title: Intramuscular hepatitis B immunoglobulins for reinfection control after liver transplantation: a cost-saving alternative.
abstract: OBJECTIVE
  We explore the effectiveness and cost-effectiveness of intramuscular versus intravenous hepatitis B immunoglobulins (HBIG-IV vs HBIG-IM) to prevent reinfection with the hepatitis B virus after orthotopic liver transplantation.
  
  
  METHODS
  Overall, 14 patients had orthotopic liver transplantation in 2003-2013 at Ghent University Hospital for HBV-related liver disease. On average 32 months after transplantation patients switched from high-dose HBIG-IV to low-dose HBIG-IM, always in combination with a nucleos(t)ide analog.
  
  
  RESULTS
  Seven patients were switched so far. No significant differences between HBIG-IV and HBIG-IM were found in HBsAg and hepatitis B virus-DNA.
  
  
  CONCLUSIONS
  Switching patients from HBIG-IV to HBIG-IM can be done safely if well monitored. Net yearly savings for the healthcare payer were €5000 for each patient switched to HBIG-IM.
authors.affiliation: Department of Hepatology, University Hospital Ghent, De Pintelaan 185, B9000 Ghent, Belgium.
authors.forename: Eva
authors.initials: E
authors.lastname: Hulstaert
authors.affiliation: Department of Hepatology, University Hospital Ghent, De Pintelaan 185, B9000 Ghent, Belgium.
authors.forename: Xavier
authors.initials: X
authors.lastname: Verhelst
authors.affiliation: Department of Hepatology, University Hospital Ghent, De Pintelaan 185, B9000 Ghent, Belgium.
authors.forename: Anja
authors.initials: A
authors.lastname: Geerts
authors.affiliation: Department of Hepatology, University Hospital Ghent, De Pintelaan 185, B9000 Ghent, Belgium.
authors.forename: Hans
authors.initials: H
authors.lastname: Van Vlierberghe
keywords: comparative effectiveness; hepatitis B; hepatitis B immunoglobulins; liver transplantation