Immunotherapy for Infectious Diseases

72 Kunert and Katinger
Fig. 6. Different ways of preserving the humoral immune reaction. EBV, Epstein-Barr virus.
anti-Rh-D immunoglobulin has reduced the prevalence of Rh isoimmunization in the
United States and Canada by 96% since the 1940s; interestingly, it only received U.S.
Food and Drug Administration (FDA) licensing approval in 1968.
Hyperimmune sera against different viruses, such as varicella-zoster virus, hepatitis
B virus, cytomegalovirus (CMV), and respiratory syncytial virus (RSV) are used either
after accidental exposure or to treat high-risk groups, such as immunocompromised
patients.
Polyclonal human hyperimmunoglobulins are used to prevent lower RSV disease in
high-risk children under 24 months of age (12). Theses infants suffer from bronchopulmonary
dysplasia or chronic lung disease or have a history of premature birth
(13). CMV immunoglobulin is used to attenuate primary CMV disease associated with
renal transplantation if CMV-seronegative patients receive a kidney from a CMVseropositive
donor. When used prophylactically in renal allograft recipients, CMV-IGIV
has been shown to reduce the incidence of virologically confirmed CMV-associated
syndromes (14,15).
Hepatitis B immunoglobulin (HBIG) has been shown to decrease the rate of recurrence
after liver transplantation for hepatitis B (16). Antibodies to the hepatitis B surface
antigen (anti-HBs) are collected from individuals who have been hyperimmunized
with hepatitis B vaccine. Varicella-zoster immunoglobulin (VZIG) is a prophylactic
agent against chickenpox in immunocompromised children and is used in the prevention
of postnatal chickenpox after intrauterine exposure and in immunocompromised