Hepatitis B Immune Globulin as a Prophylactic Measure for Spouses Exposed to Acute Type B Hepatitis

Abstract

Because the value of usual immune globulin preparations in preventing Type B hepatitis is doubtful, we carried out a double-blind comparison of a control human immune globulin preparation with one--identified as HBIG--that had a high concentration (442 mug per milliliter) of antibodies to surface components of hepatitis B virus. Effectiveness was tested in spouses of patients with acute Type B hepatitis. Within 150 days after injection, nine of 33 spouses in the control group had symptomatic Type B hepatitis, compared with one of 25 spouses receiving HBIG. One non-B case also occurred in the HBIG group. Five control globulin recipients had evidence of subclinical hepatitis B infection, compared with one HBIG recipient. Thus, HBIG appeared effective in suppressing not only disease, but also infection itself. Prophylactic value has been demonstrated in persons who should now be recognized as being at exceptionally high risk.

Markedly prolonged incubation period of hepatitis B in a chimpanzee passively immunized with a human monoclonal antibody to the a determinant of hepatitis B surface antigen.

“…Instead, the incubation period of HBV infection was prolonged. These results were similar to those obtained in a number of trials of HBIG for the prevention of hepatitis B in adults in the 1970s and 1980s (41)(42)(43)(44), although immunoprophylaxis trials of HBIG in newborns were generally successful (45), especially when coupled with active immunoprophylaxis (46)(47)(48). Thus, the failure of HBIG and/or monoclonal anti-HBs antibodies to protect in vivo against the MS-2 strain of HBV is probably not due to the nucleotide change that replaces the amino acid Proline with isoleucine at position 127 in the MS-2 strain of HBV.…”

The Genome of Hepatitis B Virus

“…Persuasive al though indirect evi dence suggests that HBV is a virus-specified anti gen. HBsAg appears in the blood early after infec tion with HBsAg (90), and an antibody response after infection results in immunity (95). Immunization with highly purified HBsAg particles results in protection against HBV infe ction and/or disease (75), as does administration of "y-globulin with a high titer of antibody against HBsAg (anti-HBs) (33,73,78,86). The anti ge nic subtype fou nd in second ary cases of HBV infection is regularly the same as the subtype of the index case or of the ori ginal source used in experimental infections (54,63), indicating tha t the subtype determinants are specified by the viral ge nome and not by the host.…”

Developing an evidence‐based guideline for the management of exposure to hepatitis B at a Victorian tertiary hospital

“…14 It is recommended that HBV post-exposure prophylaxis (PEP) be given as soon as possible, however, there is evidence that it may be beneficial up to seven days following needlestick injury (NSI) 11 and up to 21 days following sexual exposure. 12,13 …”