A Systematic Review of COVID-19 Vaccine Antibody Responses in People With HIV

Chun, Helen M.; Milligan, Kyle; Agyemang, Elfriede; Ford, Nathan; Rangaraj, Ajay; Desai, Shalini; Wilder‐Smith, Annelies; Vitória, Marco; Zulu, Isaac

doi:10.1093/ofid/ofac579

Cited by 16 publications

(12 citation statements)

References 35 publications

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“…Two meta‐analyses, from Kang et al [15] and Farhadian et al [17], demonstrated even greater pooled seroconversion rates in PLWH after second vaccine doses: 96.65% and 98.4% from 28 and 16 studies, respectively. Additionally, while Chun et al [91] did not calculate any pooled seroconversion response, the systematic review demonstrated that the immunogenicity overall was very high in PLWH. In another systematic review of 23 included studies, Griffin et al [92] demonstrated a reduction of 3% in serological response in PLWH compared with healthy controls.…”

Section: Discussionmentioning

confidence: 99%

SARS‐CoV‐2 vaccine immunogenicity for people living with HIV: A systematic review and meta‐analysis

Søndergaard,

Thavarajah,

Churchill Henson

et al. 2023

HIV Medicine

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BackgroundPrevious publications on the immunogenicity of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccines in people living with HIV (PLWH) have reported inconsistent results. Additionally, a meta‐analysis investigating the immunogenicity in PLWH after the third SARS‐CoV‐2 vaccine dose is lacking. In this article we aim to provide a systematic review and a meta‐analysis studying the immunogenicity of SARS‐CoV‐2 vaccines in PLWH and to identify potential drivers for antibody response in PLWH.MethodsWe used three databases (PubMed, Embase and Web of Science) to conduct our review. Studies with information on numbers of PLWH producing immunoglobulin G (IgG) antibodies or neutralizing antibodies were included.ResultsThe meta‐analysis included 59 studies and illustrated a pooled serological response of 87.09% in the 10 343 PLWH after they received a SARS‐CoV‐2 vaccine. High CD4 T‐cell counts and low viral load indicated that the study populations had HIV that was well treated, despite varying in location. The pooled effect increased to 91.62% for 8053 PLWH when excluding studies that used inactivated vaccines (BBIBP‐CorV and CoronaVac). For the third vaccine dose, the pooled effect was 92.35% for 1974 PLWH. Additionally, weighted linear regression models demonstrated weak relationships between CD4 T‐cell count, percentages of people with undetectable HIV load, and age compared with the percentages of PLWH producing a serological response. However, more research is needed to determine the effect of those factors on SARS‐CoV‐2 vaccine immunogenicity in PLWH.ConclusionSARS‐CoV‐2 vaccines show a favourable effect on immunogenicity in PLWH. However, the results are not ideal. This meta‐analysis suggests that a third SARS‐CoV‐2 vaccine dose and good HIV treatment procedures are vital to induce a good immunogenicity in PLWH.

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Section: Discussionmentioning

confidence: 99%

SARS‐CoV‐2 vaccine immunogenicity for people living with HIV: A systematic review and meta‐analysis

Søndergaard,

Thavarajah,

Churchill Henson

et al. 2023

HIV Medicine

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“…HIV-1 seropositive specimens were obtained from patients receiving Cotrimoxazole prophylaxis, which is routinely administered to patients with low CD4+ T-lymphocyte counts in order to prevent potentially fatal bacterial infections. Immunocompromised status may have had a further impact on the frequency of detectable cross-reactivity, as other studies have demonstrated that HIV-1-infected individuals have lower cross-reactive responses to SARS-CoV-2 ( 4 , 22 ), particularly those with lower CD4 counts ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Pre-pandemic SARS-CoV-2-specific IFN-γ and antibody responses were low in Ugandan samples and significantly reduced in HIV-positive specimens

Nantambi¹,

Sembera²,

Ankunda³

et al. 2023

Front. Immunol.

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IntroductionWe investigated whether prior SARS-CoV-2-specific IFN-γ and antibody responses in Ugandan COVID-19 pre-pandemic specimens aligned to this population's low disease severity.MethodsWe used nucleoprotein (N), spike (S), NTD, RBD, envelope, membrane, SD1/2-directed IFN-γ ELISpots, and an S- and N-IgG antibody ELISA to screen for SARS-CoV-2-specific cross-reactivity.ResultsHCoV-OC43-, HCoV-229E-, and SARS-CoV-2-specific IFN-γ occurred in 23, 15, and 17 of 104 specimens, respectively. Cross-reactive IgG was more common against the nucleoprotein (7/110, 15.5%; p = 0.0016, Fishers' Exact) than the spike (3/110, 2.72%). Specimens lacking anti-HuCoV antibodies had higher rates of pre-epidemic SARS-CoV-2-specific IFN-γ cross-reactivity (p-value = 0.00001, Fishers’ exact test), suggesting that exposure to additional factors not examined here might play a role. SARS-CoV-2-specific cross-reactive antibodies were significantly less common in HIV-positive specimens (p=0.017; Fishers' Exact test). Correlations between SARS-CoV-2- and HuCoV-specific IFN-γ responses were consistently weak in both HIV negative and positive specimens.DiscussionThese findings support the existence of pre-epidemic SARS-CoV-2-specific cellular and humoral cross-reactivity in this population. The data do not establish that these virus-specific IFN-γ and antibody responses are entirely specific to SARS-CoV-2. Inability of the antibodies to neutralise SARS-CoV-2 implies that prior exposure did not result in immunity. Correlations between SARS-CoV-2 and HuCoV-specific responses were consistently weak, suggesting that additional variables likely contributed to the pre-epidemic cross-reactivity patterns. The data suggests that surveillance efforts based on the nucleoprotein might overestimate the exposure to SARS-CoV-2 compared to inclusion of additional targets, like the spike protein. This study, while limited in scope, suggests that HIV-positive people are less likely than HIV-negative people to produce protective antibodies against SARS-CoV-2.

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“…This continuing high death rate in PWH might be explained by the low vaccination coverage in South Africa, where only 32% of the population is fully vaccinated against COVID-19 [ 51 ]. These findings underscore the importance of prioritizing PWH for vaccination, and indeed, recent studies show that PWH are able to mount a strong humoral response to COVID-19 vaccines, especially if they are on ART with suppressed viral loads, higher CD4 cell counts, and higher CD4/CD8 ratios [ 52 ]. Even under the condition of low CD4 counts, despite low humoral responses, the CD4 cellular immune response to vaccination seems to be preserved [ 53 ].…”

Section: Clinical Outcomesmentioning

confidence: 99%

HIV and COVID-19 Co-Infection: Epidemiology, Clinical Characteristics, and Treatment

Basoulis

Mastrogianni

Voutsinas

et al. 2023

Viruses

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The COVID-19 pandemic has been a global medical emergency with a significant socio-economic impact. People with HIV (PWH), due to the underlying immunosuppression and the particularities of HIV stigma, are considered a vulnerable population at high risk. In this review, we report what is currently known in the available literature with regards to the clinical implications of the overlap of the two epidemics. PWH share the same risk factors for severe COVID-19 as the general population (age, comorbidities), but virological and immunological status also plays an important role. Clinical presentation does not differ significantly, but there are some opportunistic infections that can mimic or co-exist with COVID-19. PWH should be prime candidates for preventative COVID-19 treatments when they are available, but in the setting of resistant strains, this might be not easy. When considering small-molecule medications, physicians need to always remember to address potential interactions with ART, and when considering immunosuppressants, they need to be aware of potential risks for opportunistic infections. COVID-19 shares similarities with HIV in how the public perceives patients—with fear of the unknown and prejudice. There are opportunities for HIV treatment hidden in COVID-19 research with the leaps gained in both monoclonal antibody and vaccine development.

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A Systematic Review of COVID-19 Vaccine Antibody Responses in People With HIV

Cited by 16 publications

References 35 publications

SARS‐CoV‐2 vaccine immunogenicity for people living with HIV: A systematic review and meta‐analysis

SARS‐CoV‐2 vaccine immunogenicity for people living with HIV: A systematic review and meta‐analysis

Pre-pandemic SARS-CoV-2-specific IFN-γ and antibody responses were low in Ugandan samples and significantly reduced in HIV-positive specimens

HIV and COVID-19 Co-Infection: Epidemiology, Clinical Characteristics, and Treatment

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