March 1, 2023

A Correlation has been Found among Liver Cirrhosis and a Lower Humoral Response to Covid-19 Vaccines

Results of a prospective study of patients with chronic liver disease (CLD) from 6 European countries, published in JHEP Reports, show that age, cirrhosis and type of vaccine predict a “lower” humoral response, while viral hepatitis etiology and prior antiviral therapy predict a “higher” humoral response to two-dose Covid-19 mRNA vaccines.  

A new study led by Rui Castro, Professor at Faculty of Pharmacy of Universidade de Lisboa (FFUL) and Researcher at Research Institute for Medicines of FFUL (iMed.ULisboa), has found that there is a difference on humoral response to Covid-19 vaccines on patients with chronic liver disease (CLD). Patients with cirrhosis have a lower immune response up to six months after the two doses; a higher immune response was observed on patients with viral hepatitis etiology and prior antiviral therapy. This result “could relate with cirrhosis-associated immune dysfunction (CAID)” says Rui Castro, adding that “the link between viral hepatitis and higher IgG titers was interesting and warrants further studies”.

The study included patients vaccinated with different mRNA Covid-19 Vaccines, and results were compared between patients who have been infected by SARS-COV-2 virus between 2 and 6 months after the immunization, with patients who had not been infected. Results showed no correlation among the type of vaccine and the infection by Covid-19, as well as no link between antibodies level and vaccines efficacy. This reinforces the importance of booster doses of the vaccine in this group of patients. Rui Castro claims “though additional studies should ideally be performed, I think this message can already be convened to patients, that is, that different two-dose mRNA COVID-19 vaccines are effective in a diverse group of patients with CLD. This will help to boost confidence in the vaccination plans put in place by the different governments”

The goal of the consortium behind this study – HEPCOVIVac – was to “create a prospective clinical registry of patients with CLD vaccinated for Covid-19, allowing for comprehensive studies on vaccination safety and efficacy”. The study was co-led by Helena Cortez-Pinto from the Faculty of Medicine of Lisbon, co-supervisoned by João Gonçalves, and also with the contribution of André Simão and Carolina Palma, from iMed-ULisboa.

The study had more than 350 patients with CLD, recruited on clinical centers from Belgium, Austria, Italy, Portugal, Romania and Spain. The full paper can be read online on Journal of Hepatology, JHP Reports.

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