Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant

G. Mehta; A. Riva; M.P. Ballester; E. Uson; M. Pujadas; Â. Carvalho-Gomes; I. Sahuco; A. Bono; F. D'Amico; R. Viganò; E. Diago; B.T. Lanseros; E. Inglese; Dani Martinez Vazquez; R. Sharma; H.L.P. Tsou; N. Harris; A. Broekhoven; M. Kikkert; S.P. Torres Morales; S.K. Myeni; Mar Riveiro-Barciela; Adriana Palom; N. Zeni; A. Brocca; A. Cussigh; S. Cmet; D. Escudero-García; M. Stocco; L.A. Natola; D. Ieluzzi; V. Paon; A. Sangiovanni; E. Farina; C. di Benedetto; Y. Sánchez-Torrijos; A. Lucena-Varela; Eva Roman; Elisabet Sánchez; R. Sánchez-Aldehuelo; J. López-Cardona; I. Canas-Perez; C. Eastgate; D. Jeyanesan; A.E. Morocho; S. Di Cola; L. Lapenna; G. Zaccherini; D. Bongiovanni; P. Zanaga; K. Sayaf; S. Hossain; J. Crespo; M. Robles-Díaz; A. Madejón; H. Degroote; Javier R. Fernández; M. Korenjak; X. Verhelst; J. García-Samaniego; R.J. Andrade; P. Iruzubieta; G. Wright; P. Caraceni; M. Merli; V.C. Patel; A. Gander; Agustín Albillos; German Soriano Pastor; M.F. Donato; D. Sacerdoti; P. Toniutto; Maria Buti Ferret; C. Duvoux; P.A. Grossi; T. Berg; W.G. Polak; M. Puoti; A. Bosch-Comas; L. Belli; P. Burra; F.P. Russo; M. Coenraad; J.L. Calleja; G. Perricone; M. Berenguer; Joan Claria; R. Moreau; V. Arroyo; P. Angeli; C. Sánchez; J. Ampuero; S. Piano; S. Chokshi; R. Jalan

doi:10.1097/HC9.0000000000000273

Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant

G. Mehta, A. Riva, M.P. Ballester, E. Uson, M. Pujadas, Â. Carvalho-Gomes, I. Sahuco, A. Bono, F. D'Amico, R. Viganò, E. Diago, B.T. Lanseros, E. Inglese, Dani Martinez Vazquez, R. Sharma, H.L.P. Tsou, N. Harris, A. Broekhoven, M. Kikkert, S.P. Torres MoralesS.K. Myeni, Mar Riveiro-Barciela, Adriana Palom, N. Zeni, A. Brocca, A. Cussigh, S. Cmet, D. Escudero-García, M. Stocco, L.A. Natola, D. Ieluzzi, V. Paon, A. Sangiovanni, E. Farina, C. di Benedetto, Y. Sánchez-Torrijos, A. Lucena-Varela, Eva Roman, Elisabet Sánchez, R. Sánchez-Aldehuelo, J. López-Cardona, I. Canas-Perez, C. Eastgate, D. Jeyanesan, A.E. Morocho, S. Di Cola, L. Lapenna, G. Zaccherini, D. Bongiovanni, P. Zanaga, K. Sayaf, S. Hossain, J. Crespo, M. Robles-Díaz, A. Madejón, H. Degroote, Javier R. Fernández, M. Korenjak, X. Verhelst, J. García-Samaniego, R.J. Andrade, P. Iruzubieta, G. Wright, P. Caraceni, M. Merli, V.C. Patel, A. Gander, Agustín Albillos, German Soriano Pastor, M.F. Donato, D. Sacerdoti, P. Toniutto, Maria Buti Ferret, C. Duvoux, P.A. Grossi, T. Berg, W.G. Polak, M. Puoti, A. Bosch-Comas, L. Belli, P. Burra, F.P. Russo, M. Coenraad, J.L. Calleja, G. Perricone, M. Berenguer, Joan Claria, R. Moreau, V. Arroyo, P. Angeli, C. Sánchez, J. Ampuero, S. Piano, S. Chokshi, R. Jalan

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2 Citas (Scopus)

Resumen

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.

Idioma original	Inglés
Publicación	Hepatology Communications
Volumen	7
N.º	11
DOI	https://doi.org/10.1097/HC9.0000000000000273
Estado	Publicada - 2023

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Mehta, G., Riva, A., Ballester, M. P., Uson, E., Pujadas, M., Carvalho-Gomes, Â., Sahuco, I., Bono, A., D'Amico, F., Viganò, R., Diago, E., Lanseros, B. T., Inglese, E., Vazquez, D. M., Sharma, R., Tsou, H. L. P., Harris, N., Broekhoven, A., Kikkert, M., ... Jalan, R. (2023). Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant. Hepatology Communications, 7(11). https://doi.org/10.1097/HC9.0000000000000273

@article{b4ceae689b884b4d9bf7b7e9904e7004,

title = "Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant",

abstract = "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.",

author = "G. Mehta and A. Riva and M.P. Ballester and E. Uson and M. Pujadas and {\^A}. Carvalho-Gomes and I. Sahuco and A. Bono and F. D'Amico and R. Vigan{\`o} and E. Diago and B.T. Lanseros and E. Inglese and Vazquez, {Dani Martinez} and R. Sharma and H.L.P. Tsou and N. Harris and A. Broekhoven and M. Kikkert and {Torres Morales}, S.P. and S.K. Myeni and Mar Riveiro-Barciela and Adriana Palom and N. Zeni and A. Brocca and A. Cussigh and S. Cmet and D. Escudero-Garc{\'i}a and M. Stocco and L.A. Natola and D. Ieluzzi and V. Paon and A. Sangiovanni and E. Farina and {di Benedetto}, C. and Y. S{\'a}nchez-Torrijos and A. Lucena-Varela and Eva Roman and Elisabet S{\'a}nchez and R. S{\'a}nchez-Aldehuelo and J. L{\'o}pez-Cardona and I. Canas-Perez and C. Eastgate and D. Jeyanesan and A.E. Morocho and {Di Cola}, S. and L. Lapenna and G. Zaccherini and D. Bongiovanni and P. Zanaga and K. Sayaf and S. Hossain and J. Crespo and M. Robles-D{\'i}az and A. Madej{\'o}n and H. Degroote and Fern{\'a}ndez, {Javier R.} and M. Korenjak and X. Verhelst and J. Garc{\'i}a-Samaniego and R.J. Andrade and P. Iruzubieta and G. Wright and P. Caraceni and M. Merli and V.C. Patel and A. Gander and Agust{\'i}n Albillos and {Soriano Pastor}, German and M.F. Donato and D. Sacerdoti and P. Toniutto and {Buti Ferret}, Maria and C. Duvoux and P.A. Grossi and T. Berg and W.G. Polak and M. Puoti and A. Bosch-Comas and L. Belli and P. Burra and F.P. Russo and M. Coenraad and J.L. Calleja and G. Perricone and M. Berenguer and Joan Claria and R. Moreau and V. Arroyo and P. Angeli and C. S{\'a}nchez and J. Ampuero and S. Piano and S. Chokshi and R. Jalan",

year = "2023",

doi = "10.1097/HC9.0000000000000273",

language = "English",

volume = "7",

journal = "Hepatology Communications",

issn = "2471-254X",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "11",

}

Mehta, G, Riva, A, Ballester, MP, Uson, E, Pujadas, M, Carvalho-Gomes, Â, Sahuco, I, Bono, A, D'Amico, F, Viganò, R, Diago, E, Lanseros, BT, Inglese, E, Vazquez, DM, Sharma, R, Tsou, HLP, Harris, N, Broekhoven, A, Kikkert, M, Torres Morales, SP, Myeni, SK, Riveiro-Barciela, M, Palom, A, Zeni, N, Brocca, A, Cussigh, A, Cmet, S, Escudero-García, D, Stocco, M, Natola, LA, Ieluzzi, D, Paon, V, Sangiovanni, A, Farina, E, di Benedetto, C, Sánchez-Torrijos, Y, Lucena-Varela, A, Roman, E, Sánchez, E, Sánchez-Aldehuelo, R, López-Cardona, J, Canas-Perez, I, Eastgate, C, Jeyanesan, D, Morocho, AE, Di Cola, S, Lapenna, L, Zaccherini, G, Bongiovanni, D, Zanaga, P, Sayaf, K, Hossain, S, Crespo, J, Robles-Díaz, M, Madejón, A, Degroote, H, Fernández, JR, Korenjak, M, Verhelst, X, García-Samaniego, J, Andrade, RJ, Iruzubieta, P, Wright, G, Caraceni, P, Merli, M, Patel, VC, Gander, A, Albillos, A, Soriano Pastor, G, Donato, MF, Sacerdoti, D, Toniutto, P, Buti Ferret, M, Duvoux, C, Grossi, PA, Berg, T, Polak, WG, Puoti, M, Bosch-Comas, A, Belli, L, Burra, P, Russo, FP, Coenraad, M, Calleja, JL, Perricone, G, Berenguer, M, Claria, J, Moreau, R, Arroyo, V, Angeli, P, Sánchez, C, Ampuero, J, Piano, S, Chokshi, S & Jalan, R 2023, 'Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant', Hepatology Communications, vol. 7, n.º 11. https://doi.org/10.1097/HC9.0000000000000273

TY - JOUR

T1 - Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant

AU - Mehta, G.

AU - Riva, A.

AU - Ballester, M.P.

AU - Uson, E.

AU - Pujadas, M.

AU - Carvalho-Gomes, Â.

AU - Sahuco, I.

AU - Bono, A.

AU - D'Amico, F.

AU - Viganò, R.

AU - Diago, E.

AU - Lanseros, B.T.

AU - Inglese, E.

AU - Vazquez, Dani Martinez

AU - Sharma, R.

AU - Tsou, H.L.P.

AU - Harris, N.

AU - Broekhoven, A.

AU - Kikkert, M.

AU - Torres Morales, S.P.

AU - Myeni, S.K.

AU - Riveiro-Barciela, Mar

AU - Palom, Adriana

AU - Zeni, N.

AU - Brocca, A.

AU - Cussigh, A.

AU - Cmet, S.

AU - Escudero-García, D.

AU - Stocco, M.

AU - Natola, L.A.

AU - Ieluzzi, D.

AU - Paon, V.

AU - Sangiovanni, A.

AU - Farina, E.

AU - di Benedetto, C.

AU - Sánchez-Torrijos, Y.

AU - Lucena-Varela, A.

AU - Roman, Eva

AU - Sánchez, Elisabet

AU - Sánchez-Aldehuelo, R.

AU - López-Cardona, J.

AU - Canas-Perez, I.

AU - Eastgate, C.

AU - Jeyanesan, D.

AU - Morocho, A.E.

AU - Di Cola, S.

AU - Lapenna, L.

AU - Zaccherini, G.

AU - Bongiovanni, D.

AU - Zanaga, P.

AU - Sayaf, K.

AU - Hossain, S.

AU - Crespo, J.

AU - Robles-Díaz, M.

AU - Madejón, A.

AU - Degroote, H.

AU - Fernández, Javier R.

AU - Korenjak, M.

AU - Verhelst, X.

AU - García-Samaniego, J.

AU - Andrade, R.J.

AU - Iruzubieta, P.

AU - Wright, G.

AU - Caraceni, P.

AU - Merli, M.

AU - Patel, V.C.

AU - Gander, A.

AU - Albillos, Agustín

AU - Soriano Pastor, German

AU - Donato, M.F.

AU - Sacerdoti, D.

AU - Toniutto, P.

AU - Buti Ferret, Maria

AU - Duvoux, C.

AU - Grossi, P.A.

AU - Berg, T.

AU - Polak, W.G.

AU - Puoti, M.

AU - Bosch-Comas, A.

AU - Belli, L.

AU - Burra, P.

AU - Russo, F.P.

AU - Coenraad, M.

AU - Calleja, J.L.

AU - Perricone, G.

AU - Berenguer, M.

AU - Claria, Joan

AU - Moreau, R.

AU - Arroyo, V.

AU - Angeli, P.

AU - Sánchez, C.

AU - Ampuero, J.

AU - Piano, S.

AU - Chokshi, S.

AU - Jalan, R.

PY - 2023

Y1 - 2023

N2 - 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.

AB - 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.

U2 - 10.1097/HC9.0000000000000273

DO - 10.1097/HC9.0000000000000273

M3 - Article

C2 - 37870985

SN - 2471-254X

VL - 7

JO - Hepatology Communications

JF - Hepatology Communications

IS - 11

ER -

Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant

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