TOPLINE:

Among people with HIV-1 infection, peak levels of anti-HBs (hepatitis B surface antibodies) predicted longer antibody persistence, with peak levels > 100 IU/L associated with significantly slower antibody clearance rates.

METHODOLOGY:

• Researchers retrospectively assessed the decline of anti-HBs level in vaccinated people with HIV-1 infection using data from the French national database between October 1988 and March 2024.
• They analyzed data from 11,082 people with HIV-1 infection (median age, 38 years; 74.2% men) who had anti-HBs level ≥ 10 IU/L at baseline and at least two measurements of anti-HBs obtained more than 6 months apart.
• The peak level of anti-HBs was defined as the highest level of anti-HBs observed and was considered the study entry value for the analysis.
• The primary outcome was the occurrence of anti-HBs clearance, with a median follow-up duration of 3.8 years.
• Secondary objectives were to identify risk factors for anti-HB waning and to quantify the incidence of HB among vaccinated people with HIV-1 infection who lost these antibodies.

TAKEAWAY:

• Overall, 40.4% of people had peak levels of anti-HBs of 10-99 IU/L, 29.5% had 100-499 IU/L, 10.9% had 500-999 IU/L, and 19.2% had ≥ 1000 IU/L.
• Peak levels of anti-HBs showed protective effects against antibody clearance, with hazard ratios [HRs] of 0.26 for 100-499 IU/L, 0.17 for 500-999 IU/L, and 0.10 for ≥ 1000 IU/L compared with levels < 100 IU/L (P < .001 for all).
• Risk factors for faster antibody clearance included being older than 45 years (HR, 1.32; P < .001), having a BMI > 25 (HR, 1.20; P = .019), being born in Africa (HR, 1.40; P < .001), and being born in countries other than France (HR, 1.46; P < .001).
• No incidence of HB among vaccinated people with HIV-1 infection was observed among those who lost anti-HBs.

IN PRACTICE:

“PWH [people with HIV] with anti-HBs levels below 100 IU/L, especially those harbouring other identified risk factors, should be monitored closely and considered for a booster vaccination dose,” the authors wrote.

SOURCE:

This study was led by Axel Ursenbach, Hôpitaux Universitaires de Strasbourg, Strasbourg, France. It was published online on December 11, 2025, in Open Forum Infectious Diseases.

LIMITATIONS:

The study population primarily consisted of men born in France with controlled HIV infection, possibly limiting generalizability to other populations. Only peak measurements of anti-HBs were analyzed; therefore, changes in antibody levels over time were not captured. Additionally, vaccination dates prior to peak levels of anti-HBs, number of doses, vaccine type, dosage, and schedule were not analyzed due to limited availability of these data in the database.

DISCLOSURES:

This study did not receive any financial support. The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.