Abstract：
The clinical and immunological features after breakthrough infection (BTI) during Omicron wave in patients with chronic hepatitis B virus infection (CHB) are still unclear. A total of 101 patients with CHB from our previous coronavirus disease 2019 (COVID-19) vaccination cohort (NCT05007665), were continued to be followed up at the Second Affiliated Hospital of Chongqing Medical University after BTI, while an additional 39 healthcare workers after BTI were recruited as healthy controls (HCs). Clinical data were collected using questionnaire survey and electronic medical record. Blood samples were used to determine the antibody responses, as well as B and T cell responses. After BTI, the clinical symptoms of COVID-19 were mild to moderate in patients with CHB, with a median duration of 5 days. Compared with HCs, patients with CHB were more susceptible to develop moderate COVID-19. The liver function was not significantly damaged, and HBV-DNA was not activated in patients with CHB after BTI. Patients with CHB could elicit robust antibody responses after BTI (NAbs 13.0-fold, BA.5 IgG: 24.2-fold, respectively), which was also significantly higher than that in every period after vaccination (all p < 0.001), and compared to that in HCs after BTI. The CD4+, cTfh, and CD8+ T cell responses were also augmented in patients with CHB after BTI, while exhibiting comparability to those observed in HCs. In patients with CHB after BTI, the immune imprint was observed in B cell responses, rather than in T cell responses. In conclusion, Omicron breakthrough infection induced mild to moderate COVID-19 symptoms in patients with CHB, without exacerbating the progress of liver diseases. Meanwhile, BTI demonstrated the ability to induce robust antibody and T cell responses in patients with CHB, which was comparable to those observed in HCs.
摘要：
慢性乙型肝炎病毒感染（CHB）患者在O微米波中突破感染（BTI）后的临床和免疫学特征仍不清楚。共有101例CHB患者从我们以前的冠状病毒疾病2019（COVID-19）疫苗接种队列（NCT05007665），在BTI之后继续在重庆医科大学附属第二医院进行随访，同时招募了另外39名BTI后的医护人员作为健康对照（HCs）。使用问卷调查和电子病历收集临床数据。血液样本用于确定抗体反应，以及B和T细胞反应。BTI之后,CHB患者COVID-19的临床症状为轻度至中度，中位持续时间为5天。与HC相比，CHB患者更容易发生中度COVID-19.肝功能没有明显受损，BTI后CHB患者HBV-DNA未激活。CHB患者可以在BTI后引发稳健的抗体反应（NABs13.0倍，BA.5IgG：24.2倍，分别)，也显著高于接种后每个时期(均p<0.001)，并与BTI后的HC相比。CD4+,cTfh,和CD8+T细胞反应也增加了患者CHB后BTI，同时与HCs中观察到的具有可比性。在BTI后的CHB患者中，在B细胞反应中观察到免疫印记，而不是T细胞反应。总之,Omicron突破性感染在CHB患者中引起轻度至中度COVID-19症状，不会加剧肝脏疾病的进展。同时,BTI证明了在CHB患者中诱导稳健抗体和T细胞应答的能力，这与在HC中观察到的情况相当。
