Weaker SARS-CoV-2 vaccine responses in nonalcoholic fatty liver disease with advanced liver fibrosis.

Autor:	Hakimian D; Hadassah Medical Center, Liver insitute, Hadassah-Hebrew University Medical Center, Israel., Amer J; Hadassah Medical Center, Liver insitute, Hadassah-Hebrew University Medical Center, Israel., Jammal A; Hadassah Medical Center, Liver insitute, Hadassah-Hebrew University Medical Center, Israel., Shafrir A; Hadassah Medical Center, Liver insitute, Hadassah-Hebrew University Medical Center, Israel., Milgrom Y; Hadassah Medical Center, Liver insitute, Hadassah-Hebrew University Medical Center, Israel., Masarowah M; Hadassah Medical Center, Liver insitute, Hadassah-Hebrew University Medical Center, Israel., Hazou W; Hadassah Medical Center, Liver insitute, Hadassah-Hebrew University Medical Center, Israel.; Hadassah Medical Center, Department of Surgery, Jerusalem, Israel., Ishay Y; Hadassah Medical Center, Liver insitute, Hadassah-Hebrew University Medical Center, Israel., Imam A; Hadassah Medical Center, Department of Surgery, Jerusalem, Israel., Francis A; Hadassah Medical Center, Cardiac Care Unit, Holy Family Hospital, Bar-Ilan University, Nazareth, Israel., Khalaileh A; Hadassah Medical Center, Department of Surgery, Jerusalem, Israel., Safadi R; Hadassah Medical Center, Liver insitute, Hadassah-Hebrew University Medical Center, Israel.
Jazyk:	angličtina
Zdroj:	Vaccine: X [Vaccine X] 2023 Oct 12; Vol. 15, pp. 100359. Date of Electronic Publication: 2023 Oct 12 (Print Publication: 2023).
DOI:	10.1016/j.jvacx.2023.100359
Abstrakt:	Background: SARS-CoV-2 vaccine responses that could harbor potential risks to chronic liver diseased patients. Aims: To assess immune response following Pfizer's SARS-CoV-2 vaccine in patients with different liver fibrosis severities of nonalcoholic fatty liver disease (NAFLD). Methods: Clinical and histological (NAS-score and fibrosis stage) characteristics of NAFLD patients before vaccine were correlated with serologic vaccine responses of two doses of the BNT162b2. Serum SARS-CoV-2 spike immunoglobulins (anti-S) were assessed on day seven following immunization (Liaison assay). Results: The mean-age of patients (n = 157) was 56.9 ± 13.2 years (46.5 % males). 94.8 % had a positive response (anti-S levels ≥ 19 AU/ml). The anti-S cutoff of 200 AU/ml used to separate strong vs. weak responses. A strong response (anti-S titers ≥ 200 AU/ml) was observed in 93/157 (59.2 %) patients with a mean-age of 53.1 ± 13.8 years (45.2 % males). A weak response (anti-S titers < 200 AU/ml) was observed in 64/157 (40.8 %) cases with a mean-age of 62.3 ± 10.2 years (p < 0.0001). The strong response subgroup had lower metabolic comorbidities, including glucose hemostasis, hypertension, and dyslipidemia (p < 0.04). Moreover, the strong response subgroup had fibrosis stages F0-F2 (75.3 % vs. 56.3 %) and lower rates of advanced stages F3-F4 (24.7 % vs. 43.8 %). The F0-F2 subgroups had significantly higher rates of strong responses than the F3-F4 stages. The anti-S ≥ 200 and anti-S ≥ 400 AU/ml response achieved in 66 % and 36.8 % of the F0-F2 population was significantly higher than the 45.1 % (p = 0.006) and 23.5 % (p = 0.05) in the F3-F4 population, respectively. The Fib-4 calculations and Fibroscan evaluations were consistent with histologic fibrosis assessment. Conclusion: Advanced liver fibrosis (assessed by histology, Fib-4, or Fibroscan) is a risk factor for lower response to Pfizer's BNT162b2 vaccine, and patients should be prioritized for the vaccine booster against SARS-CoV-2. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2023 The Author(s).)
Databáze:	MEDLINE
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