Liver transplantation linked to lower antibody, T-cell response to COVID-19 vaccine
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LONDON — Patients who received a liver transplant had significantly reduced antibody and T-cell responses to SARS-CoV-2 vaccination compared with healthy controls, according to research presented at the International Liver Congress.
“Emerging data have demonstrated suboptimal immune responses to SARS-CoV-2 vaccination in immunosuppressed cohorts,” Thomas Marjot, a clinical research training fellow at the Oxford Liver Unit at Oxford University Hospitals NHS Foundation Trust, and colleagues wrote. “However, unified assessments comparing multiple vaccine platforms across the spectrum of liver disease are lacking.”
Seeking to investigate humoral and cellular responses to the SARS-CoV-2 vaccine in patients with cirrhosis, autoimmune hepatitis, LT and vascular liver disorders, Marjot and colleagues analyzed serum and peripheral blood mononuclear cells from 792 patients from the EASL COVID-Hep network and 283 patients from the UK OCTAVE study. They also collected and compared data from 93 healthy controls from the UK PITCH consortium. Samples were collected at baseline, less than 1 week before second vaccination (V2) and 28-days after V2, with anti-spike (S) and nucleocapsid (N) Ig titers and spike specific T-cell responses available in 151 and 75 patients, respectively, as well as in all healthy controls.
According to results, the two-dose series of the BNT162b2 vaccine induced a 10-fold increase in median anti-S Ig titer compared with two doses of the ChAdOx1 vaccine in healthy controls (15,634 U/mL vs. 1,198 U/mL).
Compared with controls, LT recipients had diminished median anti-S Ig titers following two doses of BNT162b2 (169 U/mL vs. 15,634 U/mL) or ChAdOx1 (51 U/mL vs. 1,198 U/mL) vaccines, and patients with cirrhosis had reduced anti-S Ig titers after receiving BNT162b2 vaccines (1,155 U/mL vs. 15,634 U/mL) and comparable titers after vaccination with ChAdOx1 (1,259 U/mL vs. 1,198 U/mL).
In addition, patients with autoimmune hepatitis had lower anti-S Ig titers with ChAdOx1 compared with controls (443 U/mL vs. 1,198 U/mL). Relative to healthy controls, all disease groups yielded a suboptimal antibody response to a single vaccine dose.
Further analysis showed seroconversion occurred in 100% of healthy controls, 100% of patients with cirrhosis, 99.5% of patients with autoimmune hepatitis and 70% of patients who underwent LT. Heterogeneous T-cell responses were reported across all cohorts; however, compared with healthy controls, a higher proportion of patients who underwent LT failed to generate a spike specific T-cell response following V2 (32% vs. 10%).
“LT recipients had markedly reduced antibody and T-cell responses to SARS-CoV-2 vaccination,” Marjot and colleagues concluded. “Responses to BNT162b2 were significantly reduced in patients with cirrhosis compared to healthy controls.
“Ongoing analysis across the rest of the cohort will define SARS-CoV-2 specific T- and B-cell function,” they added.
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Marjot T, et al. Abstract OS069. Presented at: International Liver Congress; June 22-26, 2022; London (hybrid meeting).
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