Hepatitis A immune globulin

Hepatitis A Immune globulin (intramuscular [IM]) Preexposure prophylaxis 0.02 mL/ kg IM for anticipated risk of s 3 months, 0.06 mL/kg for anticipated risk of > 3 months, repeated every 4-6 months for continued exposure. Preexposure and postexposure hepatitis A prophylaxis. The availability of hepatitis A vaccine has greatly reduced the need for preexposure prophylaxis. 

About 15 to SO days of incubation arc required before the disease becomes clinically noticeable. The primary sign is jaundice. The disease lasts several weeks and is followed by complete recovery. Hepatitis A is transmitted when the virus is taken in by mouth. The fecal-oral route and elose conluct. unwashed food, and contaminated water account for most of the routes of transmission. The sexual anal-oral route is also u route of spread. Children under the age of 3 frequently have no symptoms but can transmit the diseo.se to adults in child care centers. An injection of hepatitis A immune globulin is one way of preventing the di.seu.se but is only effective for about 30 days. 

Hepatitis A Immune globulin Prophylaxis postexposure and chronic exposure... 

Two types of products are available for the prevention of hepatitis A immune globulin (IG) and hepatitis A vaccine. IG is a solution of antibodies prepared from human plasma that is made with a serial ethanol precipitation procedure that inactivates HBV and HIV. When administered intramuscularly before exposure to HAV, or within 2 weeks after exposure, IG is >85% effective in preventing hepatitis A. IG administration is recommended for a variety of exposure situations (e.g., for persons who have sexual or household contact with patients who have hepatitis A). The duration of protection is relatively short (i.e., 3-6 months) and dose dependent. 

Hepatitis B immune globulin, a hepatitis B prophylaxis product (0.6 ml/kg IM) is used within seven days of exposure to hepatitis B. 

The HBV needlestick situation is best handled by a combination passive-active immunization approach. Immediate and long-term protection is afforded by the administration of hepatitis B vaccine and hepatitis B immune globulin at different intramuscular sites. The answer is (E). 

Grady, G. F. and Lee, V. A. (1975) Hepatitis B immune globulin - prevention of hepatitis from accidental exposure among medical personnel. New Engl. J. Med., 293, 1067. 

Managing viral hepatitis involves both prevention and treatment. Prevention of hepatitis A and B (and indirectly for hepatitis D) can be achieved with immune globulin or vaccines. There is no specific pharmacologic treatment for acute viral hepatitis A, B, C, D, or E only supportive care is available. Individuals with mild to moderate symptoms rarely require hospitalization. Occasionally, hospitalization is required in individuals experiencing significant nausea, vomiting, diarrhea, and encephalopathy. Liver transplantation may be required in rare instances if fulminant hepatitis develops. 

Individuals at high risk of acquiring hepatitis A (see Table 21-1) should receive either serum immune globulin or the hepatitis A vaccine, depending on their personal circumstances, as described below.1,5... 

Immune globulin (IG) is a solution containing antibodies from sterilized pooled human plasma that provides passive immunization against various infectious diseases, including hepatitis A.5 Immune globulin is available for either intravenous (IVIG)... 

Immune Globulin (IG) IG is a sterile solution containing antibodies from human blood. It is obtained by cold ethanol fractionation of large pools of blood plasma and contains 15-18 percent protein. Intended for intramuscular administration, IG is primarily indicated for routine maintenance of immunity of certain immunodeficient persons and for passive immunity against measles and hepatitis. IG does not transmit hepatitis B virus, human immunodeficiency virus (HIV), or other infectious diseases. 

Hepatitis A vaccine (Havrix) Vaccine Inj 1 mL 1 mL IM folbwed by 1 mL IM 6-12 months later. 96% effective. For immediate protection, give immune globulin (0.02 mL/kg IM) simultaneously. 

Passive immunity can be obtained by i.m. injection of globulin containing antibody to the virus normal immunoglobulin prepared from pooled plasma from known immune donors) which confers temporary protection for travellers visiting areas where the virus is endemic. Active immunisation with Hepatitis A vaccine is now preferable protective antibody takes about two weeks to develop. 

Some immunoglobulins cannot be obtained from normal, healthy blood donors and are obtained instead by inoculation of volunteers, so that they develop the required antibody. Such procedures are used for immunoglobulins against vaccinia, tetanus, measles, hepatitis A, Rhesus incompatibility and rabies. The biological factory for the immune globulin, in such cases, is the body of the volunteer. 

Recommendations of the Advisory Committee on Immunization Practices Use of vaccines and immune globulins in persons with altered immunocompetence. Morb Mortal Wkly Rep 1993 42(RR-4) 1-18 and Centers for Disease Control and Prevention. Hepatitis B virus A comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination. Morb Mortal Wkly Rep 1991 40(RR-13) 1 -25. 

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