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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.
  • Ruether DF; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Schaub GM; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Germany.
  • Duengelhoef PM; Institute of Immunology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Haag F; Institute of Immunology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Brehm TT; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Germany.
  • Fathi A; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Germany; Bernhard-Nocht-Institute for Tropical Medicine, Department for Clinical Immunology of Infectious Disease
  • Wehmeyer M; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Jahnke-Triankowski J; Department of Visceral Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Mayer L; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Germany; Bernhard-Nocht-Institute for Tropical Medicine, Department for Clinical Immunology of Infectious Diseases, Hamburg, Germany.
  • Hoffmann A; Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Fischer L; Department of Visceral Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Addo MM; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Germany; Bernhard-Nocht-Institute for Tropical Medicine, Department for Clinical Immunology of Infectious Disease
  • Lütgehetmann M; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Germany; Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Lohse AW; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Germany.
  • Schulze Zur Wiesch J; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: j.schulze-zur-wiesch@uke.de.
  • Sterneck M; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Clin Gastroenterol Hepatol ; 20(1): 162-172.e9, 2022 01.
Article in English | MEDLINE | ID: covidwho-1401300
ABSTRACT
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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Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: RNA, Viral / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Aged / Humans Language: English Journal: Clin Gastroenterol Hepatol Journal subject: Gastroenterology Year: 2022 Document Type: Article Affiliation country: J.cgh.2021.09.003

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Full text: Available Collection: International databases Database: MEDLINE Main subject: RNA, Viral / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Aged / Humans Language: English Journal: Clin Gastroenterol Hepatol Journal subject: Gastroenterology Year: 2022 Document Type: Article Affiliation country: J.cgh.2021.09.003