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SARS-CoV2-specific Humoral and T-cell Immune Response After Second Vaccination in Liver Cirrhosis and Transplant Patients

BACKGROUND & AIMS: 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...

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Autores principales: Ruether, Darius F., Schaub, Golda M., Duengelhoef, Paul M., Haag, Friedrich, Brehm, Thomas T., Fathi, Anahita, Wehmeyer, Malte, Jahnke-Triankowski, Jacqueline, Mayer, Leonie, Hoffmann, Armin, Fischer, Lutz, Addo, Marylyn M., Lütgehetmann, Marc, Lohse, Ansgar W., Schulze zur Wiesch, Julian, Sterneck, Martina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: by the AGA Institute 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8427908/
https://www.ncbi.nlm.nih.gov/pubmed/34509643
http://dx.doi.org/10.1016/j.cgh.2021.09.003
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author Ruether, Darius F.
Schaub, Golda M.
Duengelhoef, Paul M.
Haag, Friedrich
Brehm, Thomas T.
Fathi, Anahita
Wehmeyer, Malte
Jahnke-Triankowski, Jacqueline
Mayer, Leonie
Hoffmann, Armin
Fischer, Lutz
Addo, Marylyn M.
Lütgehetmann, Marc
Lohse, Ansgar W.
Schulze zur Wiesch, Julian
Sterneck, Martina
author_facet Ruether, Darius F.
Schaub, Golda M.
Duengelhoef, Paul M.
Haag, Friedrich
Brehm, Thomas T.
Fathi, Anahita
Wehmeyer, Malte
Jahnke-Triankowski, Jacqueline
Mayer, Leonie
Hoffmann, Armin
Fischer, Lutz
Addo, Marylyn M.
Lütgehetmann, Marc
Lohse, Ansgar W.
Schulze zur Wiesch, Julian
Sterneck, Martina
author_sort Ruether, Darius F.
collection PubMed
description BACKGROUND & AIMS: 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. METHODS: 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. RESULTS: 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 age >65 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). CONCLUSION: 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.
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spelling pubmed-84279082021-09-09 SARS-CoV2-specific Humoral and T-cell Immune Response After Second Vaccination in Liver Cirrhosis and Transplant Patients Ruether, Darius F. Schaub, Golda M. Duengelhoef, Paul M. Haag, Friedrich Brehm, Thomas T. Fathi, Anahita Wehmeyer, Malte Jahnke-Triankowski, Jacqueline Mayer, Leonie Hoffmann, Armin Fischer, Lutz Addo, Marylyn M. Lütgehetmann, Marc Lohse, Ansgar W. Schulze zur Wiesch, Julian Sterneck, Martina Clin Gastroenterol Hepatol Original Article BACKGROUND & AIMS: 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. METHODS: 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. RESULTS: 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 age >65 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). CONCLUSION: 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. by the AGA Institute 2022-01 2021-09-09 /pmc/articles/PMC8427908/ /pubmed/34509643 http://dx.doi.org/10.1016/j.cgh.2021.09.003 Text en © 2022 by the AGA Institute. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Original Article
Ruether, Darius F.
Schaub, Golda M.
Duengelhoef, Paul M.
Haag, Friedrich
Brehm, Thomas T.
Fathi, Anahita
Wehmeyer, Malte
Jahnke-Triankowski, Jacqueline
Mayer, Leonie
Hoffmann, Armin
Fischer, Lutz
Addo, Marylyn M.
Lütgehetmann, Marc
Lohse, Ansgar W.
Schulze zur Wiesch, Julian
Sterneck, Martina
SARS-CoV2-specific Humoral and T-cell Immune Response After Second Vaccination in Liver Cirrhosis and Transplant Patients
title SARS-CoV2-specific Humoral and T-cell Immune Response After Second Vaccination in Liver Cirrhosis and Transplant Patients
title_full SARS-CoV2-specific Humoral and T-cell Immune Response After Second Vaccination in Liver Cirrhosis and Transplant Patients
title_fullStr SARS-CoV2-specific Humoral and T-cell Immune Response After Second Vaccination in Liver Cirrhosis and Transplant Patients
title_full_unstemmed SARS-CoV2-specific Humoral and T-cell Immune Response After Second Vaccination in Liver Cirrhosis and Transplant Patients
title_short SARS-CoV2-specific Humoral and T-cell Immune Response After Second Vaccination in Liver Cirrhosis and Transplant Patients
title_sort sars-cov2-specific humoral and t-cell immune response after second vaccination in liver cirrhosis and transplant patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8427908/
https://www.ncbi.nlm.nih.gov/pubmed/34509643
http://dx.doi.org/10.1016/j.cgh.2021.09.003
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