Persistence of HBsAg‐specific antibodies and immune memory two to three decades after hepatitis B vaccination in adults

Abstract

The duration of protection after hepatitis B vaccination is not exactly known. This phase IV study evaluated antibody persistence and immune memory 20‐30 years after adult immunization with recombinant hepatitis B vaccine (HBsAg vaccine, Engerix‐B) in routine clinical practice. Men and women 40‐60 years old, with documented evidence of vaccination with three or four HBsAg vaccine doses 20‐30 years earlier and without subsequent booster, were enrolled and received HBsAg vaccine as challenge dose. HBsAg‐specific antibodies (anti‐HBs) and frequencies of HBsAg‐specific circulating memory B cells and CD4+ T cells expressing combinations of activation markers (CD40L, IL2, IFNγ, TNFα) were measured prechallenge, 7 and 30 days postchallenge. Of 101 participants in the according‐to‐protocol cohort for immunogenicity, 90.1% had anti‐HBs concentrations ≥ 10 mIU/mL prechallenge administration; 84.2% and 100% mounted an anamnestic response 7 and 30 days postchallenge, respectively. HBsAg‐specific memory B and CD4+ T cells expressing at least two activation markers were low prechallenge and increased markedly postchallenge. These results suggest sustained immune memory and long‐term protection 20‐30 years after a complete primary HBsAg vaccination course during adulthood, in line with current recommendations that a booster is not needed in fully vaccinated immunocompetent adults.

A Universal Plug-and-Display Vaccine Carrier Based on HBsAg VLP to Maximize Effective Antibody Response

“…However, it would be preferred to analyze the longevity of the response in humans, rather than in a mouse model, as the latter might indicate too optimistic scenarios. Several studies have analyzed the long-term protection of HBsAg vaccination in humans, suggesting that this VLP is able to induce long-lasting memory cell response and protection against HBV; nevertheless, results on the persistence of antibodies 20-30 years after vaccination can vary from 50 to 90% of individuals with persistent anti-HBsAg levels ≥10 mIU/mL, depending on the geography of the cohorts analyzed, the dosage and number of doses of vaccine used, and, more importantly, the age at time of vaccination (45)(46)(47)(48)(49). How this would impact the long-term response against heterologous antigens carried by a HBsAg-based vaccine platform remains to be determined.…”

Influence of immune aging on vaccine responses

“…This immunologic memory is mediated by B and T cells and typically manifests as the presence of antibodies in sufficient concentrations to neutralize the pathogen as well as the rapid effector cell generation when this pathogen is encountered in real life (ie, a ''recall response''). Immunologic memory can last for decades [6][7][8] and thus provide lifelong protection against infection. To generate effective immunologic memory in response to vaccination, the specific orchestra of events must occur, starting from naive cell activation to memory cell formation and subsequent long-term memory cell homeostasis (overviewed in Fig 1).…”

Reduced immune responses to hepatitis B primary vaccination in obese individuals with nonalcoholic fatty liver disease (NAFLD)

“…Gara et al 40 determined that anti-HBs titers decline more slowly among at-risk adults compared to childhood vaccine recipients. Although a recent study showed vaccine-specific-T-cell responses lasting at~20-30 years after adult immunization 41 , to date no studies have explored long-term humoral and adaptive immune response to the HBV vaccine in NAFLD adults. We plan to conduct a follow-up study to assess long-term responses (i.e., antibody waning, the persistence of T-cell immunity and anamnestic response) to the vaccine in individuals enrolled in this study.…”