Advances in treatment and prevention of hepatitis B

Table 2 Studies addressing hepatitis B vaccination strategies

Ref.	Study type	Main findings
Koc et al[49], 2018	Prospective open label trial	HBAI20 (HBVaxPro©-10-μg vaccine combined with an adjuvant AI20, a recombinant human IL-2) exhibited protective anti-HBs titers in 90% of previous non-responders likely due to an enhanced immune response
Qiu et al[53], 2018	Prospective trial	Genome wide comparative analysis revealed significant transcriptome and cytokine changes in HBV vaccine non-responders
Da Silva et al[54], 2018	Randomized prospective trial	Impaired seroconversion for HBV vaccination in CKD patients was linked to reduced baseline CXCR3 + CCR6- CXCR5+ memory T cells levels
Van Damme et al[59], 2019	Prospective trial	Immune challenge, in previously vaccinated adults (HBsAg vaccine 2-3 decades prior) showed a 100% anamnestic response by day 30 with significant increase in HBsAg-specific memory B and CD4+ T cells
Raven et al[48], 2020	Open-labeled, randomized, controlled superiority trial	In Immunocompetent non-responders, revaccination with Fendrix 20 μg or HBVaxPro 40 μg resulted in significantly higher response rates compared to HBVaxPro 10 μg, Energix B 20 μg, or Twinrix 20 μg
Chawansuntati et al[63], 2018	Prospective trial	HBV patients with HIV co-infection have reduced levels of TNF-α and IL-2 levels, and may require an increased HBV vaccine dose to counter this problem
Palazzo et al[64], 2018	Prospective trial	Revaccination with the Hepatitis B vaccine (Twinrix, GlaxoSmithKline, London), in HBV patients on maintenance Lenalidomide post autologous hematopoietic stem cell transplant was absolutely safe with 40% efficacy
Nishikawa et al[65], 2020	Prospective trial	For HBV vaccinated, HSCT recipients, 2-year and 3-year cumulative HBV reactivation rates were 22.2% and 28.9% respectively. Discontinuation of immunosuppressants (P = 0.0379) and baseline titers of anti-Hbs (P = 0.004) were related to HBV reactivation

IL-2: Interleukin 2; anti-HBs: Anti Hepatitis B surface antibody; HBsAg: Hepatitis B surface antigen; HIV: Human Immunodeficiency virus; HBV: Hepatitis B virus; TNF: Tumor necrosis factor; HSCT: Hematopoietic stem cell transplant; CKD: Chronic kidney disease.