The Influence of Initial Immunosuppression on the Kinetics of Humoral Response after SARS-CoV-2 Vaccination in Patients Undergoing Kidney Transplantation

Author(s):Show less -

Foresto, Renato Demarchi ; Souza, Roberto Matias ; dos Anjos, Gustavo Rodrigues ; Nakamura, Monica Rika ; Goulart, Haryanne de Souza ; Sampaio, Rayra ; Franca, Daniela Pereira ; Marques, Emanuelle Ferreira ; Lucena, Elisabeth Franca ; Cristelli, Marina Pontello ; Silva Jr, Helio Tedesco ; Requiao-Moura, Lucio ; Pestana, Jose Medina

• Document type: Journal article
• Source: VACCINES; v. 12, n. 10, p. 12-pg., 2024-10-01.

Abstract

Background: The effect of initial immunosuppressive therapy on the kinetics of the SARS-CoV-2 vaccine-induced humoral response is unknown. Here, we compared the kinetics of SARS-CoV-2 vaccine-induced humoral response in chronic kidney disease patients undergoing kidney transplantation (KTRs) and compared to patients remaining on dialysis during the Omicron circulation. Methods: This prospective, non-randomized, real-world study included 113 KTRs and 108 patients on dialysis. Those with previous COVID-19 or negative IgG at screening were excluded. Blood samples were collected to assess SARS-CoV-2 IgG titers and neutralizing antibodies at months (M) 1, 3, 6, and 12. Results: Seroreversion occurred in one KTR and in three patients on dialysis. KTRs had lower IgG titers over time (M1: 10,809.3 +/- 12,621.7 vs. 15,267.8 +/- 16,096.2 AU/mL; M3: 12,215.5 +/- 12,885.8 vs. 15,016.2 +/- 15,346.1 AU/mL; M6: 12,540.4 +/- 13,010.7 vs. 18,503.5 +/- 14,581.0 AU/mL; p = 0.005), but neutralizing antibodies were similar (M1: 94.0 vs. 90.3%; M3: 92.9 vs. 90.5%; M6: 99.0 vs. 95.5%; M12: 98.9 vs. 97.5%; p = 0.812). During follow-up, KTRs received more vaccines (141 vs. 73; p < 0.001) and contracted more COVID-19 (32.7% vs. 14.8%; p = 0.002). Conclusions: Compared to patients on dialysis, KTRs had lower SARS-CoV-2 IgG titers and similar rates of seroreversion and neutralizing antibodies over time. Although KTRs received more boosters, they had a higher incidence of COVID-19. (AU)

• FAPESP's process: 21/13680-6 - Evaluation of SARS-CoV-2 infection and Coronavirus vaccine response in transplant recipients, dialysis patients, and health workers
• Grantee: Jose Osmar Medina de Abreu Pestana
• Support Opportunities: Research Projects - Thematic Grants