Impact of immunosuppressive regimens on antibody response after COVID-19 vaccination among Thai kidney transplant recipients
Background: The lower humoral immunity response after the COVID-19 vaccine in kidney transplant recipients (KTR) has been reported in several studies. However, there are few studies on the efficacy of the ChAdOx1 nCoV-19 (AstraZeneca) vaccine compared between various immunosuppressive regimens. Meth...
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Elsevier
2025-02-01
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844025006711 |
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| author | Nuttasith Larpparisuth Kritsada Pongsakornkullachart Nartsiri Ratchawang Attapong Vongwiwatana Peenida Skulratanasak |
| author_facet | Nuttasith Larpparisuth Kritsada Pongsakornkullachart Nartsiri Ratchawang Attapong Vongwiwatana Peenida Skulratanasak |
| author_sort | Nuttasith Larpparisuth |
| collection | DOAJ |
| description | Background: The lower humoral immunity response after the COVID-19 vaccine in kidney transplant recipients (KTR) has been reported in several studies. However, there are few studies on the efficacy of the ChAdOx1 nCoV-19 (AstraZeneca) vaccine compared between various immunosuppressive regimens. Methods: We conducted a prospective cohort study at Siriraj Hospital, Bangkok, Thailand. Adult KTRs who received two doses of the ChAdOx1 nCoV-19 vaccine at intervals of 3 months were enrolled. Anti-SARS-COV-2 S-RBD-IgG antibody (anti-RBD) was assessed at the one month after the second dose and considered positive if the level ≥50 AU/mL or 7 BAU/mL. The primary outcome was the seropositivity of anti-RBD. The association between type, dose, and level of immunosuppressive regimen and anti-RBD seropositivity was analyzed. Results: Between October 2021 and January 2022, 139 KTRs with a median time of 55 months (IQR, 29–102 months), were enrolled. The mean age was 49.1 ± 11.3 years and 64.7 % were men. Seroconversion of anti-RBD was found in 72 patients (51.8 %). The seropositive rate was significantly higher in KTR who received tacrolimus (TAC)/everolimus (EVR)/prednisolone (CS) immunosuppression than EVR/mycophenolic acid (MPA)/CS and TAC/MPA/CS, respectively (95 % vs. 65 % vs. 34 %; p < 0.001). The MPA-containing regimen is associated with an inferior humoral response (OR 0.02, 95%CI 0.01–0.16; p < 0.001). In contrast, KTRs who received EVR had the highest immunogenic response (OR 12.97, 95%CI 4.69–35.84; p < 0.001). During the 11-month follow-up period, COVID-19 pneumonia occurred in 3 KTR in the seronegative group and none in the seropositive group. Conclusion: The anti-RBD response after ChAdOx1 nCoV-19 vaccination was revealed in 51.8 % of the KTR. KTRs who received the TAC/EVR/CS regimen had the highest immune response after vaccination, relatively comparable to the general population. The immunosuppressive regimen should be considered for a further vaccine dose in KTR. |
| format | Article |
| id | doaj-art-7c0f265e6e524ccf998987321eb6e789 |
| institution | Kabale University |
| issn | 2405-8440 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
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| spelling | doaj-art-7c0f265e6e524ccf998987321eb6e7892025-01-28T04:14:47ZengElsevierHeliyon2405-84402025-02-01113e42291Impact of immunosuppressive regimens on antibody response after COVID-19 vaccination among Thai kidney transplant recipientsNuttasith Larpparisuth0Kritsada Pongsakornkullachart1Nartsiri Ratchawang2Attapong Vongwiwatana3Peenida Skulratanasak4Division of Nephrology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDivision of Nephrology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDepartment of Nursing Siriraj Hospital, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDivision of Nephrology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDivision of Nephrology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; Corresponding author. Division of Nephrology, Department of Medicine Faculty of Medicine Siriraj Hospital, Mahidol University 2 Prannok Road, Bangkok Noi, Bangkok, 10700, Thailand.Background: The lower humoral immunity response after the COVID-19 vaccine in kidney transplant recipients (KTR) has been reported in several studies. However, there are few studies on the efficacy of the ChAdOx1 nCoV-19 (AstraZeneca) vaccine compared between various immunosuppressive regimens. Methods: We conducted a prospective cohort study at Siriraj Hospital, Bangkok, Thailand. Adult KTRs who received two doses of the ChAdOx1 nCoV-19 vaccine at intervals of 3 months were enrolled. Anti-SARS-COV-2 S-RBD-IgG antibody (anti-RBD) was assessed at the one month after the second dose and considered positive if the level ≥50 AU/mL or 7 BAU/mL. The primary outcome was the seropositivity of anti-RBD. The association between type, dose, and level of immunosuppressive regimen and anti-RBD seropositivity was analyzed. Results: Between October 2021 and January 2022, 139 KTRs with a median time of 55 months (IQR, 29–102 months), were enrolled. The mean age was 49.1 ± 11.3 years and 64.7 % were men. Seroconversion of anti-RBD was found in 72 patients (51.8 %). The seropositive rate was significantly higher in KTR who received tacrolimus (TAC)/everolimus (EVR)/prednisolone (CS) immunosuppression than EVR/mycophenolic acid (MPA)/CS and TAC/MPA/CS, respectively (95 % vs. 65 % vs. 34 %; p < 0.001). The MPA-containing regimen is associated with an inferior humoral response (OR 0.02, 95%CI 0.01–0.16; p < 0.001). In contrast, KTRs who received EVR had the highest immunogenic response (OR 12.97, 95%CI 4.69–35.84; p < 0.001). During the 11-month follow-up period, COVID-19 pneumonia occurred in 3 KTR in the seronegative group and none in the seropositive group. Conclusion: The anti-RBD response after ChAdOx1 nCoV-19 vaccination was revealed in 51.8 % of the KTR. KTRs who received the TAC/EVR/CS regimen had the highest immune response after vaccination, relatively comparable to the general population. The immunosuppressive regimen should be considered for a further vaccine dose in KTR.http://www.sciencedirect.com/science/article/pii/S2405844025006711SARS-CoV-2COVID-19Kidney transplantationChAdOx1 nCoV-19 vaccineAnti-Spike RBD IgG |
| spellingShingle | Nuttasith Larpparisuth Kritsada Pongsakornkullachart Nartsiri Ratchawang Attapong Vongwiwatana Peenida Skulratanasak Impact of immunosuppressive regimens on antibody response after COVID-19 vaccination among Thai kidney transplant recipients Heliyon SARS-CoV-2 COVID-19 Kidney transplantation ChAdOx1 nCoV-19 vaccine Anti-Spike RBD IgG |
| title | Impact of immunosuppressive regimens on antibody response after COVID-19 vaccination among Thai kidney transplant recipients |
| title_full | Impact of immunosuppressive regimens on antibody response after COVID-19 vaccination among Thai kidney transplant recipients |
| title_fullStr | Impact of immunosuppressive regimens on antibody response after COVID-19 vaccination among Thai kidney transplant recipients |
| title_full_unstemmed | Impact of immunosuppressive regimens on antibody response after COVID-19 vaccination among Thai kidney transplant recipients |
| title_short | Impact of immunosuppressive regimens on antibody response after COVID-19 vaccination among Thai kidney transplant recipients |
| title_sort | impact of immunosuppressive regimens on antibody response after covid 19 vaccination among thai kidney transplant recipients |
| topic | SARS-CoV-2 COVID-19 Kidney transplantation ChAdOx1 nCoV-19 vaccine Anti-Spike RBD IgG |
| url | http://www.sciencedirect.com/science/article/pii/S2405844025006711 |
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