HBV Vaccination Response — SCE Infectious Diseases MCQ

Correct answer: C — This is seroprotective but less robust than a titre at or above 100 mIU/mL, so follow the HIV-specific booster and monitoring pathway after susceptibility review with review

The best answer is “This is seroprotective but less robust than a titre at or above 100 mIU/mL, so follow the HIV-specific booster and monitoring pathway after susceptibility review with review”. Anti-HBs at or above 10 mIU/mL is protective, but people with HIV may lose antibody more quickly and a 10–99 response warrants HIV-guideline follow-up. “The vaccine has failed because titres above 1000 mIU/mL are needed” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement. “The titre suggests occult hepatitis-B infection requiring tenofovir treatment” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement. “Post-vaccination serology has little value in people with HIV” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement. “Hepatitis-B immunoglobulin is required in the absence of exposure” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement.

Reference: BHIVA vaccination guidelines: https://bhiva.org/clinical-guideline/vaccination-guidelines/