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Hyperimmune anti-HBs plasma as alternative to commercial immunoglobulins for prevention of HBV recurrence after liver transplantation

Russmann, Stefan
Gurtner, Vanina
Di Giammarino, Loriana
Pizzi-Bosman, Loredana
Michel, Martine
Cerny, Andreas
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Published in BMC Gastroenterology. 2010, vol. 10, p. 71
Abstract BACKGROUND: Hepatitis B immune globulins (HBIG) in combination with nucleos(t)ide analogues (NA) are effectively used for the prevention of hepatitis B virus (HBV) recurrence after liver transplantation (LT). However, associated treatment costs for HBIG are exceedingly high. METHODS: Fresh frozen plasma obtained from blood donors with high anti-HBs levels (hyperimmune plasma, HIP) containing at least 4,500 IU anti-HBs was used as alternative treatment for HBV recurrence prophylaxis post-LT. RESULTS: Twenty-one HBV-related LT recipients received HIP starting at transplantation, followed by long-term combination treatment with NA. Mean follow-up time was 4.5 years (range 0.5-12.6) and each patient received on average 8.2 HIP per year (range 5.8-11.4). Anti-HBs terminal elimination kinetic after HIP administration was 20.6 days (range 13.8-30.9), which is comparable to values reported for commercial HBIG products. All 21 patients remained free of HBV recurrence during follow-up and no transfusion-transmitted infection or other serious complication was observed. Seven patients developed reversible mild transfusion reactions. The cost for one HIP unit was US$140; average yearly HBIG treatment cost was US$1,148 per patient, as compared to US$25,000-100,000 for treatment with commercial HBIG. CONCLUSION: The results of this study suggest that the use of HIP may be a useful and economical approach for the prevention of HBV recurrence post-LT if used in combination with NA. Additional prospective controlled studies in larger populations are needed to confirm these results.
Keywords AdultAntiviral Agents/therapeutic useCost-Benefit AnalysisDrug Therapy, CombinationFemaleFollow-Up StudiesHepatitis B/economics/immunology/ prevention & controlHepatitis B Antibodies/adverse effects/economics/ therapeutic useHumansImmunoglobulins/economics/ therapeutic useLiver Transplantation/ immunologyMaleMiddle AgedPlasmaRecurrence/prevention & controlTreatment Outcome
PMID: 20598161
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Research group Hépatologie chirurgicale (327)
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BIHL, Florian et al. Hyperimmune anti-HBs plasma as alternative to commercial immunoglobulins for prevention of HBV recurrence after liver transplantation. In: BMC Gastroenterology, 2010, vol. 10, p. 71. doi: 10.1186/1471-230X-10-71 https://archive-ouverte.unige.ch/unige:20609

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Deposited on : 2012-05-22

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