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Brief Report: Hepatitis B Vaccination Histories in Persons With HIV Needing Revaccination
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may 2026
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Long-acting ART regimens do not provide the same protection against HBV as tenofovir-based therapies, and switching to HBV-inactive regimens has been linked to both new HBV infections and reactivation of prior HBV in PWH. Before initiating or switching, guidelines recommend assessing HBsAg, anti-HBs, and anti-HBc unless evaluated within 3 months. Our findings taken with the previously reported BEe-HIVe trial results support reassessing serologies and offering a CpG-adjuvanted vaccine series to individuals without seroprotection, particularly those initiating LA ART. Although CpG-adjuvanted vaccines show promising durability, further data are needed to guide long-term anti-HBs monitoring strategies.
Results:
Of the 1098 trial candidates, 561 (51%) did not have seroprotective titers at the time of screening and enrolled in A5379. Median age at the time of screening was 46 years (18–70 years), which varied across the regions: the lowest in Africa and the highest in the United States. The number of past hepatitis B vaccines varied widely across and within geographic regions. Twenty-four percent of the participants received ≥4 doses, up to 12, yet did not have seroprotective antibody titers.
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