Effectiveness of low-dose intramuscular Anti-VHB immune globulin in the prophylaxis of viral B hepatitis reinfection after liver transplantation: preliminary report

• Published in: Transplantation proceedings Vol. 35; no. 5; pp. 1850 - 1851
• Main Authors: Alonso, I, Herreros de Tejada, A, Moreno, J.M, Rubio, E, Lucena, J.L, De la Revilla, J, Sánchez Turrión, V, Gomez, A, Lopez, J, Cuervas-Mons, V
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01-08-2003; Elsevier Science
• Subjects: Adult; Biological and medical sciences; DNA, Viral - blood; Hepatitis B - immunology; Hepatitis B - prevention & control; Hepatitis B - surgery; Hepatitis B Antibodies - blood; Hepatitis B virus - isolation & purification; Human viral diseases; Humans; Immunization, Passive; Immunoglobulins - therapeutic use; Infectious diseases; Liver Transplantation; Liver, biliary tract, pancreas, portal circulation, spleen; Medical sciences; Recurrence; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Viral diseases; Viral hepatitis; Hepatitis B antigen; Orthohepadnavirus; Hepatic disease; Transplantation; Homotransplantation; Intramuscular administration; Globulin; Viral hepatitis B; Prevention; Hepadnaviridae; Surgery; Immunotherapy; Graft; Hepatitis B virus; Human; Immunoglobulins; Antibody; Low dose; Treatment efficiency; Reinfection; Infection; Virus; Treatment; Viral disease; Digestive diseases
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/S0041-1345(03)00634-1

Prophylaxis using high-dose intravenous anti-HBV immune globulin (HBIG) is effective to prevent reinfection due to hepatitis B virus (HBV) after orthotopic liver transplantation (OLT). However, this treatment is expensive and intravenous administration is difficult during outpatient care. Our aim was to assess the effectiveness of low-dose intramuscular HBIG to prevent HBV reinfection after OLT.
Six patients (all men, mean age 41 years, negative HBV DNA without hepatotropic virus coinfection) were transplanted in our institution due to HBV cirrhosis and included in a prospective noncomparative study. Intramuscular HBIG (2000 IU) was administered during the anhepatic phase of OLT, followed by daily 2000 IU doses for 7 days and then monthly. HBV antibody titers were measured every month. Reinfection was defined as the recurrence of surface HBV antigen in serum after transplantation.
After 1 year follow-up, none of the six patients had detectable HBV surface antigen and the liver biopsies were normal in all cases. Using 2000 IU, anti-HBs levels were: 880 ± 356 IU/L at 1 month, 191 ± 123 at 6 months, and 225 ± 49 after 1 year. In all cases anti-HBs titers were above 100 IU/L during the follow-up.
Monthly administration of low-dose (2000 IU) intramuscular HBIG effectively prevents recurrence of HBV infection as well as attains a protective level of anti-HBs antibodies (over 100 IU/L) for at least the first year after transplantation.