Not So Fast: Hepatitis B Vaccination in HIV-Infected Patients

Vaccination against hepatitis B virus (HBV) typically involves three immunizations over a period of 6 months. However, many patients do not complete the full series. In a recent open-label, noninferiority study, investigators assessed whether an accelerated schedule of vaccination among HIV-infected patients would improve compliance without jeopardizing efficacy.

Patients were randomized to receive HBV vaccine (HBvaxPro) at 0, 1, and 3 weeks (the accelerated schedule) or at 0, 4, and 24 weeks (the standard schedule). Response was defined as an anti-hepatitis B surface antigen (anti-HBs) level ≥10 IU/L at week 28.

Compliance was better with the accelerated schedule (92% vs. 83%), but the efficacy results were mixed. In a modified intent-to-tre…