title: Effectiveness of low-dose intramuscular anti-VHB immune globulin in the prophylaxis of viral B hepatitis reinfection after liver transplantation: preliminary report.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Liver Transplant Unit, Hospital Puerta de Hierro, Madrid, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Alonso
authors.forename: A
authors.initials: A
authors.lastname: Herreros de Tejada
authors.forename: J M
authors.initials: JM
authors.lastname: Moreno
authors.forename: E
authors.initials: E
authors.lastname: Rubio
authors.forename: J L
authors.initials: JL
authors.lastname: Lucena
authors.forename: J
authors.initials: J
authors.lastname: De la Revilla
authors.forename: V
authors.initials: V
authors.lastname: Sánchez Turrión
authors.forename: A
authors.initials: A
authors.lastname: Gomez
authors.forename: J
authors.initials: J
authors.lastname: Lopez
authors.forename: V
authors.initials: V
authors.lastname: Cuervas-Mons
mesh_terms: D000328:Adult; D004279:DNA, Viral / Q000097:blood; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control* / Q000601:surgery*; D006510:Hepatitis B Antibodies / Q000097:blood; D006515:Hepatitis B virus / Q000302:isolation & purification; D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins / Q000627:therapeutic use*; D016031:Liver Transplantation; D012008:Recurrence
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin