Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant-Reference-Cited by-同舟云学术

Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant

Published:2023-10-18 Issue:11 Volume:7 Page:
ISSN:2471-254X
Container-title:Hepatology Communications
language:en
Short-container-title:

Author:

Mehta Gautam¹²³,Riva Antonio²⁴,Ballester Maria Pilar⁵,Uson Eva⁶,Pujadas Montserrat⁶,Carvalho-Gomes Ângela⁷⁸,Sahuco Ivan⁷⁸,Bono Ariadna⁷⁸,D’Amico Federico⁹¹⁰,Viganò Raffaela¹¹,Diago Elena¹²¹³¹⁴,Lanseros Beatriz Tormo¹²¹⁴,Inglese Elvira¹¹¹⁵,Vazquez Dani Martinez¹⁶,Sharma Rajni²,Tsou Hio Lam Phoebe²,Harris Nicola²,Broekhoven Annelotte¹⁷,Kikkert Marjolein¹⁸,Morales Shessy P. Torres¹⁸,Myeni Sebenzile K.¹⁸,Riveiro-Barciela Mar¹⁶,Palom Adriana¹⁶,Zeni Nicola¹⁹,Brocca Alessandra¹⁹,Cussigh Annarosa²⁰,Cmet Sara²⁰,Escudero-García Desamparados⁵,Stocco Matteo⁵,Natola Leonardo Antonio²¹,Ieluzzi Donatella²¹,Paon Veronica²¹,Sangiovanni Angelo²²,Farina Elisa²²,di Benedetto Clara²²,Sánchez-Torrijos Yolanda²³,Lucena-Varela Ana²³,Román Eva²⁴²⁵,Sánchez Elisabet¹⁴²⁴,Sánchez-Aldehuelo Rubén²⁶²⁷,López-Cardona Julia²⁶,Canas-Perez Itzel³,Eastgate Christine³,Jeyanesan Dhaarica²⁸,Morocho Alejandro Esquivel²⁸,Di Cola Simone²⁹,Lapenna Lucia²⁹,Zaccherini Giacomo³⁰,Bongiovanni Deborah³⁰,Zanaga Paola³¹³²,Sayaf Katia³¹³²,Hossain Sabir³³,Crespo Javier³⁴³⁵,Robles-Díaz Mercedes¹⁴³⁶,Madejón Antonio³⁷,Degroote Helena³⁸³⁹⁴⁰,Fernández Javier⁶⁴¹,Korenjak Marko⁴²,Verhelst Xavier³⁸³⁹⁴⁰,García-Samaniego Javier³⁷,Andrade Raúl J.¹⁴³⁶,Iruzubieta Paula³⁴³⁵,Wright Gavin³³,Caraceni Paolo³⁰⁴³,Merli Manuela²⁹,Patel Vishal C²⁴²⁸,Gander Amir³,Albillos Agustín²⁶,Soriano Germán¹⁴²⁴,Donato Maria Francesca²²,Sacerdoti David²¹,Toniutto Pierluigi²⁰,Buti Maria¹⁶,Duvoux Christophe⁴⁴,Grossi Paolo Antonio⁴⁵,Berg Thomas⁴⁶,Polak Wojciech G.⁴⁷,Puoti Massimo⁴⁸,Bosch-Comas Anna⁶,Belli Luca¹¹,Burra Patrizia³¹³²,Russo Francesco Paolo³¹³²,Coenraad Minneke¹⁷,Calleja José Luis¹²¹⁴,Perricone Giovanni¹¹,Berenguer Marina⁷⁸,Claria Joan⁶⁴⁹,Moreau Richard⁶⁵⁰⁵¹,Arroyo Vicente⁶,Angeli Paolo¹⁹,Sánchez Cristina⁶,Ampuero Javier²³,Piano Salvatore¹⁹,Chokshi Shilpa²⁴,Jalan Rajiv¹³,

Affiliation:

1. Institute for Liver and Digestive Heath, University College London, London, UK

2. The Roger Williams Institute of Hepatology, Foundation for Liver Research, London, UK

3. Royal Free London NHS Foundation Trust, London, UK

4. Faculty of Life Sciences and Medicine, King’s College London, London, UK

5. Department of Gastroenterology and Hepatology, Hospital Clínico Universitario de Valencia, Valencia, Spain

6. European Foundation for the Study of Chronic Liver Failure (EF CLIF), EASL-CLIF Consortium and Grifols Chair, Barcelona, Spain

7. Hepatology, HBP Surgery and Transplantation, Hepatology & Liver Transplant Unit, La Fe University Hospital, Valencia, Spain

8. Ciberehd, Universidad de Valencia, Valencia, Spain

9. ASST Grande Ospedale Metropolitano Niguarda, Infectious Diseases Unit, Milan, Italy

10. Department of Medical Biotechnology and Translational Medicine, Postgraduate School of Clinical Pharmacology and Toxicology, University of Milan, Milan, Italy

11. ASST Grande Ospedale Metropolitano Niguarda, Hepatology and Gastroenterology Unit, Milan, Italy

12. Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, IDIPHIM, Madrid, Spain

13. Central Unit of Clinical Research and Clinical Trials, Hospital Universitario La Paz, IdiPaz, Madrid, Spain

14. CIBERehd, Madrid, Spain

15. Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy

16. Liver Unit, Hospital Universitario Valle de Hebron, Barcelona, Spain

17. Department of Gastroenterology and Hepatology, Leiden University Medical Center, RC Leiden, the Netherlands

18. Department of Medical Microbiology, Leiden University Medical Center, RC Leiden, the Netherlands

19. Department of Medicine - DIMED, Unit of Internal Medicine and Hepatology (UIMH), University of Padova, Padova, Italy

20. Hepatology and Liver Transplantation Unit, Azienda Sanitaria Universitaria Integrata, University of Udine, Udine, Italy

21. Azienda Ospedaiera Universitaria Integrata Verona, Verona Italy

22. Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Division of Gastroenterology and Hepatology, Milan, Italy

23. Hospital Universitario Virgen del Rocio, Sevilla. Instituto de Biomedicina de Sevilla, Universidad de Sevilla, Sevilla, Spain

24. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

25. EUI-Sant Pau School of Nursing, Barcelona, Spain

26. Servicio de Gastroenterología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto Salud Carlos III, Madrid, Spain

27. Universidad de Alcalá, Madrid, Spain

28. Institute of Liver Studies, King’s College Hospital NHS Foundation Trust, London, UK

29. Department of Translational and Precision Medicine, University of Rome Sapienza, Roma, Italy

30. Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy

31. Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy

32. Gastroenterology and Multivisceral Transplant Units, Azienda Ospedale Università’ di Padova, Padova, Italy

33. Mid & South Essex NHS Foundation Trust, Basildon, UK

34. Gastroenterology and Hepatology Department, Marqués de Valdecilla University Hospital, Santander, Spain

35. Clinical and Traslational Digestive Research Group, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain

36. Servicio de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain

37. Liver Unit, Hospital Universitario La Paz, CIBERehd, IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain

38. Department of Gastroenterology and Hepatology, Ghent University Hospital, Belgium

39. Liver Research Center Ghent, Ghent University, Belgium

40. European Reference Network (ERN)RARE-LIVER

41. Liver Unit, Hospital Clínic, Universitat de Barcelona, Institut d’Investigacions Biomèdiques August Pi-Sunyer (IDIBAPS) and Centro de Investigación Biomèdica en Red (CIBEREHD), Barcelona, Spain

42. European Liver Patients’ Association (ELPA)

43. Unit of Semeiotics, Liver and Alcohol-related Diseases, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

44. Department of Hepatogy-Liver Transplant Unit, Henri Mondor Hospital-APHP, Paris Est University, Paris, France

45. Department of Medicine and Surgery, University of Insubria, Infectious and Tropical Diseases Unit, ASST Sette Laghim, Varese, Italy

46. European Association for the Study of the Liver (EASL)

47. Department of Surgery, Division of HPB and Transplant Surgery, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands

48. University of Milano Bicocca, Infectious Diseases Niguarda Great Metropolitan Hospital, Milan, Italy

49. Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi-Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red (CIBERehd) and Universitat de Barcelona, Barcelona, Spain

50. INSERM and Université Paris Cité, Centre de Recherche sur l’inflammation (CRI), Paris, France

51. APHP, Service d’hépatologie, Hôpital Beaujon, Clichy, France

Abstract

Background: Vaccine hesitancy and lack of access remain major issues in disseminating COVID-19 vaccination to liver patients globally. Factors predicting poor response to vaccination and risk of breakthrough infection are important data to target booster vaccine programs. The primary aim of the current study was to measure humoral responses to 2 doses of COVID-19 vaccine. Secondary aims included the determination of factors predicting breakthrough infection. Methods: COVID-19 vaccination and Biomarkers in cirrhosis And post-Liver Transplantation is a prospective, multicenter, observational case-control study. Participants were recruited at 4–10 weeks following first and second vaccine doses in cirrhosis [n = 325; 94% messenger RNA (mRNA) and 6% viral vaccine], autoimmune liver disease (AILD) (n = 120; 77% mRNA and 23% viral vaccine), post-liver transplant (LT) (n = 146; 96% mRNA and 3% viral vaccine), and healthy controls (n = 51; 72% mRNA, 24% viral and 4% heterologous combination). Serological end points were measured, and data regarding breakthrough SARS-CoV-2 infection were collected. Results: After adjusting by age, sex, and time of sample collection, anti-Spike IgG levels were the lowest in post-LT patients compared to cirrhosis (p < 0.0001), AILD (p < 0.0001), and control (p = 0.002). Factors predicting reduced responses included older age, Child-Turcotte-Pugh B/C, and elevated IL-6 in cirrhosis; non-mRNA vaccine in AILD; and coronary artery disease, use of mycophenolate and dysregulated B-call activating factor, and lymphotoxin-α levels in LT. Incident infection occurred in 6.6%, 10.6%, 7.4%, and 15.6% of cirrhosis, AILD, post-LT, and control, respectively. The only independent factor predicting infection in cirrhosis was low albumin level. Conclusions: LT patients present the lowest response to the SARS-CoV-2 vaccine. In cirrhosis, the reduced response is associated with older age, stage of liver disease and systemic inflammation, and breakthrough infection with low albumin level.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Hepatology

Reference38 articles.

1. Impact of COVID-19 on the liver and on the care of patients with chronic liver disease, hepatobiliary cancer, and liver transplantation: An updated EASL position paper;Marjot;J Hepatol,2022

2. Ten Actions to Counteract Vaccine Hesitancy Suggested by the Italian Society of Hygiene, Preventive Medicine, and Public Health;Costantino;Vaccines (Basel),2022

3. Vaccination in liver diseases and liver transplantation: recommendations, implications and opportunities in the post-Covid era;Ballester;JHEP Rep,2023

4. SARS-CoV-2 infection and liver involvement;Luo;Hepatol Int,2022

5. Safety and immunogenicity of COVID-19 vaccination in patients with non-alcoholic fatty liver disease (CHESS2101): A multicenter study;Wang;J Hepatol,2021

Cited by 2 articles. 订阅此论文施引文献订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献

1. Immune Response and Risk of Decompensation following SARS-CoV-2 Infection in Outpatients with Advanced Chronic Liver Disease;International Journal of Molecular Sciences;2024-07-30

2. Reply: Serological response after COVID-19 vaccination, cirrhosis, and postliver transplant;Hepatology Communications;2024-05-10