Persistence of Protective Hepatitis B Surface Antibody Titers after Successful Double-Dose Hepatitis B Virus Rescue Vaccination in HIV-Infected Patients

BACKGROUND/AIMS To assess the durability of protective hepatitis B surface antibody (anti-HBs) titers in HIV-infected patients who responded to double-dose hepatitis B virus (HBV) rescue vaccination. METHODS A retrospective chart review was performed for HIV-infected patients who received the double-dose HBV rescue vaccination at 0-, 1-, and 2-month intervals after they had failed conventional HBV vaccination series. A protective antibody response was defined as an anti-HBs titer ≥10 mIU/mL. RESULTS Of 54 HIV-infected patients who received a double-dose HBV rescue vaccination, 44 patients (81.5%) had a positive response and achieved protective anti-HB titers. Of the 44 patients who developed protective anti-HB titers, 33 patients received an evaluation of their anti-HB titers 12 months later. Of the 33 patients, 19 (57.6%) had persistent protective anti-HB titers (persistent responders, PR), and 14 patients (42.4%) lost their protective anti-HB titers (nonpersistent responders, NPR). There were significantly more patients who had an undetectable HIV viral load (<50 copies/mL) at baseline and follow-up in the PR group (11/19, 57.9%) than in the NPR group (3/14, 21.4%, p=0.036). Logistic regression analysis showed that an undetectable HIV viral load at baseline and follow-up (odds ratio, 12.973; 95% confidence interval, 1.189 to 141.515; p=0.036) was associated with PR. CONCLUSIONS Protective anti-HB titers may decrease over time after successful double-dose HBV rescue vaccination in HIV-infected patients. HIV viral load suppression could improve the persistence of anti-HB titers.