Evaluation of a personalized, dose-sparing revaccination strategy in hepatitis B vaccine non-responders

•The baseline anti-HBs titre in non-responders affects the seroconversion rate after revaccination.•Agreement of assays to differentiate between presence or absence of anti-HBs below the titre of 10 IU/L was substantial, except for ADVIA.•The limit of detection is a reliable cutoff to differentiate between a zero- and poor- responder.•The titre-based strategy results in a reduction of revaccinations needed compared to the standard series. The detection of low levels of antibodies against HBsAg (anti-HBs) below 10 IU/L in non-responders after a primary hepatitis B vaccination, is associated with seroconversion after revaccination. We compared the diagnostic performance of four anti-HBs assays in non-responders in their ability to differentiate between absence or presence of low levels of anti-HBs and propose a revaccination strategy guided by anti-HBs titres. Non-responders were revaccinated with Fendrix 20 μg at 0, 1 and 2 months. Anti-HBs titres were determined by Abbott Architect, Diasorin Liaison, Roche Cobas and Siemens ADVIA Centaur. Inter-assay agreement was evaluated with Cohen’s Kappa (k) in baseline samples between zero-responders without detectable antibodies and poor-responders with detectable antibodies