Abstract
A short-time trial of small sample size for an evaluation of the hepatitis B vaccine is proposed and designed. The vaccine is based on the premise that antibody to the surface antigen of the hepatitis B virus is protective against viral infection. This premise is verified by using the presence of the surface antigen as the marker of infection and comparing infection rates in renal dialysis patients who had naturally acquired antibody to patients without antibody. Patients with antibody have an extremely low risk of infection. The probability of remaining uninfected decreases at an exponential rate for patients without antibody, implying a constant risk of infection at any point in time. The study design described makes use of this time independence and the observed infection rates to formulate a clinical trial which can be accomplished with a relatively small number of patients. This design might be useful if, in preliminary studies, it is shown that the vaccine produces antibody in the patients and that protection against hepatitis B virus would be beneficial to the patients.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Gocke D. J., Howe C. Rapid detection of Australia antigen by counterimmunoelectrophoresis. J Immunol. 1970 Apr;104(4):1031–1034. [PubMed] [Google Scholar]
- Hilleman M. R., Buynak E. B., Roehm R. R., Tytell A. A., Bertland A. U., Lampson G. P. Purified and inactivated human hepatitis B vaccine: progress report. Am J Med Sci. 1975 Sep-Oct;270(2):401–404. doi: 10.1097/00000441-197509000-00025. [DOI] [PubMed] [Google Scholar]
- Kaplan P. M., Greenman R. L., Gerin J. L., Purcell R. H., Robinson W. S. DNA polymerase associated with human hepatitis B antigen. J Virol. 1973 Nov;12(5):995–1005. doi: 10.1128/jvi.12.5.995-1005.1973. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Maugh T. H., 2nd Hepatitis B: a new vaccine ready for human testing. Science. 1975 Apr 11;188(4184):137–138. doi: 10.1126/science.188.4184.137. [DOI] [PubMed] [Google Scholar]
- Purcell R. H., Gerin J. L. Hepatitis B subunit vaccine: a preliminary report of safety and efficacy tests in chimpanzees. Am J Med Sci. 1975 Sep-Oct;270(2):395–399. [PubMed] [Google Scholar]
- Vyas G. N., Shulman N. R. Hemagglutination assay for antigen and antibody associated with viral hepatitis. Science. 1970 Oct 16;170(3955):332–333. doi: 10.1126/science.170.3955.332. [DOI] [PubMed] [Google Scholar]