A real-world pattern on the long-term durability of the immune response to hepatitis B vaccination among people living with HIV in China: an 8.5-year retrospective study.

Authors

Honghong Yang, Xiang Du, Lvlang Zhang, Tongxin Li, Pengle Guo, Jingmin Nie

Published in

Frontiers in public health. Volume 14. Pages 1901939. Epub Aug 14, 2026.

Abstract

The long-term durability of the immune response after primary hepatitis B (HBV) vaccination in people living with HIV (PLWH) remains unclear. This real-world study aimed to assess HBV vaccination immunogenicity in PLWH and explore the factors influencing long-term immunogenicity. A total of 195 PLWH with baseline anti-HBs < 10 IU/mL who received ≥1 dose of Heplisav-B vaccine and underwent anti-HBs measurement at 7-9 months after the first dose were retrospectively analyzed. Longitudinal follow-up of 1.5-8.5 years was conducted to evaluate long-term trend of anti-HBs titer. The study population was predominantly male (88.2%), with a median baseline CD4 + cell count of 351.8 cells/μL, and 81.0% had undetectable HIV RNA at baseline. In total, 44 (22.5%), 38 (19.5%), 100 (51.3%), and 13 (6.7%) PLWH received 1, 2, 3, and 4 vaccine doses, respectively. The initial immune response (7-9 months post-dose 1) was dose-dependent, with rates of 77% (1 dose), 79% (2 doses), 98% (3 doses), and 85% (4 doses). Compared with the 1- and 2-dose regimens, both the 3- and 4-dose regimens induced significantly higher response rates, characterized by a predominance of high responses (HRs). Over the 8.5-year follow-up period, response rates gradually decreased across all the groups. However, the 3- and 4-dose groups reached superior durability (83 and 88% response rates at year 8.5 years post-dose 1, respectively), with median anti-HBs titers persistently >100 IU/mL. Multivariable analysis revealed the number of vaccine doses and a robust early serological response were consistent independent correlates of antibody persistence at 3.5, 5.5, and 8.5 years post-dose 1, with HIV RNA negativity additionally emerging as a key factor related to the 8.5-year outcome. These findings suggest that a complete 3- or 4-dose HBV vaccination series, coupled with an early serological response, is associated with sustained long-term antibody persistence in PLWH.

PMID:
42666258
Bibliographic data and abstract were imported from PubMed on 29 Aug 2026.

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