Peer-reviewed article
The role of new hepatitis B vaccines in South Africa.
Van Zyl GU, Maponga T, Rabie H, Taljaard J ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001Hepatitis B infection remains endemic in South Africa despite introducing vaccination in 1995. Two new hepatitis B vaccines have been licensed internationally: HEPLISAV-B with an adjuvant and PreHevbrio with multiple surface protein domains, both potentially offering improved immune response. These vaccines have not yet been studied in children or licensed in South Africa, but HEPLISAV-B may be particularly beneficial for high-risk groups including people living with HIV who respond poorly to current vaccines.
Key points
- Hepatitis B virus infection remains endemic in South Africa despite EPI vaccine coverage since 1995
- HEPLISAV-B shows improved vaccine response in individuals with HIV, old age, or diabetes mellitus
- PreHevbrio contains three hepatitis B surface protein domains instead of one and may be more immunogenic, though clinical data are limited
- South Africa has large populations at risk: 8.45 million people living with HIV, 13% with diabetes, and 5 million over 60 years old
- Neither new vaccine has been investigated in children or licensed in South Africa
Limitations
This is a review article that discusses vaccine characteristics and potential benefits without presenting new empirical data or outcomes from trials in South African populations. It cannot tell us about actual effectiveness, safety, or implementation outcomes if these vaccines were introduced in South Africa.
Abstract
Vaccination is key to eliminating hepatitis B virus infection in South Africa (SA). Despite introducing immunisation in 1995, as part of the expanded programme of immunisation (EPI), hepatitis B virus infection remains endemic, and EPI vaccine coverage is incomplete. In addition to infants, non-immune adults at risk of infection through their occupation or with behavioural risk factors should receive vaccination. SA has many individuals with diabetes mellitus (a prevalence of almost 13%), obesity, HIV (8.45 million) or older age (5 million >60 years old), associated with a poorer vaccine response. Recently two new hepatitis B vaccines have been licensed: HEPLISAV-B includes an adjuvant that improves immunogenicity and has shown improved vaccine response in individuals with HIV, old age or diabetes mellitus. PreHevbrio, which includes three hepatitis B surface protein domains, instead of one, may also be more immunogenic, although clinical study data are still limited. These two novel vaccines have not yet been investigated in children and licensed in SA. Should HEPLISAV-B become available in SA, it may be particularly valuable to target high-risk groups in the country, such as people living with HIV, who show a poor response to the currently licensed vaccine.