Hepatitis A virus antibodies in immunoglobulin preparations

Farcet, Maria R.; Planitzer, Christina B.; Stein, O. von; Modrof, Jens; Kreil, Thomas R.

doi:10.1016/j.jaci.2009.09.008

Cited by 33 publications

(29 citation statements)

References 19 publications

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“…However, the titers of anti-HAV antibody we measured in IVIG products were lower than those reported in previous studies, which were performed with IVIG products derived from the EU, USA, and Taiwan (2232). These findings support that interval monitoring of specific antibody levels in various IVIG products is required for the establishment of appropriate guidelines for treatment.…”

Section: Discussioncontrasting

confidence: 81%

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

Lee

Kim

2016

J Korean Med Sci

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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.

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Section: Discussioncontrasting

confidence: 81%

“…However, until now, few studies have analyzed the concentrations of antibodies against HAV or HBV in commercially available IVIG products (1322). Therefore, this study was performed to evaluate and compare the titers of specific antibodies against HAV and HBV in commercial IVIG products from several countries.…”

Section: Introductionmentioning

confidence: 99%

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

Lee

Kim

2016

J Korean Med Sci

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“…Recent studies have shown that for some microorganisms there is significant variation in antibody levels in IVIG preparations of different brands, as well as in different batches of the same brand [5-7]. For measles, varicella, tetanus and diphtheria, there was no significant difference in antibody concentrations between the three different commercial preparations of IVIG.…”

Section: Discussionmentioning

confidence: 99%

Antibody levels to tetanus, diphtheria, measles and varicella in patients with primary immunodeficiency undergoing intravenous immunoglobulin therapy: a prospective study

et al. 2014

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BackgroundPatients with antibody deficiencies depend on the presence of a variety of antibody specificities in intravenous immunoglobulin (IVIG) to ensure continued protection against pathogens. Few studies have examined levels of antibodies to specific pathogens in IVIG preparations and little is known about the specific antibody levels in patients under regular IVIG treatment. The current study determined the range of antibodies to tetanus, diphtheria, measles and varicella in IVIG products and the levels of these antibodies in patients undergoing IVIG treatment.MethodsWe selected 21 patients with primary antibody deficiencies who were receiving regular therapy with IVIG. Over a period of one year, we collected four blood samples from each patient (every 3 months), immediately before immunoglobulin infusion. We also collected samples from the IVIG preparation the patients received the month prior to blood collection. Antibody levels to tetanus, diphtheria, measles and varicella virus were measured in plasma and IVIG samples. Total IgG levels were determined in plasma samples.ResultsAntibody levels to tetanus, diphtheria, varicella virus and measles showed considerable variation in different IVIG lots, but they were similar when compared between commercial preparations. All patients presented with protective levels of antibodies specific for tetanus, measles and varicella. Some patients had suboptimal diphtheria antibody levels. There was a significant correlation between serum and IVIG antibodies to all pathogens, except tetanus. There was a significant correlation between diphtheria and varicella antibodies with total IgG levels, but there was no significant correlation with antibodies to tetanus or measles.ConclusionsThe study confirmed the variation in specific antibody levels between batches of the same brand of IVIG. Apart from the most common infections to which these patients are susceptible, health care providers must be aware of other vaccine preventable diseases, which still exist globally.

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“…Although there is no standard for antibody levels in IG preparations, reduced anti-HAV titers have been documented in pooled plasma in the United States and Europe. 39 The manufacture of IG from selected antibody-positive donors may need to be considered in order to develop a hyperimmune globlulin for HA prevention, analogous to other agent-specific hyperimmune globulins.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of hepatitis A vaccination as post-exposure prophylaxis

Parrón

Planas

Godoy

et al. 2016

Human Vaccines & Immunotherapeutics

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Hepatitis A (HA) has been a vaccine-preventable disease since 1995. In Catalonia, a universal combined hepatitis ACB vaccination program of preadolescents was initiated at the end of 1998. However, outbreaks are reported each year and post-exposure prophylaxis (PEP) with hepatitis A virus (HAV) vaccine or immunoglobulin (IG) is recommended to avoid cases.The aim of this study was to assess the effectiveness of HAV vaccine and IG in preventing hepatitis A cases in susceptible exposed people.A retrospective cohort study of contacts of HA cases involved in outbreaks reported in Catalonia between January 2006 and December 2012 was made. The rate ratios and 95% confidence intervals (CI) of HA in susceptible contacts receiving HAV or IG versus those without PEP were calculated.There were 3550 exposed persons in the outbreaks studied: 2381 received one dose of HAV vaccine (Hepatitis A or hepatitis ACB), 190 received IG, and 611 received no PEP. 368 exposed subjects received one dose of HAV vaccine and IG simultaneously and were excluded from the study. The effectiveness of PEP was 97.6% (95% CI 96.2-98.6) for HAV vaccine and 98.3% (95% CI 91.3-99.9) for IG; the differences were not statistically significant (p D 0.36).The elevated effectiveness of HAV vaccination for PEP in HA outbreaks, similar to that of IG, and the long-term protection of active immunization, supports the preferential use of vaccination to avoid secondary cases.

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Hepatitis A virus antibodies in immunoglobulin preparations

Cited by 33 publications

References 19 publications

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

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

Antibody levels to tetanus, diphtheria, measles and varicella in patients with primary immunodeficiency undergoing intravenous immunoglobulin therapy: a prospective study

Effectiveness of hepatitis A vaccination as post-exposure prophylaxis

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