Cirrhosis is associated with lower serological responses to COVID-19 vaccines in patients with chronic liver disease

作者：André L. Simão, Carolina Santos Palma, Laura Izquierdo‐Sánchez, Antonella Putignano, Ângela Carvalho‐Gomes, Andreas E. Posch, Paola Zanaga, Irina Gîrleanu, Mariana Moura Henrique, Carlos Araújo, Delphine Degré, Thierry Gustot, Iván Sahuco, Elia Spagnolo, Sofia Carvalhana, Miguel Carneiro de Moura, Diogo AE. Fernandes, Jesús M. Bañales, Manuel Romero‐Gómez, Anca Trifan, Francesco Paolo Russo, Rudolf Stauber, Marina Berenguer, Christophe Moreno, João Gonçalves, Helena Cortez‐Pinto, Rui E. Castro · 发表于：JHEP Reports · 年份：2023 · DOI：10.1016/j.jhepr.2023.100697 · 被引用次数：14 · 研究领域：SARS-CoV-2 and COVID-19 Research、COVID-19 Clinical Research Studies、Long-Term Effects of COVID-19

Background & Aims: The response of patients with chronic liver disease (CLD) to COVID-19 vaccines remains unclear. Our aim was to assess the humoral immune response and efficacy of two-dose COVID-19 vaccines among patients with CLD of different aetiologies and disease stages. Methods: A total of 357 patients were recruited in clinical centres from six European countries, and 132 healthy volunteers served as controls. Serum IgG (nM), IgM (nM), and neutralising antibodies (%) against the Wuhan-Hu-1, B.1.617, and B.1.1.529 SARS-CoV-2 spike proteins were determined before vaccination (T0) and 14 days (T2) and 6 months (T3) after the second-dose vaccination. Patients fulfilling inclusion criteria at T2 (n = 212) were stratified into 'low' or 'high' responders according to IgG levels. Infection rates and severity were collected throughout the study. Results: Wuhan-Hu-1 IgG, IgM, and neutralisation levels significantly increased from T0 to T2 in patients vaccinated with BNT162b2 (70.3%), mRNA-1273 (18.9%), or ChAdOx1 (10.8%). In multivariate analysis, age, cirrhosis, and type of vaccine (ChAdOx1 > BNT162b2 > mRNA-1273) predicted 'low' humoral response, whereas viral hepatitis and antiviral therapy predicted 'high' humoral response. Compared with Wuhan-Hu-1, B.1.617 and, further, B.1.1.529 IgG levels were significantly lower at both T2 and T3. Compared with healthy individuals, patients with CLD presented with lower B.1.1.529 IgGs at T2 with no additional key differences. No major cl...