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| Pàgina inicial > Articles > Articles publicats > Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant |
(Royal Free London NHS Foundation Trust) (King's College London) (Universitat de València) (University of Milan (Itàlia)) (University of Pavia (Itàlia)) (Hospital Universitari Vall d'Hebron) (Hospital Universitari Vall d'Hebron) (Azienda Ospedaiera Universitaria Integrata Verona (Itàlia)) (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (Milà, Itàlia)) (Institut d'Investigació Biomèdica Sant Pau) (Institut d'Investigació Biomèdica Sant Pau) (University of Bologna (Itàlia)) (Instituto de Investigación Sanitaria Valdecilla (Santander, Cantàbria)) (Universidad de Málaga) (European Liver Patients' Association (ELPA)) (European Reference Network (ERN)RARE-LIVER) (Universidad Autónoma de Madrid) (Universidad de Málaga) (Instituto de Investigación Sanitaria Valdecilla (Santander, Cantàbria)) (Azienda Ospedaliero-Universitaria di Bologna (Itàlia)) (Università degli Studi di Roma "La Sapienza") (King's College Hospital NHS Foundation Trust) (Instituto de Salud Carlos III) (Institut d'Investigació Biomèdica Sant Pau) (Azienda Ospedaiera Universitaria Integrata Verona) (University of Udine (Itàlia)) (Hospital Universitari Vall d'Hebron) (University of Insubria (Itàlia)) (European Association for the Study of the Liver (EASL)) (University of Milano Bicocca (Itàlia)) (EASL-CLIF Consortium and Grifols) (ASST Grande Ospedale Metropolitano Niguarda (Itàlia)) (Azienda Ospedale Università' di Padova (Itàlia)) (Azienda Ospedale Università' di Padova (Itàlia)) (Leiden University Medical Center) (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas) (ASST Grande Ospedale Metropolitano Niguarda (Itàlia)) (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas) (Hospital Clínic i Provincial de Barcelona) (Hôpital Beaujon (França)) (EASL-CLIF Consortium and Grifols) (University of Padova (Itàlia)) (Universidad de Sevilla) (University of Padova (Itàlia))| Data: | 2023 |
| Resum: | Vaccine hesitancy and lack of access remain major issues in disseminating COVID-19 vaccination to liver patients globally. Factors predicting poor response to vaccination and risk of breakthrough infection are important data to target booster vaccine programs. The primary aim of the current study was to measure humoral responses to 2 doses of COVID-19 vaccine. Secondary aims included the determination of factors predicting breakthrough infection. COVID-19 vaccination and Biomarkers in cirrhosis And post-Liver Transplantation is a prospective, multicenter, observational case-control study. Participants were recruited at 4-10 weeks following first and second vaccine doses in cirrhosis [n = 325; 94% messenger RNA (mRNA) and 6% viral vaccine], autoimmune liver disease (AILD) (n = 120; 77% mRNA and 23% viral vaccine), post-liver transplant (LT) (n = 146; 96% mRNA and 3% viral vaccine), and healthy controls (n = 51; 72% mRNA, 24% viral and 4% heterologous combination). Serological end points were measured, and data regarding breakthrough SARS-CoV-2 infection were collected. After adjusting by age, sex, and time of sample collection, anti-Spike IgG levels were the lowest in post-LT patients compared to cirrhosis (p < 0. 0001), AILD (p < 0. 0001), and control (p = 0. 002). Factors predicting reduced responses included older age, Child-Turcotte-Pugh B/C, and elevated IL-6 in cirrhosis; non-mRNA vaccine in AILD; and coronary artery disease, use of mycophenolate and dysregulated B-call activating factor, and lymphotoxin-α levels in LT. Incident infection occurred in 6. 6%, 10. 6%, 7. 4%, and 15. 6% of cirrhosis, AILD, post-LT, and control, respectively. The only independent factor predicting infection in cirrhosis was low albumin level. LT patients present the lowest response to the SARS-CoV-2 vaccine. In cirrhosis, the reduced response is associated with older age, stage of liver disease and systemic inflammation, and breakthrough infection with low albumin level. |
| Drets: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.  |
| Llengua: | Anglès |
| Document: | Article ; recerca ; Versió publicada |
| Publicat a: | Hepatology Communications, Vol. 7 Núm. 11 (november 2023) , p. e0273, ISSN 2471-254X |
