Immuno HBs

Passive immunisation against hepatitis B infection, Prophylaxis of hepatitis B recurrence after liver transplantation

Intramuscular Passive immunisation against hepatitis B infection Adult: 500 IU given as a single dose, given preferably within 48 hr of exposure and not >1 wk after exposure. Contents of hepatitis B immunoglobulin may vary between countries and between manufacturers (see lit). Caution should be taken in interpreting dosage recommendations which are not given in terms of IU. Intravenous Prophylaxis of hepatitis B recurrence after liver transplantation Adult: Given in doses of 20,000 IU/dose: Initially, 1 dose with liver transplant. In the 1st wk post-operation: 1 dose daily for 7 days (day 1-7); from wk 2-12 post-operation (starting from day 14): 1 dose every 2 wk; from 4th mth onwards: 1 dose mthly. Adjust dose to reach anti-HBs levels of 500 IU/L within the 1st wk post-transplantation. For patients with surgical bleeding, abdominal fluid drainage >500 ml or those undergoing plasmapheresis, 10,000 IU should be given every 6 hr until target anti-HBs levels are reached. Contents of hepatitis B immunoglobulin may vary between countries and between manufacturers. Caution should be taken in interpreting dosage recommendations which are not given in terms of IU.

Intramuscular Passive immunisation against hepatitis B infection Child: <5 yr: 200 IU; 5-9 yr: 300 IU; >10 yr: 500 IU. To be given as a single dose, preferably within 48 hr of exposure and not >1 wk after exposure. For newborns (whose mothers are persistent carriers of hepatitis B surface antigen (HbsAg) or mothers who are HBsAg-positive as a result of recent infection): 200 IU at birth or within 24 hr after birth. Contents of hepatitis B immunoglobulin may vary between countries and between manufacturers. Caution should be taken in interpreting dosage recommendations which are not given in terms of IU.

Hypersensitivity; severe allergy to gamma globulin or anti-immunoglobulin therapies. IM inj in patients with thrombocytopenia or coagulation disorders.

Hepatitis B immunoglobulins contain specific neutralising antibodies (mainly IgG) that provide passive immunisation for individuals exposed to the hepatitis B virus. It is used for post-exposure prophylaxis in persons who are not vaccinated, or whose prior vaccination regimen is incomplete or when the antibody level is <10 IU/ml. It may also be used in haemodialysis patients and receptors of certain blood products who are unable to develop adequate immune protection.

Patients with thrombocytopenia or coagulation disorders. May contain certain infectious agents that could transmit disease. Hepatitis B immunoglobulins may be administered at the same time (but at a different site) or up to 1 mth before hepatitis B vaccination without compromising the active immune response. Human hepatitis B immunoglobulin should not be administered via IV inj. May cause drowsiness. Monitor for infusion-related adverse events. Pregnancy and lactation.

Fainting, headache, lightheadedness, malaise, angioedema, bruising, urticaria, nausea, vomiting, increased AST and alkaline phosphatase. Ache, pain, erythema, and/or tenderness at inj site. Anaphylaxis, cold/flu-like syndrome, arthralgia, joint stiffness and myalgia.

May interfere with immune response when used with live vaccines; live vaccines should be given only 3 mth after admin of immunoglobulin.