Immune Netw

. 2023 Oct 17;23(5):e39.
doi: 10.4110/in.2023.23.e39. eCollection 2023 Oct. COVID-19 Vaccination Alters NK Cell Dynamics and Transiently Reduces HBsAg Titers Among Patients With Chronic Hepatitis B

Hyunjae Shin 1 , Ha Seok Lee 2 , Ji Yun Noh 3 , June-Young Koh 2 , So-Young Kim 2 , Jeayeon Park 1 , Sung Won Chung 1 , Moon Haeng Hur 1 , Min Kyung Park 1 , Yun Bin Lee 1 , Yoon Jun Kim 1 , Jung-Hwan Yoon 1 , Jae-Hoon Ko 4 , Kyong Ran Peck 4 , Joon Young Song 3 , Eui-Cheol Shin 2 5 , Jeong-Hoon Lee 1


Coronavirus disease 2019 (COVID-19) vaccination may non-specifically alter the host immune system. This study aimed to evaluate the effect of COVID-19 vaccination on hepatitis B surface Ag (HBsAg) titer and host immunity in chronic hepatitis B (CHB) patients. Consecutive 2,797 CHB patients who had serial HBsAg measurements during antiviral treatment were included in this study. Changes in the HBsAg levels after COVID-19 vaccination were analyzed. The dynamics of NK cells following COVID-19 vaccination were also examined using serial blood samples collected prospectively from 25 healthy volunteers. Vaccinated CHB patients (n=2,329) had significantly lower HBsAg levels 1-30 days post-vaccination compared to baseline (median, -21.4 IU/ml from baseline), but the levels reverted to baseline by 91-180 days (median, -3.8 IU/ml). The velocity of the HBsAg decline was transiently accelerated within 30 days after vaccination (median velocity: -0.06, -0.39, and -0.04 log10 IU/ml/year in pre-vaccination period, days 1-30, and days 31-90, respectively). In contrast, unvaccinated patients (n=468) had no change in HBsAg levels. Flow cytometric analysis showed that the frequency of NK cells expressing NKG2A, an NK inhibitory receptor, significantly decreased within 7 days after the first dose of COVID-19 vaccine (median, -13.1% from baseline; p<0.001). The decrease in the frequency of NKG2A+ NK cells was observed in the CD56dimCD16+ NK cell population regardless of type of COVID-19 vaccine. COVID-19 vaccination leads to a rapid, transient decline in HBsAg titer and a decrease in the frequency of NKG2A+ NK cells.

Keywords: COVID-19 vaccines; Chronic hepatitis B; HBsAg; NK cells; NKG2A.