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This is a combination therapy involving topical imiquimod, an immune response modifier and toll-like receptor 7 (TLR7) agonist, applied to the skin prior to administration of an intradermal hepatitis B vaccine. Imiquimod acts as an immunomodulator by activating innate immune responses through TLR7 stimulation, leading to enhanced cytokine production and improved antigen presentation. The hepatitis B vaccine is a recombinant subunit vaccine containing hepatitis B surface antigen (HBsAg), designed to induce protective immunity against hepatitis B virus infection. This combination has been studied primarily in populations with suboptimal response rates to conventional vaccination, such as patients with inflammatory bowel disease or those on renal replacement therapy. Clinical trials have shown that pre-treatment with topical imiquimod before intradermal administration of the hepatitis B vaccine can significantly increase seroprotection rates compared to standard intramuscular vaccination[1][2][5][8]. The safety profile is similar between groups, though local reactions may be more common at the application site.
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