Institute of Digestive Health & Liver Diseases, Mercy Medical Center, Baltimore, MD.
Institute of Digestive Health & Liver Diseases, Mercy Medical Center, Baltimore, MD; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD.
Ann Hepatol. 2022 Jul-Aug;27(4):100702. doi: 10.1016/j.aohep.2022.100702. Epub 2022 Mar 23.
Lower antibody (Ab) responses after SARS-CoV-2 vaccination have been reported in liver transplant (LT) recipients and those with chronic liver diseases (CLD). The role of a booster dose in those with poor responses to initial vaccination is not well defined.
In this prospective study, we determined antibody (Ab) response to spike protein after a booster dose in LT recipients and those with chronic liver diseases (CLD) with and without cirrhosis after they had a poor response to an initial standard regimen.
Of the 80 patients enrolled, 45 had LT, and 35 had CLD (18 with cirrhosis). A booster dose was given at a median of 138.5 days after the completion of the standard regimen. After the booster dose, 58 (73%, 31 LT, 27 CLD) had good response (≥250 U/mL), and 22 (28%, 14 LT, and 8 CLD) had poor response (7 undetectable and 15 with low Ab levels). No patient had any serious adverse events. The antibody responses were lower in those who had undetectable Ab (80 U/mL) than those who had low levels of Ab (0.80-249 U/mL) after the standard vaccination regimen (42% vs. 87%, p=0.0001). The antibody responses after homologous and heterologous booster doses were similar.
We have shown that a booster dose will enhance Ab responses in LT recipients and those with CLD who had poor responses after an initial vaccine regimen.
有报道称，在肝移植（LT）受者和慢性肝病（CLD）患者中，SARS-CoV-2 疫苗接种后的抗体（Ab）反应较低。对于初始疫苗接种反应不佳的患者，加强剂量的作用尚未明确。
在这项前瞻性研究中，我们确定了 LT 受者和慢性肝病（CLD）患者（包括无肝硬化和有肝硬化的患者）在初始标准方案接种后反应不佳的情况下，加强剂量后对刺突蛋白的 Ab 反应。
在 80 名入组患者中，45 名患有 LT，35 名患有 CLD（18 名患有肝硬化）。在完成标准方案后中位数为 138.5 天给予加强剂量。加强剂量后，58 名（73%，31 名 LT，27 名 CLD）有良好反应（≥250 U/mL），22 名（28%，14 名 LT，8 名 CLD）有不良反应（7 名不可检测，15 名 Ab 水平低）。没有患者发生任何严重不良事件。与标准疫苗接种方案后 Ab 水平较低（0.80-249 U/mL）的患者相比，Ab 水平不可检测（<80 U/mL）的患者的抗体反应较低（42% vs. 87%，p=0.0001）。同源和异源加强剂量后的抗体反应相似。
我们已经表明，对于初始疫苗接种方案后反应不佳的 LT 受者和 CLD 患者，加强剂量会增强 Ab 反应。
