Passive immunization with immunoglobulin in patients infected with the hepatitis B virus is only likely to be effective in those on antiviral treatment who have low pre-treatment levels of the hepatitis B surface antigen (HBsAg), a small trial suggests.
Researchers from the Erasmus Medical Centre in Rotterdam, The Netherlands, concluded that it was not feasible to immunise all HBV DNA negative patients with specific hepatitis B immunoglobulin (HBIg).
In the study, two of the six HBV infected patients on the antiviral lamivudine, who also had passive immunisation, developed levels of surface antigen (HbsAg) that were so low as to be undetectable by the assay used. These low levels persisted for 31 and 7.5 hours for each of the two patients.
Peak anti-HBs concentrations were 5100 and 4648IU/l. The researchers found that, in vitro, it was possible to neutralise HbsAg with HBIg. There were 50 percent inhibition concentrations of 100-250 IU/l, with surface antigen levels varying from 68 to 120ng/ml. But, response was poor in the other four patients where surface antigen levels were higher to start with – in fact, they hardly changed after treatment.
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