Hepatitis E: evidence for person-to-person transmission and inability of low dose immune serum globulin from an Indian source to prevent it

Abstract

This study was undertaken to assess the role of person-to-person transmission in hepatitis E and the ability of immune serum globulin (ISG) from an Indian source to prevent such transmission. Seventy six subjects (62 household contacts of patients with sporadic hepatitis E and 14 controls with no household contacts) were studied clinically, biochemically and serologically at entry and fortnightly thereafter for the next 8 weeks. Thirty two household contacts received 2 mL of 16.5% ISG 16.5% while the other 30 household contacts and 14 controls received 2 mL of normal saline intramuscularly at entry. Eighteen (29%) household contacts and none of the control subjects developed biochemical evidence of acute hepatitis E (p less than 0.01). The enzyme elevation occurred after a mean interval of 31.0 +/- 4.5 days from the onset of disease in the index case. This suggested that the disease in the case contacts had been contracted by household contact with the index case and not by simultaneous infection of the index case and the household contact. The incidence of disease was similar in the household contacts receiving ISG and normal saline (25% and 33.3% respectively, p = ns). ISG had no effect on the time interval to SGPT rise or on the severity of disease in household contacts.