The indications and dosage of
immunoglobulin prophylaxis for viral
hepatitis types A and B are well defined.
Hepatitis B immune globulin (
HBIG) is specific and effective for
hepatitis B, but its value is offset by its high cost. Immune
serum globulin (ISG) is primarily for
hepatitis A, but it also has been found to be effective for
hepatitis B and should be considered the choice from a cost-effective point of view. There is no specific
immune globulin for
hepatitis non-A, non-B, and the efficacy in using ISG has been undetermined. The prerequisite for a rational approach to immunoprophylaxis for viral
hepatitis is laboratory determination of serological markers, which confirms the diagnosis of the precise
hepatitis type of the index case. Serological testing of the contacts or potential contacts is indicated so that chronic carriers and those with active immunity should be exempted from passive immunization. The expense of laboratory tests is compromised by situations which require the costly
HBIG and when the individual is inclined to repeated
hepatitis exposure. Viral
hepatitis remains a major public health hazard in spite of recent advances in its prevention. Another stride in future control of viral
hepatitis will depend on the introduction of
vaccines for all types of
hepatitis and reliable laboratory tests for the detection of
hepatitis non-A, non-B.