SARS-CoV2-specific Humoral and T-cell Immune Response After Second Vaccination in Liver Cirrhosis and Transplant Patients
| Autor: | Leonie Mayer, Anahita Fathi, Thomas Theo Brehm, Martina Sterneck, Jacqueline Jahnke-Triankowski, Golda M. Schaub, Darius Ferenc Ruether, Marylyn M. Addo, Julian Schulze zur Wiesch, Marc Lütgehetmann, Ansgar W. Lohse, Lutz Fischer, Paul M. Duengelhoef, Armin Hoffmann, Friedrich Haag, Malte H. Wehmeyer |
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| Rok vydání: | 2022 |
| Předmět: |
Liver Cirrhosis
Cirrhosis ELISA Enzyme-linked Immunosorbent Assay EASL European Association for the Study of the Liver UKE University Medical Center Hamburg-Eppendorf T-Lymphocytes medicine.medical_treatment BAU Binding antibody units ECLIA ElectroChemiLuminescent ImmunoAssay Antibodies Viral Gastroenterology SARS-CoV-2 Severe acute respiratory syndrome coronavirus type 2 MELD Model for End-stage Liver Disease Prospective Studies Prospective cohort study COVID-19 Coronavirus disease 2019 immunosuppression IFN-γ Interferon-gamma SOT Solid-organ transplantation Vaccination Immunosuppression AASLD American Association for the Study of Liver Diseases SARS-CoV-2 vaccination RNA Viral medicine.medical_specialty COVID-19 Vaccines Article IGRA Interferon gamma release assay Immune system CLIA ChemiLuminescent ImmunoAssay Anti-S Trimer Anti-SARS-CoV-2 antibodies in DiaSorin LIAISON immunoassay Internal medicine medicine liver transplant recipients Humans Seroconversion LC Liver cirrhosis BNT162 Vaccine Aged LT Liver transplant Hepatology SARS-CoV-2 business.industry TIPS Transjugular intrahepatic portosystemic stent-shunt Immunity COVID-19 RBD Receptor Binding Domain Odds ratio medicine.disease FDA Food and Drug Administration Calcineurin CKD Chronic kidney disease CNI Calcineurin inhibitor EMA European Medicines Agency Anti-S RBD Anti-SARS-CoV-2 antibodies in Roche Elecsys immunoassay business |
| Zdroj: | Clinical Gastroenterology and Hepatology |
| ISSN: | 1542-3565 |
| Popis: | Detailed information on the immune response after second vaccination of cirrhotic patients and liver transplant (LT) recipients against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is largely missing. We aimed at comparing the vaccine-induced humoral and T-cell responses of these vulnerable patient groups.In this prospective cohort study, anti-SARS-CoV-2 spike-protein titers were determined using the DiaSorin LIAISON (anti-S trimer) and Roche Elecsys (anti-S RBD) immunoassays in 194 patients (141 LT, 53 cirrhosis Child-Pugh A-C) and 56 healthy controls before and 10 to 84 days after second vaccination. The spike-specific T-cell response was assessed using an interferon-gamma release assay (EUROIMMUN). A logistic regression analysis was performed to identify predictors of low response.After the second vaccination, seroconversion was achieved in 63% of LT recipients and 100% of cirrhotic patients and controls using the anti-S trimer assay. Median anti-SARS-CoV-2 titers of responding LT recipients were lower compared with cirrhotic patients and controls (P.001). Spike-specific T-cell response rates were 36.6%, 65.4%, and 100% in LT, cirrhosis, and controls, respectively. Altogether, 28% of LT recipients did neither develop a humoral nor a T-cell response after second vaccination. In LT recipients, significant predictors of absent or low humoral response were age65 years (odds ratio [OR], 4.57; 95% confidence interval [CI], 1.48-14.05) and arterial hypertension (OR, 2.50; 95% CI, 1.10-5.68), whereas vaccination failure was less likely with calcineurin inhibitor monotherapy than with other immunosuppressive regimens (OR, 0.36; 95% CI, 0.13-0.99).Routine serological testing of the vaccination response and a third vaccination in patients with low or absent response seem advisable. These vulnerable cohorts need further research on the effects of heterologous vaccination and intermittent reduction of immunosuppression before booster vaccinations. |
| Databáze: | OpenAIRE |
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