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

2023Artigo científico Acesso aberto
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dc.contributor.authorSimão, André
dc.contributor.authorPalma, Carolina
dc.contributor.authorIzquierdo-Sanchez, Laura
dc.contributor.authorPutignano, Antonella
dc.contributor.authorCarvalho-Gomes, Angela
dc.contributor.authorPosch, Andreas
dc.contributor.authorZanaga, Paola
dc.contributor.authorGirleanu, Irina
dc.contributor.authorHenrique, Mariana
dc.contributor.authorAraújo, Carlos
dc.contributor.authorDegre, Delphine
dc.contributor.authorGustot, Thierry
dc.contributor.authorSahuco, Iván
dc.contributor.authorSpagnolo, Elia
dc.contributor.authorCarvalhana, Sofia
dc.contributor.authorMoura, Miguel
dc.contributor.authorFernandes, Diogo AE.
dc.contributor.authorBanales, Jesus M.
dc.contributor.authorRomero-Gomez, Manuel
dc.contributor.authorTrifan, Anca
dc.contributor.authorRusso, Francesco Paolo
dc.contributor.authorStauber, Rudolf
dc.contributor.authorBerenguer, Marina
dc.contributor.authorMoreno, Christophe
dc.contributor.authorGonçalves, João manuel braz
dc.contributor.authorCortez-Pinto, Helena
dc.contributor.authorCastro, Rui E.
dc.date.accessioned2023-04-13T16:53:18Z
dc.date.available2023-04-13T16:53:18Z
dc.date.issued2023
dc.description© 2023 The Authors. Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL). This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).pt_PT
dc.description.abstractBackground & 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 clinical or immune IgG parameters associated with SARS-CoV-2 infection rates or vaccine efficacy. Conclusions: Patients with CLD and cirrhosis exhibit lower immune responses to COVID-19 vaccination, irrespective of disease aetiology. The type of vaccine leads to different antibody responses that appear not to associate with distinct efficacy, although this needs validation in larger cohorts with a more balanced representation of all vaccines. Impact and implications: In patients with CLD vaccinated with two-dose vaccines, age, cirrhosis, and type of vaccine (Vaxzevria > Pfizer BioNTech > Moderna) predict a 'lower' humoral response, whereas viral hepatitis aetiology and prior antiviral therapy predict a 'higher' humoral response. This differential response appears not to associate with SARS-CoV-2 infection incidence or vaccine efficacy. However, compared with Wuhan-Hu-1, humoral immunity was lower for the Delta and Omicron variants, and all decreased after 6 months. As such, patients with CLD, particularly those older and with cirrhosis, should be prioritised for receiving booster doses and/or recently approved adapted vaccines.pt_PT
dc.description.sponsorshipPartial funds were provided through Fundação para a Ciência e a Tecnologia (grants PTDC/MED-PAT/31882/2017 and EXPL/MED-OUT/1317/2021) and through La Caixa Scientific Foundation (grant HR17-00601).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJHEP Rep. 2023 May;5(5):100697pt_PT
dc.identifier.doi10.1016/j.jhepr.2023.100697pt_PT
dc.identifier.eissn2589-5559
dc.identifier.urihttp://hdl.handle.net/10451/57127
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relationExosomal Fat-Liver Axis in Non-Alcoholic Fatty Liver Disease: Function and Modulation
dc.relationExosomal microRNA-21 in liver muscle intercommunication during Non Alcoholic Fatty Liver Disease pathogenesis
dc.relation.publisherversionhttps://www.sciencedirect.com/journal/jhep-reportspt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectCOVID-19 vaccinept_PT
dc.subjectChronic liver diseasept_PT
dc.subjectCirrhosispt_PT
dc.subjectHumoral immunitypt_PT
dc.subjectSARS-CoV-2pt_PT
dc.titleCirrhosis is associated with lower serological responses to COVID-19 vaccines in patients with chronic liver diseasept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardNumberPTDC/MED-PAT/31882/2017
oaire.awardNumberEXPL/MED-OUT/1317/2021
oaire.awardTitleExosomal Fat-Liver Axis in Non-Alcoholic Fatty Liver Disease: Function and Modulation
oaire.awardTitleExosomal microRNA-21 in liver muscle intercommunication during Non Alcoholic Fatty Liver Disease pathogenesis
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/3599-PPCDT/PTDC%2FMED-PAT%2F31882%2F2017/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/3599-PPCDT/EXPL%2FMED-OUT%2F1317%2F2021/PT
oaire.citation.issue5pt_PT
oaire.citation.titleJHEP Reportspt_PT
oaire.citation.volume5pt_PT
oaire.fundingStream3599-PPCDT
oaire.fundingStream3599-PPCDT
person.familyNameSimão
person.familyNameSantos Palma
person.familyNameIzquierdo Sanchez
person.familyNameMoura Henrique
person.familyNamecarvalhana
person.familyNameMoura
person.familyNameCortez-Pinto
person.familyNameCastro
person.givenNameAndré
person.givenNameCarolina
person.givenNameLaura
person.givenNameMariana
person.givenNamesofia
person.givenNameMiguel
person.givenNameHelena
person.givenNameRui
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project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
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