From the Guidelines
No, Hyper Immune Globulin (HBIG) is not the primary prevention of Hepatitis B Virus (HBV) infection. The primary prevention for HBV is vaccination with the hepatitis B vaccine, as stated in the most recent guidelines from 2018 1. The vaccine provides long-term protection by stimulating the body to produce its own antibodies against HBV. The standard vaccination schedule consists of three doses given over a 6-month period (at 0,1, and 6 months), though schedules may vary. HBIG, on the other hand, provides temporary passive immunity through ready-made antibodies and is used in specific situations such as post-exposure prophylaxis for unvaccinated individuals after potential HBV exposure, for infants born to HBV-infected mothers, or for protection of liver transplant recipients. HBIG only offers short-term protection (typically 3-6 months) as the antibodies eventually break down in the body, as noted in a study from 2018 1. For comprehensive prevention, HBIG is often administered alongside the first dose of the hepatitis B vaccine in high-risk exposure situations to provide immediate protection while the vaccine begins to work. Key points to consider include:
- The hepatitis B vaccine is the primary means of preventing HBV infection, providing long-term immunity 1.
- HBIG is used as an adjunct to vaccination in certain high-risk situations, such as for infants born to HBV-infected mothers or for post-exposure prophylaxis in unvaccinated individuals 1.
- The effectiveness of HBIG diminishes over time, typically lasting 3-6 months, whereas the hepatitis B vaccine provides long-term protection 1. Given the evidence, the primary prevention strategy for HBV infection should focus on vaccination with the hepatitis B vaccine, with HBIG used in specific situations to provide temporary, immediate protection.
From the FDA Drug Label
Known or Presumed Exposure to Hepatitis B Virus: Unprotected individuals with known or presumed exposure to the hepatitis B virus (e.g., neonates born of infected mothers, others experiencing percutaneous or permucosal exposure) should be given hepatitis B immune globulin (HBIG) in addition to ENGERIX-B in accordance with ACIP recommendations1 and with the package insert for HBIG.
The primary prevention of Hepatitis B Virus (HBV) infection is vaccination, not Hyper Immune Globulin (HBIG). HBIG is used as an adjunct to vaccination in certain cases, such as in individuals with known or presumed exposure to HBV, including neonates born to infected mothers. HBIG provides temporary protection, while vaccination provides long-term immunity. Therefore, HBIG is not considered the primary prevention of HBV infection 2.
From the Research
Hyper Immune Globulin as Primary Prevention of HBV
- Hyper Immune Globulin (HBIG) is not the primary prevention of Hepatitis B Virus (HBV) infection, but rather a component of prevention strategies, particularly in high-risk situations such as mother-to-infant transmission or accidental exposure to HBV [(3,4,5)].
- The primary prevention of HBV infection is through vaccination with the HBV vaccine, which has been shown to be highly effective in preventing chronic HBV infection and hepatocellular carcinoma 4.
- HBIG is often used in combination with the HBV vaccine to provide immediate passive protection against HBV infection in high-risk individuals, such as newborns of HBV-positive mothers or individuals who have been accidentally exposed to HBV [(3,6,7,5)].
- The combination of HBIG and HBV vaccine has been shown to be highly effective in preventing HBV infection, with efficacy rates of 90-95% [(4,6)].
- HBIG is also used in other situations, such as prevention of re-infection after liver transplantation, non-responders to HBV vaccine, and immunosuppressed patients 5.