Feng C S
J Fam Pract. 1982 Apr;14(4):677-81.
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.
甲型和乙型病毒性肝炎免疫球蛋白预防的适应证和剂量已明确。乙型肝炎免疫球蛋白（HBIG）对乙型肝炎具有特异性且有效，但因其成本高昂而使其价值大打折扣。免疫血清球蛋白（ISG）主要用于甲型肝炎，但也已发现其对乙型肝炎有效，从成本效益角度应将其视为首选。目前尚无针对非甲非乙型肝炎的特异性免疫球蛋白，使用ISG的疗效尚未确定。合理进行病毒性肝炎免疫预防的前提是通过实验室检测血清学标志物，以确诊索引病例的确切肝炎类型。应对接触者或潜在接触者进行血清学检测，以便将慢性携带者和具有主动免疫者排除在被动免疫之外。当需要使用昂贵的HBIG且个体易于反复接触肝炎病毒时，实验室检测费用就成了问题。尽管病毒性肝炎的预防最近取得了进展，但它仍然是一个主要的公共卫生危害。未来控制病毒性肝炎的另一大进展将取决于推出针对所有类型肝炎的疫苗以及用于检测非甲非乙型肝炎的可靠实验室检测方法。
