Hepatitis B Immunoglobulin
Synonym :
HBIG
Mechanism :
Hepatitis B Immune Globulin is a solvent/detergent-treated sterile solution of purified gamma globulin (IgG) fraction of human plasma containing antibodies to hepatitis B surface antigen. It provides passive immunization for individuals exposed to the hepatitis B virus and reduce the infection rate of hepatitis B.
Indication :
- Newborns born to mothers with serum HBsAg positive
- Newborns whose mothers had hepatitis B during pregnancy
- Children following exposure to Hepatitis B
- Prevention of recurrence following liver transplantation
Contraindications :
Individuals known to have anaphylactic or severe systematic reactions associated with the parenteral administration of human globulin preparations should not receive Hepatitis B Immunoglobulin. Use with caution in patients with IgA deficiency as it can lead to anaphylaxis.
Dosing :
Available as 312 IU/ml of anti-HBs.
Newborns born to mothers with serum HBsAg positive:
0.5 ml IM <12 hours after birth with simultaneous Hepatitis B administration in the opposite arm. Repeat HBIG at three months of age if vaccination gets delayed by 3 months. Repeat HBIG at 3 and 6 months if not vaccinated at all.
Post-exposure prophylaxis:
0.05 ml/kg in <12 months and 0.06 mL/kg >12 months given IM and initiate Hepatitis B vaccine as per schedule. HBIG is given within 14 days after sexual exposure and within 24 hours after needle stick, or mucosal exposure.
Prevention of recurrence following liver transplantation:
20,000 IU units IV once with the grafting of the transplanted liver and then repeat every day for 7 days and then every two weekly from week 2 to 12 starting from day 14 post op. From 4 months onwards, give monthly to maintain antibody levels to HBs >500
Adverse Effect :
Fever with chills, nausea and vomiting, headache, allergic reaction, arthralgia and moderate low back pain can occur, pain at injection site.
Interaction :
Vaccination with live virus vaccines should be deferred for approximately three months after administration of Hepatitis B Immune Globulin (Human). It may be necessary to revaccinate persons who received it shortly after live virus vaccination.
Hepatic Dose :
No dosage adjustments are recommended.