus infection with hepatitis b immune globulin high dna polymerase activity in the inocula of unsuccessful cases


, : Factors influencing postexposure immunoprophylaxis of hepatitis b virus infection with hepatitis b immune globulin high dna polymerase activity in the inocula of unsuccessful cases. Gastroenterology 88(1 PART 1): 151-155

Hepatitis B immune globulin was given i.m. to 102 staff members of a dialysis unit within 48 h after the accidental needlestick exposure to blood containing hepatitis B surface antigen (HBsAg). Hepatitis B virus (HBV) infection developed in 11 of 56 persons (20%) who had been exposed to blood containing hepatitis B e antigen (HBeAg). Among 56 HBeAg-positive inocula, HBsAg-associated DNA polymerase activity in the 11 inocula that transmitted HBV infection was significantly higher than that in the remaining 45 inocula that did not (log counts/min 3.27 .+-. 0.57 vs. 2.09 .+-. 1.19, P < 0.001). These 11 HBeAg-positive inocula revealed higher hemagglutination titers of HBsAg (geometric mean 13.5 .+-. 1.4 vs. 11.2 .+-. 3.2, P < 0.001). The receptor for polymerized human serum albumin was detected significantly more often in the inocula that transmitted HBV infection than those that did not (10/11 vs. 24/45, P < 0.05). Based on the results obtained, the failure in protecting all of those exposed to HBeAg-positive blood would be attributable to a high concentration of HBV in some HBeAg-positive inocula and the inability of i.m. injection to raise a protective level of antibody in the circulation immediately.

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