Table 2.
Advantages and Disadvantages of Different Sources of Antibodies Against Ebola Virus Disease
| Characteristic/Feature | Convalescent Whole Blood | Convalescent Plasma | Hyperimmune Globulinsa | Recombinant Monoclonal Antibodies |
|---|---|---|---|---|
| Availability | Survivors in affected countries can act as source | Survivors in affected countries can act as source | Currently not available, requires high amounts of CP or production in animals | Limited; potential for more efficient production methods |
| Accessibility in affected low-income countries | Produced within and by the affected countries | Produced within and by the affected countries | Not clear how it will be marketed and how prioritization will be decided | Not clear how it will be marketed and how prioritization will be decided |
| Collection/production | 1 donation/3–4 mo (10 mL/kg) | 1 donation/2 wk (10 mL/kg) | One production plant in Africa | US (1) and Chinese (1) company |
| Storage | >1 mo (2°C–6°C) | 3 y (−30°C) | 2–3 y (4°C) | Long-term (−20°C) |
| Administration | IV (4 h) | IV (20–40 min) | IV (variable, usually <1 hour) or IM | IV (6–12 h) or subcutaneous |
| Potential side effects | +++(+)b | +(+)b | +b | +++(?)b |
| Risk with ABO incompatibility | ++++b | +b | NA | NA |
| Costs/affordability | +b | ++b | +++b | ++++b |
| Acceptability in EVD context | Well-known procedure Current data suggest reasonable donor acceptability |
New procedure; Current data suggest reasonable donor acceptability |
Presumably good | Presumably good |
| Activity against circulating virus | CWB produced during outbreak likely effective | CP produced during outbreak likely effective | Activity to be shown against viruses causing new outbreaks | Activity to be shown against viruses causing new outbreaks |
| Production time | Short (<1 d) once donors identified | Short (days) once donors identified | Months | Months |
Abbreviations: CP, convalescent plasma; CWB, convalescent whole blood; EVD, Ebola virus disease; IM, intramuscular; IV, intravenous; NA, not applicable.
a Most efforts currently focused on human sources of antibodies, but animal production is under exploration as well.
b +: Very low; ++: Low; +++: Moderate; +++(+): Moderate to high; ++++: High; (?): Substantial uncertainty given limited clinical experience.