Tri-Antigenic vs Mono-Antigenic Vaccine for Hepatitis B Virus Prevention

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In contrast with a mono-antigenic vaccine (MAV), immunogenicity of a tri-antigenic vaccine (TAV) for hepatitis B virus (HBV) an infection was discovered to be noninferior amongst adults 18 years of age and older and superior amongst adults 45 years of age and older, together with people with steady, managed persistent situations, in accordance with examine outcomes revealed in The Lancet Infectious Ailments.

A workforce of investigators carried out a multicenter, double-blind, part 3, randomized medical trial (PROTECT; Identifier: NCT03393754; EudraCT: 2017–001819-36) to check seroprotection charges of MAV and TAV towards HBV in adults with steady and managed persistent situations.

From December 2017 to April 2019, contributors at hospitals in the USA, Finland, Canada, and Belgium had been randomly assigned 1:1 to both TAV (10 μg) or MAV (20 μg) on days 0, 28, and 168. The trial included 6 examine visits and 24 weeks of follow-up following the third vaccination. Each vaccines had been administered intramuscularly.

Proceed Studying

The first outcomes of the examine had been noninferiority of the seroprotection price of TAV vs MAV in adults 18 years of age and older, and the prevalence of TAV to MAV in sufferers 45 years of age and older. The vaccine-induced seroprotective price was outlined as the share of sufferers who had hepatitis B floor antibodies (anti-HBs) titers of 10 mIU/mL or extra.

Of the 2472 sufferers who had been screened, 1607 sufferers (62% girls) had been randomly assigned to obtain both TAV (n=796) or MAV (n=811); 18.6% had been aged 18 to 44 years, 44.6% had been aged 45 to 64 years, and 36.8% had been 65 years and older.

Seroprotection charges had been 91.4% for recipients of TAV and 76.5% for recipients of MAV 18 years and older, suggesting noninferiority of TAV (distinction, 14.9%). Seroprotection charges in contributors 45 years and older within the TAV and MAV teams had been 89.4% and 73.1%, respectively, suggesting superiority of TAV in contrast with MAV (distinction, 16.4%).

In contrast with MAV, recipients of TAV skilled extra solicited native adversarial occasions together with any solicited native adversarial occasion (71.9%; P <.0001), ache (63.2%, P <.0001), and tenderness (60.8%, P <.0001). Vital solicited systemic adversarial occasions within the TAV group in contrast with the MAV group included any systemic adversarial occasion (55.9%, P =.02) and myalgia (P =.008).

“The flexibility of TAV to soundly seroprotect extra adults earlier following fewer vaccinations in adults aged 18 [to] 44 years, together with these with impaired vaccine immune responses in people with well-controlled comorbidities, exhibits its potential to beat the restrictions of present normal MAVs and to assist tackle ongoing unmet medical wants within the prevention of HBV an infection,” the authors famous.

Disclosure: This analysis was supported by VBI Vaccines. Please see the unique reference for a full listing of disclosures.


Vesikari T, Langley JM, Segall N, et al; PROJECT Examine Group. Immunogenicity and security of a tri-antigenic versus a mono-antigenic hepatitis B vaccine in adults (PROTECT): a randomised, double-blind, part 3 trial. Lancet Infect Dis. Printed on-line Might 11, 2021. doi:10.1016/S1473-3099(20)30780-5

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