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

Abstract

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.

Keywords

• CHB
• cirrhosis
• influenza
• SARS‐CoV‐2
• immune response