TY - JOUR
AU - Murray, Sam M.
AU - Pose, Elisa
AU - Wittner, Melanie
AU - Londoño, Maria-Carlota
AU - Schaub, Golda
AU - Cook, Jonathan E.
AU - Dimitriadis, Stavros
AU - Meacham, Georgina
AU - Irwin, Sophie
AU - Lim, Zixiang
AU - Duengelhoef, Paul
AU - Sterneck, Martina
AU - Lohse, Ansgar W.
AU - Perez, Valeria
AU - Trivedi, Palak
AU - Bhandal, Khushpreet
AU - Mullish, Benjamin H.
AU - Manousou, Pinelopi
AU - Provine, Nicholas
AU - Avitabile, Emma
AU - Carroll, Miles W.
AU - Tipton, Tom
AU - Healy, Saoirse
AU - Burra, Patrizia
AU - Klenerman, Paul
AU - Dunachie, Susanna
AU - Kronsteiner, Barbara
AU - Maciola, Agnieszka Katarzyna
AU - Pasqual, Giulia
AU - Hernandez-Gea, Virginia
AU - Garcia-Pagan, Juan Carlos
AU - Lampertico, Pietro
AU - Iavarone, Massimo
AU - Ginès, Pere
AU - Lütgehetmann, Marc
AU - Schulze zur Wiesch, Julian
AU - Russo, Francesco Paolo
AU - Barnes, Eleanor
AU - Marjot, Thomas
PY - 2023
DA - October
TI - Immune responses and clinical outcomes after COVID-19 vaccination in patients with liver disease and liver transplant recipients
JO - Journal of Hepatology
EP - 123
VL - 80
IS - 1
DO - http://dx.doi.org/10.1016/j.jhep.2023.10.009
AB - Background &amp; Aims: Comparative assessments of immunogenicity following different COVID-19 vaccines in patients with distinct liver diseases are lacking. SARS-CoV-2-specific T-cell and antibody responses were evaluated longitudinally after one to three vaccine doses, with long-term follow-up for COVID-19-related clinical outcomes. Methods: A total of 849 participants (355 with cirrhosis, 74 with autoimmune hepatitis [AIH], 36 with vascular liver disease [VLD], 257 liver transplant recipients [LTRs] and 127 healthy controls [HCs]) were recruited from four countries. Standardised immune assays were performed pre and post three vaccine doses (V1-3). Results: In the total cohort, there were incremental increases in antibody titres after each vaccine dose (p &lt;0.0001). Factors associated with reduced antibody responses were age and LT, whereas heterologous vaccination, prior COVID-19 and mRNA platforms were associated with greater responses. Although antibody titres decreased between post-V2 and pre-V3 (p = 0.012), patients with AIH, VLD, and cirrhosis had equivalent antibody responses to HCs post-V3. LTRs had lower and more heterogenous antibody titres than other groups, including post-V3 where 9% had no detectable antibodies; this was heavily influenced by intensity of immunosuppression. Vaccination increased T-cell IFNγ responses in all groups except LTRs. Patients with liver disease had lower functional antibody responses against nine Omicron subvariants and reduced T-cell responses to Omicron BA.1-specific peptides compared to wild-type. 122 cases of breakthrough COVID-19 were reported of which 5/122 (4%) were severe. Of the severe cases, 4/5 (80%) occurred in LTRs and 2/5 (40%) had no serological response post-V2. Conclusion: After three COVID-19 vaccines, patients with liver disease generally develop robust antibody and T-cell responses to vaccination and have mild COVID-19. However, LTRs have sustained no/low antibody titres and appear most vulnerable to severe disease.
PB - Elsevier
UR - https://eprints.gla.ac.uk/319680/
KW - Coronavirus (COVID-19)
KW - Immunisation and screening
ER