LAUSR

Background and aims Persistent HBs antigenemia >1000 IU/ml has a possibility of viral reactivation and HCC in 8%, so we investigated the effect of HBV vaccine on HBsAg, IP‐10, and recurrence of viremia. Methods Group I: inactive carriers (n = 100). Group II: CHB exposed to nucleos(t)ides (n = 120) till 1 year after HBe seroconversion and HBV DNA disappearance in HBeAg positive (n = 60) or 3 years after DNA disappearance in HBeAg negative patients (n = 60). All showed persistent HBs antigenemia. A control group (n = 100) did not receive HBV vaccine. 30 &mgr;g of HBV vaccine initiated at the determined points of time. 3 months after the last vaccine dose; IP‐10, HBsAb, HOMA‐IR and liver stiffness by fibroscan were evaluated. HBV DNA and HBsAg were detected every 6 months for 3 years post vaccination. Results 46 patients (20.9%) were vaccine nonresponders. 174 patients were responders (79.1%). 62 patients (28.2%) cleared HBsAg, 143 patients showed marked reduction of HBsAg (65%). Recurrence of viremia occurred in 4 vaccinated patients (7.8%) vs. 30 patients in the control group (30%, p = 0.000). The vaccine enhanced IP‐10 which at a cutoff 350 pg/ml helped in HBsAg reduction to a favorable level. The vaccine had no significant effect on HOMA‐IR nor fibroscan value. Conclusions HBV vaccine was efficient in enhancing IP‐10 level with HBsAg clearance, or reduction to a favorable level. ClinicalTrials.gov Identifier: NCT03193775. HighlightsA significant number of patients after disappearance of HBV DNA and HBe seroconversion showed persistent HBs antigenemia and find difficulty in indefinite treatment.With HBsAg level > 1000 IU/ml, the possibility of viral reactivation and hepatocellular carcinoma approaches 8%.HBV vaccine given in 30 &mgr;g of HBV vaccine (0, 1, 6 months), initiated 6 months after HBe seroconversion and disappearance of HBV DNA.It was highly efficient, safe, and cost effective in enhancing HBsAg clearance, causes its reduction to a favorable level less than 1000 IU/ml and halts fibrosis progression