University of South Florida Morsani College of Medicine and James A. Haley Veterans Hospital Department of Internal Medicine and Division of Allergy and Immunology.
Hepatitis B (HBV) is a viral illness that chronically infects 240 million people worldwide, leads to cirrhotic liver disease, and increases risk of hepatocellular carcinoma. The HBV vaccine has decreased HBV infection and along with human papilloma virus (HPV) vaccine are the only vaccines that prevent cancer. Despite the effectiveness of HBV vaccine, some populations do not develop protective responses. The risk groups for poor response include those with immunosuppression or dialysis-dependent, end-stage renal disease. Five percent of normal people do not respond. These subjects are deemed HBV "non-responders". Multiple strategies to improve the immunogenicity of the HBV vaccine are currently being pursued, including vaccine adjuvants, recombinant vaccines, and immune enhancement via up-regulation of dendritic cells.
PubMed was searched for peer-reviewed publications published from January 1980 to September 2017.
Studies retrieved for inclusion summarized potential mechanisms behind HBV vaccine non-responsiveness and potential solutions.
The mechanisms behind HBV vaccine non-responsiveness vary between each subject population. There are many current and future strategies that may provide protective immunity against HBV in each of these populations.
This review will provide a background on the immunology of HBV infection, the possible immunologic mechanisms to explain HBV vaccine non-responsiveness, current research aimed at improving vaccine effectiveness, and possible future approaches for providing non-responders protection from HBV.