在实体器官移植接受者中对SARS-CoV-2预防策略的更新:专家意见
Paolo Antonio Grossi1, Patrizia Burra2, Emanuele Cozzi2
1Università degli Studi dell'Insubria - Malattie infettive e tropicali e Dipartimento Clinico e di Ricerca delle Malattie infettive dell'Asst dei Sette Laghi, Varese, Italy.
Transplantation reviews (Orlando, Fla.)
|October 9, 2025
概括
固体器官移植接受者 (SOTRs) 对COVID-19疫苗的免疫反应较弱. 最佳保护包括疫苗接种和暴露前预防 (PrEP) 的战略时间,以最大限度地提高免疫力和预防严重疾病.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 移植医学 移植医学 移植医学
背景情况:
- 固体器官移植接受者 (SOTRs) 与免疫能力较强的个体相比,对SARS-CoV-2感染和接种疫苗的免疫反应减弱.
- 尽管接种了疫苗,但由于持续的病毒循环,SOTRs仍然容易受到严重的COVID-19感染.
研究的目的:
- 评估SOTR中COVID-19的预防策略,重点是疫苗接种和单克隆抗体暴露前预防 (PrEP).
- 确定疫苗接种和PrEP的最佳施用时间,以最大限度地提高SOTRs的免疫反应和临床保护.
主要方法:
- 审查目前关于SARS-CoV-2疫苗接种和PrEP在SOTRs中的有效性的证据.
- 分析影响疫苗疗效的因素,包括移植类型和免疫抑制.
- 评估同时给药时间对抗体和细胞介导免疫的影响.
主要成果:
- 在SOTR中疫苗的有效性是可变的,受免疫抑制疗法和移植类型的影响.
- 预备剂的有效性独立于移植相关的因素.
- 同时服用PrEP和疫苗可能会降低疫苗的疗效; 应在疫苗接种后15天或更长时间服用PrEP.
- 在免疫抑制的最低点期间接种疫苗可以增强免疫反应.
结论:
- 战略疫苗接种,及时PrEP和持续的公共卫生措施的结合对于保护SOTRs免受COVID-19的侵害至关重要.
- 坚持非药物干预措施对于这个脆弱人群来说仍然是必不可少的.
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