Anti-HBc Transfer Common in Intravenous Immunoglobulin Infusion

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Findings suggests that early positive anti-HBc tests may indicate passive transfer rather than true infection.
Findings suggests that early positive anti-HBc tests may indicate passive transfer rather than true infection.

For patients with cancer undergoing intravenous immunoglobulin infusion, passive transfer of anti-hepatitis B core antibody (HBc) is common, according to results published in Lancet Haematology.

The study included adult participants who received outpatient chemotherapy between January 1, 2004, and December 31, 2011, at the University of Texas MD Anderson Cancer Center. Participants who had received intravenous immunoglobulin therapy, tested negative for both anti-HBc and hepatitis B surface antigen before infusion, and were tested for anti-HBc after infusion were included. The primary end point was the proportion of participants who were positive for anti-HBc after intravenous immunoglobulin infusion.

Of 18,874 participants who underwent chemotherapy during the study period, 950 received intravenous immunoglobulin. Of these, 870 participants had been tested for anti-HBc before infusion.

Among participants who were negative for anti-HBc before infusion, 199 were retested after infusion; 15% (n=29) of these individuals were positive for anti-HBc on retesting.

The researchers calculated that the probability of anti-HBc conversion at 1 week after intravenous immunoglobulin infusion was 34% (95% CI, 22-48); after 12 weeks, the probability was 4% (95% CI, 2-7). This suggests that early positive anti-HBc tests may indicate passive transfer rather than true infection.

“Our results suggest that passive transfer of anti-HBc is common after intravenous immunoglobulin infusion,” the researchers wrote. “This finding has important implications for patients with cancer who are receiving intravenous immunoglobulin therapy and might require immunosuppressive therapy.”

Reference

Lu H, Lok AS, Warneke CL, et al. Passive transfer of anti-HBc after intravenous immunoglobulin administration in patients with cancer: a retrospective chart review. Lancet Haematol 2018;5:E474-E478.

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