Immunogenicity and risk factors for poor humoral immune response to SARS-CoV-2 vaccine in patients with autoimmune hepatitis: a systematic review and meta-analysis.

Immunogenicity and risk factors for poor humoral immune response to SARS-CoV-2 vaccine in patients with autoimmune hepatitis: a systematic review and meta-analysis.

Publication date: Jan 18, 2024

Research on the immunogenicity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine in patients with autoimmune hepatitis (AIH) has produced varied results, and the determinants of the immunological response remain largely elusive. A comprehensive search of three primary databases (PubMed, Embase, and Web of Science) yielded pertinent studies on the topic. The data extraction was a collaborative effort among three independent researchers, who subsequently reconvened to validate the key data that were collated. The primary outcomes were the magnitudes of humoral and cellular immune responses to the vaccines. The secondary outcomes were related to factors affecting the humoral immune response post-vaccination. Our systematic review incorporated eight studies, and the meta-analysis involved three. The average antibody response rates after one, two, and three doses of the SARS-CoV-2 vaccine were 86%, 82%, and 91%, respectively. Unexpectedly, the antibody concentrations of seropositive patients were markedly lower than those of their healthy counterparts. The cellular immune response rates after two and three vaccine doses were 74% and 56%, respectively. Treatment with mycophenolate mofetil and corticosteroids was associated with a notable decrease in seropositivity [pooled odds ratio (95% confidence interval): 2. 62 (2. 12-3. 25) and 2. 4 (1. 51-3. 82), respectively]. In contrast, azathioprine had no discernable impact on the humoral response. In patients with AIH, the immune response to COVID-19 vaccination is attenuated. Specific immunosuppressive agents, such as steroids and MMF, have been found to reduce antibody responses. Recognizing these determinants is foundational to formulating individualized vaccination strategies for patients with AIH. Further research with an emphasis on post-vaccination cellular immunity will be essential to refine the vaccination approaches for this demographic.

Concepts Keywords
Coronavirus Analysis
Covid Antibody
Immunosuppressive Autoimmune
Researchers Cellular
Systematic Cov
Factors
Hepatitis
Humoral
Immune
Immunogenicity
Meta
Sars
Systematic
Vaccination
Vaccine

Semantics

Type Source Name
disease IDO humoral immune response
disease VO vaccine
disease MESH autoimmune hepatitis
disease VO Severe acute respiratory syndrome coronavirus 2
disease VO vaccination
drug DRUGBANK Mycophenolate mofetil
drug DRUGBANK Azathioprine
disease IDO immune response
disease MESH COVID-19
drug DRUGBANK Monomethyl fumarate

Original Article

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