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Intramuscular hepatitis B immunoglobulins for reinfection control after liver transplantation: a cost-saving alternative.

AIM
We explore the effectiveness and cost-effectiveness of intramuscular versus intravenous hepatitis B immunoglobulins (HBIG-IV vs HBIG-IM) to prevent reinfection with the hepatitis B virus after orthotopic liver transplantation.


PATIENTS & METHODS
Overall, 14 patients had orthotopic liver transplantation in 2003-2013 at Ghent University Hospital for HBV-related liver disease. On average 32 months after transplantation patients switched from high-dose HBIG-IV to low-dose HBIG-IM, always in combination with a nucleos(t)ide analog.


RESULTS
Seven patients were switched so far. No significant differences between HBIG-IV and HBIG-IM were found in HBsAg and hepatitis B virus-DNA.


CONCLUSION
Switching patients from HBIG-IV to HBIG-IM can be done safely if well monitored. Net yearly savings for the healthcare payer were €5000 for each patient switched to HBIG-IM.