JAC Advance Access originally published online on September 23, 2005
Journal of Antimicrobial Chemotherapy 2005 56(5):919-922; doi:10.1093/jac/dki346
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Experience of using convalescent plasma for severe acute respiratory syndrome among healthcare workers in a Taiwan hospital
1 Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Cheng-Kung Road, Sec. 2, Neihu, Taipei, 114, Taiwan; 2 Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; 3 Division of Clinical Research, National Health Research Institutes, Taipei, Taiwan; 4 Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; 5 Biochip R & D Center, School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; 6 Division of Infectious Diseases, Taipei Municipal Hoping Hospital, Taipei, Taiwan
Received 23 June 2005; returned 25 August 2005; revised 30 August 2005; accepted 31 August 2005
* Corresponding author. Tel: +866-2-8792-7257; Fax: +866-2-8792-7258; E-mail: fychang{at}mail.ndmctsgh.edu.tw
Objectives: To describe the immunological responses and clinical outcome of coronavirus (SARS) infected healthcare workers (HCW) who had been administered with convalescent plasma as a treatment.
Methods: Convalescent plasma (500 mL) was obtained from each of three SARS patients and transfused into the three infected HCW. Donors were blood type O and seronegative for hepatitis B and C, HIV, syphilis and human T-cell lymphotropic virus types I and II (HTLV-I and -II). Serum antibody (IgG) titre was >640. Apharesis was performed with a CS 3000 plus cell separator followed by the forming of the convalescent phase plasma. As part of the routine check with donated plasma, the convalescent plasma was confirmed free of residual SARS-CoV by RT–PCR. Serial serum samples obtained from the recipients of the convalescent plasma were collected to undertake real-time quantitative RT–PCR for SARS-CoV for direct measurement of viral concentration. Specific immunoglobulin IgM and IgG concentrations were titrated using an antigen microarray developed in-house.
Results: Viral load dropped from 495 x 103, 76 x 103 or 650 x 103 copies/mL to zero or 1 copy/mL one day after transfusion. Anti-SARS-CoV IgM and IgG also increased in a time-dependent manner following transfusion. All three patients survived. One HCW became pregnant subsequently, delivering 13 months after discharge. Positive anti-SARS-CoV IgG was detected in the newborn. Passive transfer of anti-SARS-CoV antibody from the mother was considered as a possibility.
Conclusions: All infected HCW whose condition had progressed severely and who had failed to respond to the available treatment, survived after transfusion with convalescent plasma.
Keywords: SARS , coronavirus , therapy
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