Low antibody titers after second SARS-CoV-2 vaccination in patients with autoimmune hepatitis

Aims/Background Patients with autoimmune hepatitis (AIH) require immunosuppressive treatment, which might impair the immune response to vaccination. In this prospective cohort study, we assessed the humoral immune response of AIH patients to SARS-CoV-2 vaccination.

Methods Anti-SARS-CoV-2 antibody titers of 96 consecutive patients with AIH (78% female, median age 53y, range 19–83y, 34% with liver cirrhosis) were included 1–6 months after the second SARS-CoV-2 vaccination. Vaccination responses were explored for their association with prescribed immunosuppression, comorbidities and laboratory values. These data/findings were compared to 56 healthy controls.

Results 93 (97%) patients achieved a seroconversion with median anti-SARS-CoV-2 titers of 660 BAU/ml (range 20–11400 BAU/ml). A low or no response defined as antibody-titers < 100 BAU/ml was detected in 10% (N=10) of the patients, of which all were under immunosuppression (N=4 azathioprine, 3 prednisone, 2 MMF + prednisone, 1 azathioprine + Tacrolimus). Antibody levels were significantly lower in AIH patients than in healthy controls (1700 BAU/ml). Interestingly, antibody-titers of AIH patients without immunosuppression (n=10) were comparably low to AIH patients with immunosuppression. No additional, individual risk factors for impaired response to vaccination could be identified in this cohort.

Conclusion Despite high seroconversion rates, AIH patients show a significantly reduced magnitude of the humoral immune response. Therefore, these data suggest that AIH patients should be recommended an early third booster shot in agreement with recent advice by the German STIKO.

Poster Visit Session lll Metabolism (incl. NAFLD)

28/01/2022, 18.50 pm – 19.35 pm

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Artikel online veröffentlicht:
26. Januar 2022