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

Autor: Andreas Cerny, Gilles Mentha, Florian Bihl, Pietro Majno, Antoine Hadengue, Loredana Pizzi-Bosman, Loriana Di Giammarino, Vanina Gurtner, Stefan Russmann, Emiliano Giostra, Damiano Castelli, Martine Michel
Přispěvatelé: University of Zurich, Bihl, F
Rok vydání: 2009
Předmět:
Male
medicine.medical_treatment
Cost-Benefit Analysis
Liver transplantation
medicine.disease_cause
Plasma
Secondary Prevention
ddc:616
Antiviral Agents/therapeutic use
biology
ddc:617
Gastroenterology
General Medicine
Hepatitis B
Middle Aged
Recurrence/prevention & control
Treatment Outcome
Drug Therapy
Combination
Female
Antibody
Research Article
Adult
medicine.medical_specialty
Globulin
Immunoglobulins
Immunoglobulins/economics/ therapeutic use
610 Medicine & health
Liver Transplantation/ immunology
Antiviral Agents
Internal medicine
medicine
Humans
2715 Gastroenterology
lcsh:RC799-869
Hepatitis B Antibodies
Hepatitis B virus
business.industry
Immunotherapy
Hepatology
Hepatitis B Antibodies/adverse effects/economics/ therapeutic use
medicine.disease
Liver Transplantation
Transplantation
10199 Clinic for Clinical Pharmacology and Toxicology
Immunology
Hepatitis B/economics/immunology/ prevention & control
biology.protein
lcsh:Diseases of the digestive system. Gastroenterology
business
Follow-Up Studies
Zdroj: BMC Gastroenterology
BMC Gastroenterology, Vol 10, Iss 1, p 71 (2010)
BMC Gastroenterology, Vol. 10 (2010) P. 71
ISSN: 1471-230X
Popis: 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.
Databáze: OpenAIRE
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