Gastroenterology Book

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Hepatitis A ImmunoglobulinAka: Hepatitis A Ig

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  1. See Also
    1. Hepatitis A
    2. Hepatitis A Vaccine
  2. Indications (otherwise administer Hepatitis A Vaccine)
    1. Preexposure Travel to endemic areas
      1. Travel within 1 month (otherwise use vaccine)
      2. Age under 1 year or vaccine otherwise contraindicated
    2. Postexposure (within 2 weeks of exposure)
      1. Household and institutional contacts
      2. Not necessary for casual work contacts
  3. Epidemiology
    1. Most frequent vaccine preventable disease in travelers
  4. Protocol
    1. Pre-exposure for travelers to endemic areas
      1. Travel <3 months
        1. Hepatitis A Immunoglobulin 0.02 ml/kg IM
      2. Travel Longer than 3 months (protective for 5 months)
        1. Hepatitis A Immunoglobulin 0.06 ml/kg IM q4 months
    2. Post-exposure (within 2 weeks)
      1. Hepatitis A Immunoglobulin 0.02 ml/kg IM
  5. Preparation
    1. Immunoglobulin from pooled human plasma
    2. Considered safe from transmission of contagious disease
      1. Viruses inactivated
      2. Tested for Hepatitis B, Hepatitis C and HIV
  6. Contraindications
    1. IgA Deficiency
    2. Not contraindicated in pregnancy or Lactation
  7. Efficacy
    1. Pre-exposure before travel
      1. Prevents infection in up to 85%
    2. Post-exposure (if given within 2 weeks of exposure)
      1. Prevents infection in up to 89%
  8. Drug Interactions: Live attenuated vaccines
    1. Immunoglobulin decreases immunogenicity
    2. Delay MMR for 3 months after Immunoglobulin
    3. Delay Varicella Vaccine for 5 months after Ig
  9. References
    1. Bianco (2004) Dig Liver Dis 36:834
    2. Craig (2004) N Engl J Med 350:476

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