Unsolved problems and future perspectives of hepatitis B virus vaccination

Area of Science:

• Hepatology and Virology
• Immunology
• Vaccinology

Background:

• Hepatitis B virus (HBV) infection remains a significant global health challenge.
• Vaccination is the primary prevention strategy, yet universal programs are not globally adopted.
• Non-response to current HBV vaccines is a recognized clinical issue with proposed underlying mechanisms.

Discussion:

• Third-generation vaccines incorporating pre-S proteins demonstrate enhanced anti-HBs responses.
• These advanced vaccines may offer protection against HBV with S mutations.
• Strategies like intradermal administration or co-administration with cytokines/adjuvants are being explored to boost efficacy in non-responders.

Key Insights:

• Pre-S containing HBV vaccines show improved immunogenicity.
• Alternative vaccine delivery and adjuvant strategies can enhance response rates.
• Addressing vaccine non-response is critical for achieving HBV eradication.

Outlook:

• Further research is needed on the necessity, timing, and methods of booster vaccinations in individuals with waning immunity.
• Developing effective vaccination strategies against S-mutant HBV is essential for global prevention efforts.
• Optimizing vaccine efficacy and overcoming non-response are key to controlling the worldwide burden of Hepatitis B.