Use of intravenous vs. intramuscular hepatitis B immunoglobulin in prevention of relapse of hepatitis B in post liver transplant patients

OBJECT: To see the response of HBIg in post liver transplant patients in prevention of hepatitis B relapse by using two different routes of administration. STUDY DESIGN: prospective comparative study. PLACE AND DURATION OF STUDY: Sultan Qaboos University Hospital, Oman. From December 2001 ± December 2007. PATIENTS AND METHODS: Total 32 patients who underwent cadavaric liver-transplantation due to hepatitis B related end-stage liver disease were included in this study. Patients were divided into two groups by simple random technique. HBIg was administered through intravenous route to subjects of Group 1, whereas to subjects of Group II it was administered through intramuscular route. All patients received full recommended dose of HBIg with oral lamirudine for the prevention of relapse. Subjects were followed up for 30-months to record any event of relapse in both groups. RESULTS: There were 24 (75%) males and 8 (25%) females, with median age of 37 years. Pretreatment HBV - DNA was detected in 28 (87.5%) and anti-HBS levels were <10-IU in all patients. During the course of treatment HBV-DNA found to be un-detectable and anti-HBS levels were maintained >100 in all patients. None of the study subjects in both groups had relapse of Hepatitis B. CONCLUSION: Intramuscular route of administrating HBIg in post liver transplant cases secondary to hepatitis B was found to be as effective as intra venous route.