Immunosuppressive Treatments and Risk Factors Associated with Non-Response to Hepatitis B Vaccination: A Cohort Study Padilla-Matas, Raquel Salguero-Cano, Victoria Soler-Iborte, Eva Baca-Hidalgo, Javier Pérez-Dionisio, Marta Gutiérrez-Linares, Soledad Guerrero Fernández de Alba, Inmaculada Valero Ubierna, María del Carmen Fernández-Prada, María Rivera Izquierdo, Mario Monoclonal antibodies Biologics Elderly Smoking Andalusia Background: The aim of this study was to evaluate the serological response after the complete hepatitis B vaccination of patients according to the immunosuppressive treatment they underwent, and to identify potential factors associated with non-responders. Methods: A prospective cohort study was conducted, and patients under immunosuppressive therapies were considered exposed. The main outcome was non-response to hepatitis B vaccination. Bivariate analysis was conducted to detect differences between exposed and non-exposed patients. A multivariable log-binomial regression model was designed to analyze potential factors independently associated with non-responders. Results: A total of 289 patients were included. Immunosuppressive treatment was associated with non-response to hepatitis B vaccination (RR = 2.49, 95% CI: 1.26–4.96). Concretely, the use of cytotoxic therapies showed increased risk, although anti-CD20 and anti-JAK also showed a tendency to be associated with non-responders. Other variables associated with non-responders were older age (6–7% higher risk per year), smoking (RR = 3.08, 95% CI: 1.41–6.74) and certain vaccine regimens. These findings were similar for persistent non-responders despite an additional booster dose. Conclusions: Patients receiving immunosuppressive treatments, who are older in age or who are smokers have a higher risk of non-response to conventional hepatitis B vaccination. These data might serve to optimize hepatitis B vaccination in high-risk patients. 2025-03-24T09:03:46Z 2025-03-24T09:03:46Z 2025-02-14 journal article Padilla-Matas, R.; Salguero-Cano, V.; Soler-Iborte, E.; Baca-Hidalgo, J.; Pérez-Dionisio, M.; Gutiérrez-Linares, S.; Guerrero- Fernández de Alba, I.; Valero-Ubierna, M.d.C.; Fernández-Prada, M.; Rivera-Izquierdo, M. Immunosuppressive Treatments and Risk Factors Associated with Non-Response to Hepatitis B Vaccination: A Cohort Study. Vaccines 2025, 13, 184. https://doi.org/10.3390/vaccines13020184 https://hdl.handle.net/10481/103262 10.3390/vaccines13020184 eng http://creativecommons.org/licenses/by/4.0/ open access Atribución 4.0 Internacional MDPI