The worldwide seroprevalence of hepatitis A virus (HAV) and hepatitis B virus (HBV) has changed over the last two decades, indicating a declining incidence of HAV and HBV infections. Therefore, vaccinations against HAV and HBV are recommended for unimmunized people before traveling to an endemic area. Unfortunately, primary antibody deficiency (PAD) patients can only obtain humoral immunity through intravenous immunoglobulin G (IVIG) replacement and not from vaccination because of a defect in antibody production. However, few studies have analyzed the titers of antibodies against HAV or HBV in IVIG products. In this study, the titers of anti-HAV and anti-HBs antibodies were measured in nineteen lots of IVIG products from five manufacturers from three countries (A, B from Korea; C, D from Japan; and E from the USA), and trough titers in plasma were estimated. Concentrations of anti-HAV antibody ranged from 1,888-8,927 mIU/mL and estimated trough titers exceeded the minimal protective value in all evaluated IVIG products. Concentrations of anti-HBs antibody ranged from 438-965 mIU/mL in products A and B and were 157, 123, and 1,945 mIU/mL in products C, D, and E, respectively. Estimated trough titers in products A, B, and E exceeded the minimal protective value but those in products C and D did not reach this threshold. These data demonstrated that available IVIG products generally provide sufficient antibodies against HAV and HBV to protect patients with PAD, although the trough concentrations of anti-HBs antibody in two IVIG products did not reach the minimum protective value.

/pdf/antibodies-against-hepatitis-a-and-hepatitis-b-virus-in-2miqtui530.pdf

Antibodies against Hepatitis A and Hepatitis B Virus in Intravenous Immunoglobulin Products

https://onlinelibrary.wiley.com/doi/pdf/10.1111/trf.15017

Antibodies to vaccine antigens in pooled polyclonal human IgG products

At hepatology intravenous immunoglobulin was tested in several areas, but the evidence base of effectiveness is different at each nosology and often insufficient for routine use of the drug. However, immunoglobulin therapy may be useful for hepatologist in the management of severe, unusual clinical cases in the framework of a personalized treatment, in connection with which specialist should be well informed about the current experience of using immunotherapy for various hepatological indications.
This article describes clinical case of fulminant viral hepatitis B with acute liver failure and encephalopathy in which managed to save the life of the patient only after the addition to the standard treatment regimen intravenous immunoglobulin.

/pdf/treatment-of-fulminant-viral-hepatitis-b-with-acute-hepatic-oikafu5tp5.pdf

Treatment of fulminant viral hepatitis b with acute hepatic encephalopathy with intravenous immunoglobulin: presentation of a clinical case

There are no recommendations concerning preoperative management of primary immunodeficiency patients in cases of emergency or planned surgery in relation to risk of hepatitis type B virus infection. To assess if immunodeficient patients regularly supplemented with immunoglobulins are protected against hepatitis B. IgG, IgM and IgA total levels and anti-HBs level were estimated in adult patients with primary humoral immunodeficiency before and after immunoglobulins supplementation according to a standardized schedule. Serum IgG and anti-HBs level significantly increased after immunoglobulin supplementation. Anti-HBs titer increased in all cases over 100 IU/L regardless of initial total IgG serum value, reaching a highly protective level. There was no correlation between increase in concentration of IgG (ΔIgG) versus Δanti-HBs in the studied patients. Patients with primary hypogammaglobulinemia supplemented with immunoglobulin are protected against hepatitis type B.

Does the proper intravenous immunoglobulin substitution in primary immunodeficiency protect against HBV infections?: a description of a case series.

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Does the proper intravenous immunoglobulin substitution in primary immunodeficiency protect against HBV infections?: a description of a case series.