Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Dec 11;13(1):ofaf754.
doi: 10.1093/ofid/ofaf754. eCollection 2026 Jan.

Hepatitis B Surface Antibody Clearance After Vaccination in People With HIV

Axel Ursenbach  1 , François Séverac  2 , Archia Chahard  2 , Dulce Alfaiate  3 , Firouzé Bani-Sadr  4 , Laurent Hocqueloux  5 , David Rey  1 ; Dat’AIDS study group
Collaborators, Affiliations

Hepatitis B Surface Antibody Clearance After Vaccination in People With HIV

Axel Ursenbach et al. Open Forum Infect Dis. .

Abstract

Background: People with HIV (PWH) are at higher risk of developing chronic hepatitis B, and therefore vaccination against HBV is highly recommended. Clearance of hepatitis B surface antibody (anti-HBs) over time is poorly described in PWH.

Methods: We retrospectively included vaccinated PWH with anti-HBs ≥10 IU/L from the French Dat'AIDS database. Those with a cured hepatitis B were excluded. For each participant, all anti-HBs levels were collected until March 2024. Anti-HBs peak was defined as the highest anti-HBs value and corresponded to entry into the analysis. Factors associated with anti-HBs clearance below 10 IU/L were identified using a multivariable Cox model.

Results: 11 082 PWH were included, 4480 had peak anti-HBs levels between 10 and 99 IU/L, 3268 between 100 and 499 IU/L, 1205 between 500 and 999 IU/L, and 2129 ≥ 1000 IU/L. Median follow-up was 3.8 [1.6, 7.1] years. Antibody clearance over time was similar in the three groups with peak anti-HBs ≥100 IU/L, and significantly slower than in the group with anti-HBs <100 IU/L. Peak anti-HBs level was the variable with the greatest impact on anti-HBs clearance in the multivariable analysis. Compared with participants with anti-HBs <100 IU/L, having peak anti-HBs values of 100-499 IU/L, 500-999 IU/L and ≥1000 IU/L were protective factors for anti-HBs clearance, with hazard ratios of .26 [0.23, 0.30], 0.17 [0.13, 0.22] and 0.10 [0.07, 0.12], respectively, P < .001.

Conclusions: Peak anti-HBs level is the key factor of antibody persistence in PWH. Those with anti-HBs levels below 100 IU/L should be monitored closely and considered for a booster dose.

Keywords: HIV; anti-HBs; antibody; clearance; hepatitis b.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. The authors: No reported conflicts of interest.

Figures

Figure 1.
Figure 1.
Proportion of participants with hepatitis B surface antibody titer >10 IU/L over time according to peak (T0) anti-HBs level. Proportion of participants with hepatitis B surface antibody titer >10 mUI/mL over time according to peak anti-HBs level at T0.
Figure 2.
Figure 2.
Multivariate analysis of factors associated with anti-HBs clearance in the model with multiple imputations (n = 11 082). Forest plot presenting factors associated with anti-HBs clearance in multiple regression models on imputed datasets. Anti-HBs, Hepatitis B surface antibody; BMI, Body Mass Index; BRE, Blood Related Event; CDC, Centers for Disease Control and prevention; HCV, Hepatitis C Virus; IVDU, Intravenous Drug User; MSM, Men who have Sex with Men.
See this image and copyright information in PMC

References

    1. Falade-Nwulia O, Seaberg EC, Snider AE, et al. Outcomes of acute hepatitis B virus (HBV) in HIV infection with and without HBV-active antiretroviral therapy. AIDS 2021; 35:991–3. - PMC - PubMed
    1. Kim AY. Hepatitis B virus and HIV coinfection: fibrosis, fat, and future directions. Am J Gastroenterol 2019; 114:710–2. - PubMed
    1. Hu J, Liu K, Luo J. HIV-HBV and HIV-HCV coinfection and liver cancer development. Cancer Treat Res 2019; 177:231–50. - PubMed
    1. Delobel P, CNS W . Recommandations de prise en charge du VIH, des hépatites virales et des IST : rapport d’experts. Conseil national du sida et des hépatites virales. 2025. Available at: https://cns.sante.fr/dossiers/dossier-experts/rapport-experts-2023/. Accessed 2 January 2025.
    1. Ambrosioni J, Jürgen RK, EACS Guidelines . 2024. Available at: https://eacs.sanfordguide.com. Accessed 18 June 2025.