HTLV-1 携带者接种 COVID-19 疫苗后体液免疫受损。
Impaired humoral immunity following COVID-19 vaccination in HTLV-1 carriers.
机构信息
Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
Department of Hematology, Imamura General Hospital, Kagoshima, Japan.
出版信息
BMC Infect Dis. 2024 Jan 17;24(1):96. doi: 10.1186/s12879-024-09001-z.
BACKGROUND
Whether human T-lymphotropic virus type 1 (HTLV-1) carriers can develop sufficient humoral immunity after coronavirus disease 2019 (COVID-19) vaccination is unknown.
METHODS
To investigate humoral immunity after COVID-19 vaccination in HTLV-1 carriers, a multicenter, prospective observational cohort study was conducted at five institutions in southwestern Japan, an endemic area for HTLV-1. HTLV-1 carriers and HTLV-1-negative controls were enrolled for this study from January to December 2022. During this period, the third dose of the COVID-19 vaccine was actively administered. HTLV-1 carriers were enrolled during outpatient visits, while HTLV-1-negative controls included health care workers and patients treated by participating institutions for diabetes, hypertension, or dyslipidemia. The main outcome was the effect of HTLV-1 infection on the plasma anti-COVID-19 spike IgG (IgG-S) titers after the third dose, assessed by multivariate linear regression with other clinical factors.
RESULTS
We analyzed 181 cases (90 HTLV-1 carriers, 91 HTLV-1-negative controls) after receiving the third dose. HTLV-1 carriers were older (median age 67.0 vs. 45.0 years, p < 0.001) and more frequently had diabetes, hypertension, or dyslipidemia than did HTLV-1-negative controls (60.0% vs. 27.5%, p < 0.001). After the third dose, the IgG-S titers decreased over time in both carriers and controls. Multivariate linear regression in the entire cohort showed that time since the third dose, age, and HTLV-1 infection negatively influenced IgG-S titers. After adjusting for confounders such as age, or presence of diabetes, hypertension, or dyslipidemia between carriers and controls using the overlap weighting propensity score method, and performing weighted regression analysis in the entire cohort, both time since the third dose and HTLV-1 infection negatively influenced IgG-S titers.
CONCLUSIONS
The humoral immunity after the third vaccination dose is impaired in HTLV-1 carriers; thus, customized vaccination schedules may be necessary for them.
背景
人类 T 淋巴细胞白血病病毒 1 型（HTLV-1）携带者在感染 2019 冠状病毒病（COVID-19）后能否产生足够的体液免疫尚不清楚。
方法
为了研究 HTLV-1 携带者在 COVID-19 疫苗接种后的体液免疫，在日本西南部的五个机构进行了一项多中心、前瞻性观察队列研究，该地区是 HTLV-1 的流行区。本研究纳入了 2022 年 1 月至 12 月期间在这些机构接受门诊治疗的 HTLV-1 携带者和 HTLV-1 阴性对照者。在此期间，积极给予第三剂 COVID-19 疫苗。HTLV-1 携带者在门诊就诊时入组，而 HTLV-1 阴性对照者包括医疗机构的医护人员以及因糖尿病、高血压或血脂异常前来就诊的患者。主要结局是通过多变量线性回归分析，评估 HTLV-1 感染对第三剂疫苗后血浆抗 COVID-19 刺突 IgG（IgG-S）滴度的影响，其他临床因素也包括在回归模型中。
结果
本研究共纳入了 181 例患者（90 例 HTLV-1 携带者，91 例 HTLV-1 阴性对照者），这些患者均接受了第三剂疫苗接种。与 HTLV-1 阴性对照者相比，HTLV-1 携带者年龄更大（中位数 67.0 岁 vs. 45.0 岁，p<0.001），更常患有糖尿病、高血压或血脂异常（60.0% vs. 27.5%，p<0.001）。在接种第三剂疫苗后，携带者和对照者的 IgG-S 滴度随时间逐渐下降。在整个队列中进行多变量线性回归分析显示，第三剂疫苗接种后时间、年龄和 HTLV-1 感染均对 IgG-S 滴度产生负面影响。采用重叠加权倾向评分法调整携带者和对照组之间的年龄或合并糖尿病、高血压或血脂异常等混杂因素，并在整个队列中进行加权回归分析后，第三剂疫苗接种后时间和 HTLV-1 感染均对 IgG-S 滴度产生负面影响。
结论
在 HTLV-1 携带者中，第三剂疫苗接种后的体液免疫受损；因此，可能需要为他们制定个性化的疫苗接种计划。
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