ORAL IMMUNOGLOBULINS FOR TREATMENT OF ACUTE ROTAVIRAL GASTROENTERITIS

Objective. Preliminary evidence has been reported on the antirotavirus effect of human serum immunoglobulin administered orally. The aim was to see whether such treatment might be effective in rotavirus acute g astroenteritis. Methods. A prospective, double-blind, placebo-controll ed study was performed. Ninety-eight children admitted with acute gast roenteritis were enrolled and randomly assigned to groups A (treated) and B (control). Children in group A received a single oral dose of 30 0 mg/kg body weight of human serum immunoglobulin. Parameters of effic acy were clinical condition, frequency and consistency of stools, dura tion of diarrhea, duration of viral excretion, and length of hospital stay. Antirotaviral activity was determined in the immunoglobulin prep aration by a specific neutralization assay. Results. Seventy-one of th e 98 children enrolled had rotaviral gastroenteritis; 36 belonged to g roup A. Children who received immunoglobulin had significantly faster clinical improvement of clinical condition and stool pattern than cont rol children. Mean total duration of rotaviral diarrhea was 76 hours i n group A and 131 in group B (P <.01). Viral excretion lasted 114 and 180 hours, respectively (P <.01). Hospital stay was significantly redu ced in children in group A. Neutralizing antibodies against rotavirus were detected in the immunoglobulin preparation. Conclusion. Oral admi nistration of immunoglobulin is associated with a faster recovery from acute gastroenteritis and should be given to children hospitalized wi th this illness.