دورية أكاديمية
أعرض في EDS

Deficient Immune Response following SARS-CoV-2 Vaccination in Patients with Hepatobiliary Carcinoma: A Forgotten, Vulnerable Group of Patients.

التفاصيل البيبلوغرافية
العنوان: Deficient Immune Response following SARS-CoV-2 Vaccination in Patients with Hepatobiliary Carcinoma: A Forgotten, Vulnerable Group of Patients.
المؤلفون: Monin MB; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.; German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany., Baier LI; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany., Gorny JG; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany., Berger M; Institute of Medical Biometry, Informatics and Epidemiology, Faculty of Medicine, University of Bonn, Bonn, Germany., Zhou T; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany., Mahn R; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany., Sadeghlar F; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany., Möhring C; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany., Boesecke C; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.; German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany., van Bremen K; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.; German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany., Rockstroh JK; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.; German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany., Strassburg CP; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany., Eis-Hübinger AM; Institute of Virology, University Hospital Bonn, Bonn, Germany., Schmid M; Institute of Medical Biometry, Informatics and Epidemiology, Faculty of Medicine, University of Bonn, Bonn, Germany., Gonzalez-Carmona MA; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.
المصدر: Liver cancer [Liver Cancer] 2023 May 10; Vol. 12 (4), pp. 339-355. Date of Electronic Publication: 2023 May 10 (Print Publication: 2023).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: S. Karger Country of Publication: Switzerland NLM ID: 101597993 Publication Model: eCollection Cited Medium: Print ISSN: 2235-1795 (Print) Linking ISSN: 16645553 NLM ISO Abbreviation: Liver Cancer Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Basel : S. Karger
مستخلص: Introduction: Data on immune response rates following vaccination for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in patients with hepatobiliary carcinoma (HBC) are rare. However, impaired immunogenicity must be expected due to the combination of chronic liver diseases (CLDs) with malignancy and anticancer treatment.
Methods: In this prospective, longitudinal study, 101 patients were included, of whom 59 were patients with HBC under anticancer treatment. A cohort of patients with a past medical history of gastrointestinal cancer, of whom 28.6% had HBC without detectable active tumor disease having been off therapy for at least 12 months, served as control. Levels of SARS-CoV-2 anti-spike IgG, surrogate neutralization antibodies (sNABs), and cellular immune responses were compared. In uni- and multivariable subgroup analyses, risk factors for impaired immunogenicity were regarded. Data on rates and clinical courses of SARS-CoV-2 infections were documented.
Results: In patients with HBC under active treatment, levels of SARS-CoV-2 anti-spike IgG were significantly lower (2.55 log 10 BAU/mL; 95% CI: 2.33-2.76; p < 0.01) than in patients in follow-up care (3.02 log 10 BAU/mL; 95% CI: 2.80-3.25) 4 weeks after two vaccinations. Antibody levels decreased over time, and differences between the groups diminished. However, titers of SARS-CoV-2 sNAB were for a longer time significantly lower in patients with HBC under treatment (64.19%; 95% CI: 55.90-72.48; p < 0.01) than in patients in follow-up care (84.13%; 95% CI: 76.95-91.31). Underlying CLD and/or liver cirrhosis Child-Pugh A or B (less than 8 points) did not seem to further impair immunogenicity. Conversely, chemotherapy and additional immunosuppression were found to significantly reduce antibody levels. After a third booster vaccination for SARS-CoV-2, levels of total and neutralization antibodies were equalized between the groups. Moreover, cellular response rates were balanced. Clinically, infection rates with SARS-CoV-2 were low, and no severe courses were observed.
Conclusion: Patients with active HBC showed significantly impaired immune response rates to basic vaccinations for SARS-CoV-2, especially under chemotherapy, independent of underlying cirrhotic or non-cirrhotic CLD. Although booster vaccinations balanced differences, waning immunity was observed over time and should be monitored for further recommendations. Our data help clinicians decide on individual additional booster vaccinations and/or passive immunization or antiviral treatment in patients with HBC getting infected with SARS-CoV-2.
Competing Interests: M.A.G.C. has contributed to advisory boards for Roche, Eisai, BMS, MSD, and AZ. C.B. received honoraria for lectures and/or consultancies from AbbVie, Gilead, Janssen, MSD, and ViiV as well as funding from Dt. Leberstiftung, DZIF, Hector Stiftung, and NEAT ID. M.B.M. received travel expenses and honoraria from Gilead, Pfizer, and Virology Education. JKR has received honoraria for lectures and/or consultancies from Abivax, Galapagos, Gilead, Merck, Janssen, Theratechnologies, and ViiV. However, these activities have no potential conflicts of interest with the manuscript. None of the other authors have any potential conflicts (financial, professional, or personal) that are relevant to the manuscript.
(© 2023 The Author(s). Published by S. Karger AG, Basel.)
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فهرسة مساهمة: Keywords: COVID-19; Chronic liver disease; Hepatobiliary carcinoma; Liver cirrhosis; SARS-CoV-2 neutralization; Vaccination; Waning immunity
تواريخ الأحداث: Date Created: 20231030 Latest Revision: 20231031
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC10601882
DOI: 10.1159/000529608
PMID: 37901199
قاعدة البيانات: MEDLINE
الوصف
تدمد:2235-1795
DOI:10.1159/000529608