Hepatitis B immune globulin
|Trade names||HepaGam B, Nabi-HB, Zutectra, others|
|Main uses||Prevent hepatitis B|
|Side effects||Pain at the site of injection, headache, nausea, lightheadedness, fever|
|Onset of action||Immediate|
|Duration of action||3 to 6 months|
|US NLM||Hepatitis B immune globulin|
|(what is this?)|
Hepatitis B immunoglobulin (HBIG) is a medication used to prevent hepatitis B following exposure. This includes in newborns following birth to a women who is hepatitis B positive, following liver transplant in someone with hepatitis B, and following exposure in those who are not immune. It may be given by injection into a vein or muscle. Hepatitis B vaccine may be given at the same time, but at a different site on the body.
Common side effects include pain at the site of injection, headache, nausea, lightheadedness, and fever. Other side effects may include allergic reactions. It can be used in pregnancy when required. It is antibodies directed against hepatitis B surface antigen (anti-HBs).
Hepatitis B immunoglobulin come into medical use in 1974. It is available as a generic medication. In the United Kingdom 500 units costs the NHS about £500 as of 2021. In the United States it costs about 830 USD for 5 ml. It is made from human plasma.
HBIG is indicated as a postexposure prophylaxis for people at risk to develop hepatitis B because they have been recently exposed to body fluids of individuals who have hepatitis B. This includes babies of mothers with hepatitis B, sexual partners, healthcare workers, police and fire workers, and morticians. It provides a temporarily induced immunity by the transfer of immunoglobulins.
HBIG is given by either intramuscular (IM) or intravenous (IV) route, depending on the preparation. Side effects include allergic reactions, back pain, general feeling of discomfort, headaches, muscle pain, nausea, and pain or bleeding at the injection site. Allergy to human immunoglobulin is a contraindication. HIV has never been transmitted by HBIG. As with all blood-derived products, the transmission of prions is possible as a residual risk.
HBIG should be given within 14 days of exposure to the hepatitis B virus. The half-life of HBIG is about 3 weeks. In lieu of a booster administration of HBIG, a hepatitis B vaccination is initiated at the time of the initial HBIG administration, thus providing long term protection.
Protection lasts for 3 to 6 months.
In the United Kingdom it is generally given as a dose of 500 units for prevention.
In the United States it is often given at a dose of 0.06 mL/kg for prevention.
Society and culture
HBIG is prepared from the plasma of donors who have high antibody levels of the hepatitis B surface antigen. It is extracted from the Cohn fraction II. During the process, viruses are deactivated, and in the final steps, solvents used in the preparation are removed. The preparation is tested for absence of HIV, HCV, herpes virus, and reovirus.
- Bayhep B
- HepaGam B (US market; intravenous preparation)
- HyperHEP B (US market; intramuscular preparation)
- Nabi-HB NovaPlus
- Zutectra (EU)
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