Observational Study Evaluating the Seroprotection of HepB-alum Vaccine and HepB-CpG Vaccine in People With HIV

Brenna Reilly-Evans; Beatrix Dudzik; David J Costlow; Carlos Hartmann; Ann M Khalsa; Christelle Kassis; Monika T Zmarlicka

doi:10.1093/ofid/ofad267

Observational Study Evaluating the Seroprotection of HepB-alum Vaccine and HepB-CpG Vaccine in People With HIV

Open Forum Infect Dis. 2023 May 17;10(6):ofad267. doi: 10.1093/ofid/ofad267. eCollection 2023 Jun.

Authors

Brenna Reilly-Evans¹, Beatrix Dudzik², David J Costlow³, Carlos Hartmann⁴, Ann M Khalsa⁴, Christelle Kassis^{4

5}, Monika T Zmarlicka⁴

Affiliations

¹ Department of Pharmacy, Regional One Health, Memphis, Tennessee, USA.
² Department of Student Research, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, USA.
³ Department of Pharmacy, Valleywise Health, Phoenix, Arizona, USA.
⁴ Department of Medicine, Ochsner Health, Covington, Louisiana, USA.
⁵ Department of Medicine, Valleywise Health, Phoenix AZ, USA.

Abstract

Background: Hepatitis B virus (HBV) vaccine seroprotection rates with conventional aluminum adjuvanted recombinant HBV vaccines, Engerix-B (HepB-alum) vaccine, among people with HIV (PWH) are varied. Heplisav-B (HepB-CpG) vaccine, a novel adjuvanted recombinant HBV vaccine, has shown higher seroprotection rates in immunocompetent patients but is not well studied in PWH. There are no published studies comparing seroprotection rates between HepB-alum and HepB-CpG in PWH. This study aims to evaluate and compare the seroprotection incidence of HepB-alum vs HepB-CpG in PWH at least 18 years of age.

Methods: This retrospective, observational cohort study included adults diagnosed with HIV who received a complete series of HepB-alum or HepB-CpG at a community health center in Phoenix, Arizona. Patients had a hepatitis B surface antibody <10 IU/L at the time of the first vaccine dose. The primary outcome was a comparison of seroconversion incidence between HepB-CpG and HepB-alum. Secondary outcomes included identifying factors associated with likelihood of response to HBV vaccination.

Results: A total of 120 patients were included in this study, 59 in the HepB-alum cohort and 61 in the HepB-CpG cohort. In the HepB-alum cohort, 57.6% achieved seroconversion, compared with 93.4% in the HepB-CpG cohort (P < .001). Those without diabetes were more likely to have response to a vaccine.

Conclusions: Among PWH at a single community health center, HepB-CpG provided a statistically higher incidence of seroprotection against HBV compared with HepB-alum.

Keywords: HIV; hepB-CpG; hepatitis B; vaccine.