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Indications for monoclonal antibody and antiviral treatment on a preventive and curative basis in health workers exposed to the Ebola virus

During the recent Ebola virus disease (EVD) epidemics, several therapies have been developed on a preventive and curative basis: antivirals and monoclonal antibodies (alone or in combination). None of these products currently has a marketing authorization for this indication.

In May 2018, WHO assessed the data available on these therapies to determine whether their experimental use in an EVD emergency was possible. In addition to that assessment, the HCSP has considered the epidemiological situation, existence of an EVD vaccine, additional information available on existing products, the factors in favor of their use (high transmissibility and infectivity of the virus, severity of the EVD, ethical aspects and so on) as well as factors restricting use (limited data bearing on efficacy and safety, routes of administration, interaction with the vaccine).

Given the risk-benefit ratio and current data, the HCSP does not recommend using these products for pre-exposure prophylaxis, but recommends them for curative treatment and post-exposure prophylaxis on the ground and in reference health facilities; treatment decisions will be made on a case-by-case basis, in line with a multidisciplinary collegiate opinion and after obtaining the patient’s informed consent. That opinion will be updated as new knowledge comes to light in this field.

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