Decreased antibody response to influenza vaccine with an enhanced antibody response to subsequent SARS-CoV-2 vaccination in patients with chronic hepatitis B virus infection

Immun Inflamm Dis. 2023 Jan;11(1):e759. doi: 10.1002/iid3.759.

Abstract

Introduction: Influenza or SARS-CoV-2 vaccination is especially recommended for people with underlying diseases. For the large number of patients with chronic hepatitis B virus infection (CHB), studies on their immune responses to these vaccines are still lacking.

Methods: A total of 57 CHB patients and 19 healthy controls (HCs) receiving inactivated influenza vaccination were prospectively followed up. Influenza-specific immunoglobulin G (IgG) antibodies (anti-H1N1, anti-H3N2, and anti-B IgG), antibody-secreting cells (ASCs), and circulating T follicular helper cells were assessed simultaneously. Eight CHB patients subsequently got inactivated SARS-CoV-2 vaccination during 1-year follow-up, and levels of serum antibodies against SARS-CoV-2 were further analyzed.

Results: On day 28 after influenza vaccination, three influenza antibodies levels appeared to be lower in CHB patients than in HCs. And anti-H1N1 IgG level was significantly decreased in cirrhotic patients (p < .05). Anti-H1N1 IgG levels (day 28) were positively correlated with ASC frequencies (day 7) (p < .05), and negatively correlated with cirrhosis and hepatitis B surface antigen levels (p < .05). Anti-SARS-CoV-2 antibodies were higher in patients with influenza vaccination history than in patients without the history (p < .05). Moreover, positive correlations existed between influenza vaccination history and anti-SARS-CoV-2 antibody levels (p < .01).

Conclusions: CHB patients, especially those with cirrhosis, appeared to have a decreased antibody response to inactivated influenza vaccine. A history of inactivated influenza vaccination within 1 year before inactivated SARS-CoV-2 vaccination might induce stronger anti-SARS-CoV-2 antibody response.

Trial registration: ClinicalTrials.gov NCT05007665.

Keywords: CHB; SARS-CoV-2; cirrhosis; immune response; influenza.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Viral
  • Antibody Formation
  • COVID-19 Vaccines
  • COVID-19* / prevention & control
  • Hepatitis B, Chronic*
  • Humans
  • Immunoglobulin G
  • Influenza Vaccines*
  • Influenza, Human* / prevention & control
  • SARS-CoV-2
  • Vaccination
  • Vaccines, Inactivated

Substances

  • Influenza Vaccines
  • COVID-19 Vaccines
  • Antibodies, Viral
  • Vaccines, Inactivated
  • Immunoglobulin G

Associated data

  • ClinicalTrials.gov/NCT05007665