Immunoglobulins for prevention of specific infections

 All cases should be discussed with the duty virologist  who will advise and organise antibody testing, where indicated.

If you have been advised to order immunoglobulins from the Health Protection Agency (HPA) Click Here (intranet users only)

The following is only a brief summary of guidance. Links are also provided to the published guidance documents from the HPA.

Normal Human Immunoglobulin (NHIG) for intramuscular injection. (Do not confuse with NHIG for intravenous injection which is stocked by pharmacy.)

• Measles: MMR is normally used for post exposure prophylaxis. NHIG is only used in either:
  1. Immunocompromised patients
  2. Non-immune pregnant women
  3. Infants between 6 and 9 months of age

NHIG is most effective if given within 72 hours but can be given up to 6 days after exposure to measles.

• Hepatitis A: Vaccine is normally used for post exposure prophylaxis unless the onset of jaundice in the index case was more than a week ago, in which case NHIG is indicated. It may then be effective if given up to 2 weeks after exposure to hepatitis A.

For full guidance including indications, significant contact and dosage click here

Hepatitis B immunoglobulin (HBIG)

HBIG is normally used in combination with HB vaccine to confer active/passive immunity in the following groups.

• Newborn of mothers who are HBsag positive, HBeab negative
• Significant exposure to blood and other materials containing HBsag
• Sexual contacts of acute cases of hepatitis B

Known vaccine non-responders should be given HBIG after a significant exposure and repeated after 1 month unless the source is known and has been shown to be negative. HBIG should be given preferably within 12 hours of exposure and not later than a week after exposure.

For full guidance including indications, significant contact and dosage click here

Zoster Immunoglobulin (ZIG)

This is recommended for individuals who fulfil the following criteria:

1. A clinical condition which increases the risk of severe varicella: includes immunosuppressed patients, neonates and pregnant women  
2. No antibodies to VZV
3. Significant contact with chickenpox or shingles

ZIG should ideally be given within 7 days of contact but may attenuate infection up to 10 days after contact.

For full guidance including indications, significant contact and dosage click here

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.

Read our copyright and disclaimer statement