DOI: 10.12890/2026_006714

Serological interference related to intravenous immunoglobulins: a case of false immunization against hepatitis B virus

Authors

  • Hajar Fadili Laboratory Medicine, Cheikh Khalifa International University Hospital, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco; Faculty of Medicine, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco
  • Jihane Smaali Department of Internal Medicine, Mohammed VI University of Sciences and Health, Casablanca, Morocco
  • Malak Snoussi Laboratory Medicine, Cheikh Khalifa International University Hospital, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco; Faculty of Medicine, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco
  • Fadwa Ousti Laboratory Medicine, Cheikh Khalifa International University Hospital, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco; Faculty of Medicine, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco
  • Abdelhamid Zrara Department of Immunology, Mohamed V Military Instruction Hospital, Rabat, Morocco
  • Jalila El Bakkouri Laboratory Medicine, Cheikh Khalifa International University Hospital, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco; Immunopathology-Immunotherapy-Immunomonitoring Laboratory, Faculty of Medicine, UM6SS, Mohammed VI University of Health and Sciences, Casablanca, Morocco

hajar.fadili12@gmail.com

Keywords

Intravenous immunoglobulin, serological interference, false-positive serology, passive antibody transfer, diagnostic challenge

Abstract

Introduction: Intravenous immunoglobulins (IVIG) are derived from pooled plasma obtained from thousands of donors and are widely used in the treatment of inflammatory, infectious, and immunodeficiency disorders. Due to their origin, these preparations may contain antibodies directed against various infectious agents. Their administration can therefore result in passive transfer of antibodies, potentially interfering with the interpretation of certain serological tests.
Case description: We report a case of false-positive anti-HBs antibodies observed following IVIG administration in a patient with no prior history of vaccination, who was being followed for polyarteritis nodosa with resistance to first- and second-line therapies.
Serological testing was performed as part of a pre-therapeutic workup prior to initiation of tocilizumab. Subsequent follow-up tests demonstrated a progressive decline in antibody titres, consistent with the clearance of passively transferred immunoglobulins.
Discussion: Passive transfer of anti-HBs and anti-HBc antibodies, as well as other antibodies targeting infectious agents or autoimmune antigens following IVIG administration, has been previously described in the literature. This situation is of particular clinical relevance in patients who are candidates for immunosuppressive therapy, which may induce reactivation of certain pathogens. Misinterpretation of these results may lead either to unnecessary prophylactic treatment or to inappropriate modification or delay of essential immunosuppressive therapy. To avoid misleading results, it is recommended to perform baseline serological screening prior to IVIG initiation, to store a reference serum sample for potential retrospective analysis, and, in patients receiving high doses, to avoid IgG-based serological assays in favour of diagnostic methods such as polymerase chain reaction.
Conclusion: Increased awareness among clinicians and laboratory specialists is essential to prevent unnecessary investigations and delays in appropriate patient management.

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References

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Published

2026-05-15

Issue

Vol. 13 No. 6 (2026)

Categories

How to Cite

1.
Fadili H, Smaali J, Snoussi M, Ousti F, Zrara A, El Bakkouri J. Serological interference related to intravenous immunoglobulins: a case of false immunization against hepatitis B virus. EJCRIM [Internet]. 2026 May 15 [cited 2026 Nov. 3];13(6). Available from: https://ejcrim.com/index.php/ejcrim/article/view/6714