Serological response with Heplisav-B® in prior Hepatitis B vaccine non-responders living with HIV

•Challenges exist in achieving seroprotection following HBV immunization in PLWH.•Heplisav-B® may be beneficial in prior HBV vaccine non-responders living with HIV.•Traditional risk factors for seroconversion failure in PLWH remain with Heplisav-B®. As people living with HIV (PLWH) are at risk for c...

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Bibliographic Details
Published in:Vaccine 2021-10, Vol.39 (44), p.6529-6534
Main Authors: Khaimova, Rebecca, Fischetti, Briann, Cope, Rebecca, Berkowitz, Leonard, Bakshi, Anjali
Format: Article
Language:English
Subjects:
Antibodies
Antigens
CD4 antigen
Dialysis
Health care
Hepatitis
Hepatitis B
Hepatitis B antibodies
Hepatitis B Virus
Hepatitis C
HIV
Human immunodeficiency virus
Immunity
Immunoassay
Infections
Non-responders
Patients
Public health
Seroconversion
Serology
Statistical analysis
Vaccine
Vaccines
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Summary:•Challenges exist in achieving seroprotection following HBV immunization in PLWH.•Heplisav-B® may be beneficial in prior HBV vaccine non-responders living with HIV.•Traditional risk factors for seroconversion failure in PLWH remain with Heplisav-B®. As people living with HIV (PLWH) are at risk for contracting Hepatitis B Virus (HBV), they should be screened for HBV and vaccinated if not immune. Seroconversion rates in PLWH receiving traditional recombinant HBV vaccines (Engerix-B® and Recombivax-HB®) have historically been low with at most 70% achieving immunity. In 2017, a recombinant, adjuvanted HBV vaccine (Heplisav-B®) was approved for use in HIV-negative patients. Heplisav-B® has shown superior seroprotection in this population compared to Engerix-B® and Recombivax-HB®, as well as interim analysis showing higher seropositivity rates in patients undergoing dialysis. However, its efficacy in PLWH is currently unknown. This study evaluates the rate of seroconversion following Heplisav-B® administration in PLWH with previous HBV vaccination failure. Retrospective, cross-sectional study at The Brooklyn Hospital Center’s HIV primary care clinic in Brooklyn, NY. HIV-positive adults who received at least two doses of Heplisav-B® and had previously failed to seroconvert after vaccination with Engerix-B® or Recombivax-HB® were included. The primary outcome is the percentage of PLWH who became seropositive following Heplisav-B®. A total of 67 patients met the inclusion criteria. Twenty-five (37.3%) PLWH had failed at least 2 courses of recombinant vaccines. Fifty-eight (86.6%) PLWH became seropositive (Anti-HBs > 10 mIU/mL) at least two months after completing Heplisav-B®. For the 9 (13.4%) patients that did not develop immunity, 3 (33%) had a detectable HIV RNA and 3 (33%) had a CD4 count 
ISSN:0264-410X
1873-2518
DOI:10.1016/j.vaccine.2021.09.050