Infections in cirrhosis

˜The œLancet. Gastroenterology & hepatology, Journal Year: 2024, Volume and Issue: 9(8), P. 745 - 757

Published: May 13, 2024

Language: Английский

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Global burden of vaccine‐associated hepatobiliary and gastrointestinal adverse drug reactions, 1967–2023: A comprehensive analysis of the international pharmacovigilance database

Journal of Medical Virology, Journal Year: 2024, Volume and Issue: 96(7)

Published: July 1, 2024

Abstract Although previous studies have focused on hepatobiliary and gastrointestinal adverse drug reactions (ADRs) associated with COVID‐19 vaccines, literature such ADRs other vaccines is limited, particularly a global scale. Therefore, we aimed to investigate the burden of vaccine‐associated identify implicated in these occurrences. This study utilized data from World Health Organization (WHO) international pharmacovigilance database extract reports 1967 2023 (total = 131 255 418). Through reporting counts, reported odds ratios (ROR) 95% confidence interval (CI), information components (IC) IC 0.25 , examined association between 16 incidence across 156 countries. Of 6 842 303 ADRs, 10 786 liver injury, 927 870 symptoms, 2978 pancreas bile duct 96 intra‐abdominal hemorrhage were identified. Most surged after 2020, majority attributed messenger RNA (mRNA) vaccines. Hepatitis A exhibited highest injury (ROR [95% CI]: 10.30 [9.65–10.99]; [IC ]: 3.33 [3.22]), followed by hepatitis B, typhoid, rotavirus. Specifically, ischemic had significant both Ad5‐vectored mRNA Gastrointestinal symptoms all except for tuberculosis rotavirus (11.62 [11.45–11.80]; 3.05 [3.03]) typhoid (11.02 [10.66–11.39]; 3.00 [2.96]). Pancreas (1.99 [1.89–2.09]; 0.90 [0.83]), MMR (measles, mumps, rubella), papillomavirus For hemorrhage, inactivated whole‐virus (3.93 [1.86–8.27]; 1.71 [0.41]) association, (1.81 [1.42–2.29]; 0.77 [0.39]). short time onset, within 1 day, low mortality rate. scale database, occurred emphasizing importance healthcare workers' vigilant monitoring timely management.

Language: Английский

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Immunizations in adult liver transplant candidates and recipients

Annals of Liver Transplantation, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 21, 2025

Liver transplant (LT) recipients are at high risk of infections due to both immune dysfunctions associated with liver disease and immunosuppressive therapy necessary after transplantation.Effective vaccination strategies crucial prevent vaccine-preventable diseases, which remain a significant cause morbidity mortality in this population.Vaccines should be administered as early the pre-transplant period possible when likelihood developing protective response is highest live vaccines can given safely.Live least 4 weeks prior transplantation immunocompetent patients.With rare exception, contraindicated LT recipients.Post-transplantation, inactivated generally safe, although their efficacy may diminished.This review provides detailed overview current guidelines for adult candidates recipients, covering key including influenza, pneumococcus, hepatitis A B, herpes zoster, tetanus-diphtheria.

Language: Английский

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Vaccine effectiveness against influenza-associated hospitalizations in adults with liver disease, 2015–2020: US Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN)

Human Vaccines & Immunotherapeutics, Journal Year: 2025, Volume and Issue: 21(1)

Published: Jan. 28, 2025

Influenza causes 100,000–710,000 hospitalizations annually in the U.S. Patients with liver disease are at higher risk of severe outcomes following influenza infection. This study evaluated vaccine effectiveness (VE) against influenza-associated hospitalization among adults disease. Data from Hospitalized Adult Vaccine Effectiveness Network (HAIVEN), a test-negative case-control study, 2015 to 2020 were used estimate VE ≥18 years admitted for acute respiratory illness. was calculated as (1-adjusted odds ratio)*100%, comparing receipt between laboratory-confirmed cases and controls using multiple logistic regression inverse probability treatment weighting (IPTW). In total, 1,622 (12.8%) 12,704 had ≥1 disease(s). Compared those without disease, more likely be intensive care unit (15.7% vs 12.8%, p = .001) or die hospital (3.0% 1.4%, < .001). The IPTW-adjusted 27% (95% confidence interval [CI], 22–32%) patients but 11% CI, −8–26%) not significant Significant effect modification by presence found (p .05 interaction term). While vaccination significantly reduced protective Further studies warranted evaluate different types specific formulations.

Language: Английский

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Post COVID Condition and Long‐Term COVID‐19 Impact on Hepatic Decompensation and Survival in Cirrhosis: A Propensity Matched Observational Study

JGH Open, Journal Year: 2025, Volume and Issue: 9(3)

Published: March 1, 2025

Patients with cirrhosis are susceptible to decompensation events, including ascites, variceal bleeding (VB), hepatic encephalopathy, or death after COVID-19 infection. may experience post-COVID condition (PCC) multisystem involvement that persists for at least 2 months. Hospitalized patients and between January 2021 2023 were assessed events mortality compared a propensity-matched cohort of non-COVID-19 sepsis. Both groups followed outcomes over 1 year. Of 252 Cirrhosis+ (73% men, aged 48.9 ± 13.7 years, 31%-diabetes, 44%-hypertension, 35%-alcohol-associated, 34.5%-metabolic dysfunction-associated steatotic liver disease; MASLD), 72 (28.6%) died in hospital 180 (71.4%) recovered, similar non-COVID-sepsis (58/214, 27.1%). Finally,60 (33.3%) met criteria PCC, 19 (10.5%) had no post sequelae 101 (56.1%) (N = 45) lost follow up 56). Late Mortality was higher than (56.1% vs. 35.3%, p 0.026). PCC 47.6 63.3%-men, Charlson Comorbidity Index > 4 (51.7%), 45%-diabetes, 56.7%-hypertension, 33.3%, 23.3%, 43.3% Child-Turcotte-Pugh class A, B C, respectively. symptoms included persistent dyspnea (34, 43%), cognitive impairment (20, 25.3%), anxiety (47, 59.4%). On multivariable analysis, predictors the development baseline MELDNa (HR 1.12, 95% CI: 1.05-1.17, < 0.001) age 0.9, 0.91-0.99, 0.012). Predictors following recovery 1.03, 1.01-1.05, 0.008), 1.2, 1.1-1.5, 0.002) hypertension 1.63, 1.07-2.49, 0.025). is associated long-term even from respiratory Long COVID seen third survivors cirrhosis.

Language: Английский

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Pediatric Liver and Kidney Transplant Recipients Demonstrate Greater Serological Response to SARS-CoV-2 Vaccination Than Adults

Transplantation Direct, Journal Year: 2025, Volume and Issue: 11(5), P. e1787 - e1787

Published: April 29, 2025

Adult solid organ transplant recipients (SOTRs) have decreased responsiveness to severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) vaccination and higher incidence of infection, but there are few data on the serological response in pediatric SOTR. The aim this study was determine SARS-CoV-2 liver (LT) kidney (KT) compare it with adult A European, prospective, multicenter performed. Samples were taken at 7 32 wk following COVID-19 endpoints measured by ELISA. total 42 (16 post-LT 26 post-KT) 117 (all post-LT) included. All participants 94% received mRNA vaccines. Paediatric SOTR patients had significantly anti-Spike IgG levels than week (114 220.7 [59 285.92-220 058.55] versus 8756.7 [5643.69-13 586.71], P < 0.0001) (46 113.2 [10 992.91-193 436.14] 8207.0 [3561.20-18 913.43], = 0.0032). No significant difference found between LT KT (129 434.4 [51 888.64-322 869.69] 105 304.5 [39 910.20-277 849.50], 0.9854). differences seen children adults rate decline weeks (P 0.8000). Male sex hemolytic-uremic or postischemic disease associated lower demonstrate greater vaccine responses comparable patients. These support efficacy safety child may alleviate hesitancy patient group.

Language: Английский

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Vaccine Responses in Patients with Liver Cirrhosis: From the Immune System to the Gut Microbiota

Vaccines, Journal Year: 2024, Volume and Issue: 12(4), P. 349 - 349

Published: March 23, 2024

Vaccines prevent a significant number of deaths annually. However, certain populations do not respond adequately to vaccination due impaired immune systems. Cirrhosis, condition marked by profound disruption immunity, impairs the normal immunization process. Critical vaccines for cirrhotic patients, such as hepatitis A virus (HAV), B (HBV), influenza, pneumococcal, and coronavirus disease 19 (COVID-19), often elicit suboptimal responses in these individuals. The humoral response, essential immunization, is less effective cirrhosis decline memory cells an increase plasma blasts, which interfere with creation long-lasting response antigen vaccination. Additionally, some T cell subtypes exhibit reduced activation cirrhosis. Nonetheless, persistence activity, while preventing infections, may help attenuate severity diseases patients. Alongside that, impairment innate particularly dendritic (DCs), prevents priming adaptive interrupting process at its onset. Furthermore, disrupts gut–liver axis balance, causing dysbiosis, production short-chain fatty acids (SCFAs), increased intestinal permeability, bacterial translocation. Undermining physiological activity system, alterations could impact vaccine response. Enhancing understanding molecular cellular factors contributing patients crucial improving efficacy this population developing better prevention strategies.

Language: Английский

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Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant

Hepatology Communications, Journal Year: 2023, Volume and Issue: 7(11)

Published: Oct. 18, 2023

Background: Vaccine hesitancy and lack of access remain major issues in disseminating COVID-19 vaccination to liver patients globally. Factors predicting poor response risk breakthrough infection are important data target booster vaccine programs. The primary aim the current study was measure humoral responses 2 doses vaccine. Secondary aims included determination factors infection. Methods: Biomarkers cirrhosis And post-Liver Transplantation is a prospective, multicenter, observational case-control study. Participants were recruited at 4–10 weeks following first second [n = 325; 94% messenger RNA (mRNA) 6% viral vaccine], autoimmune disease (AILD) (n 120; 77% mRNA 23% vaccine), post-liver transplant (LT) 146; 96% 3% healthy controls 51; 72% mRNA, 24% 4% heterologous combination). Serological end points measured, regarding SARS-CoV-2 collected. Results: After adjusting by age, sex, time sample collection, anti-Spike IgG levels lowest post-LT compared ( p < 0.0001), AILD control 0.002). reduced older Child-Turcotte-Pugh B/C, elevated IL-6 cirrhosis; non-mRNA AILD; coronary artery disease, use mycophenolate dysregulated B-call activating factor, lymphotoxin-α LT. Incident occurred 6.6%, 10.6%, 7.4%, 15.6% cirrhosis, AILD, post-LT, control, respectively. only independent factor low albumin level. Conclusions: LT present In associated with stage systemic inflammation,

Language: Английский

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Impact of COVID-19 on liver transplant recipients: A nationwide cohort study evaluating hospitalization, transplant rejection, and inpatient mortality

World Journal of Transplantation, Journal Year: 2024, Volume and Issue: 14(2)

Published: June 13, 2024

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has posed a major public health concern worldwide. Patients with comorbid conditions are at risk of adverse outcomes following COVID-19. Solid organ transplant recipients concurrent immunosuppression and comorbidities more susceptible to severe COVID-19 infection. It could lead higher rates inpatient complications mortality in this patient population. However, studies on liver (LT) have yielded inconsistent findings. AIM To evaluate the impact hospital-related among LT United States. METHODS We conducted retrospective cohort study using 2019–2020 National Inpatient Sample database. primary hospitalizations secondary diagnosis were identified International Classification Diseases, Tenth Revision coding system. included trends before during pandemic. Secondary comparative rejection recipients. RESULTS A total 15720 hospitalized included. Approximately 0.8% patients had In both cohorts, median admission age was 57 years. linear for did not differ significantly (P = 0.84). frequency in-hospital increased from 1.7% 4.4% between January December 2020. Compared pre-pandemic period, association noted pandemic, an odds ratio (OR) 1.69 [95% confidence interval (CI): 1.55-1.84), P < 0.001]. rejections 0.2% 3.6% than [OR: 1.53 (95%CI: 1.26-1.85), CONCLUSION hospitalization comparable

Language: Английский

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Serological responses to COVID-19 vaccination in patients with chronic liver diseases

Journal of the Formosan Medical Association, Journal Year: 2024, Volume and Issue: 123(11), P. 1194 - 1197

Published: June 21, 2024

Longitudinal analysis of antibody responses following three-dose COVID-19 vaccination in patients with chronic liver disease (CLD) has been limited. From August 2021 to February 2023, sequential anti-SARS-CoV-2 spike IgG titers were determined 45 CLD who received two or three doses vaccine. The geometric mean anti-spike at four weeks after the second and third 1313.16 BAU/mL 3042.29 BAU/mL, respectively, it decreased significantly from 24 (1313.16 vs. 198.42 p = 0.002) (3042.29 636.71 < 0.001) dose. participants receiving prime-boost homologous mRNA vaccines (BNT162b2 mRNA-1273) comparable between those without significant fibrosis each follow-up time point. This study demonstrated a notable decrease completion schedule CLD, highlighting importance additional booster doses.

Language: Английский

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