Comorbidity Burden and Suboptimal Immunological Responses to Coronavirus Disease 2019 Vaccination in People Living with Human Immunodeficiency Virus

Cossu, Maria Vittoria; Mileto, Davide; Giacomelli, Andrea; Oreni, Letizia; Bracchitta, Fiorenza; Pellicciotta, Martina; Salari, Federica; Petri, Francesco; Meraviglia, Paola; Antinori, Spinello; Rizzardini, Giuliano; Ridolfo, Anna Lisa

doi:10.1093/infdis/jiac286

Cited by 8 publications

(6 citation statements)

References 5 publications

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“…In HIV-negative individuals, antibody levels to COVID-19 mRNA vaccines were lower in older adults after 1st and 2nd doses, in adjusted multivariable analyses, including sociodemographic and chronic health and vaccine-related variables [ 26 ]. Cossu et al found reduced anti-S response to vaccination in PWH vs. HIV-negative controls, despite most PWH in their study having CD4 + cell count of more than 500 cells/μl [ 27 ]. They attributed this discrepancy to multi-morbidity burden in older adults [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

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COVID-19 vaccine immunogenicity in people with HIV

Costiniuk

Singer

Lee

et al. 2022

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In a Canadian multi-center prospective, observational cohort of PWH receiving at least two COVID-19 vaccinations, we measured vaccine-induced immunity at 3 and 6 months post 2nd and 1-month post 3rd doses.Methods: The primary outcome was the percentage of PWH mounting vaccineinduced immunity [co-positivity for anti-IgG against SARS-CoV2 Spike(S) and receptor-binding domain proteins] 6 months post 2nd dose. Univariable and multivariable logistic regressions were used to compare COVID-19-specific immune responses between groups and within subgroups.Results: Data from 294 PWH and 267 controls were analyzed. Immunogenicity was achieved in over 90% at each time point in both groups. The proportions of participants achieving comparable anti-receptor-binding domain levels were similar between the group at each time point. Anti-S IgG levels were similar by group at month 3 post 2nd dose and 1-month post 3rd dose. A lower proportion of PWH vs. controls maintained vaccine-induced anti-S IgG immunity 6 months post 2nd dose [92% vs. 99%; odds ratio: 0.14 (95% confidence interval: 0.03, 0.80; P ¼ 0.027)]. In multivariable analyses, neither age, immune non-response, multimorbidity, sex, vaccine type, or timing between doses were associated with reduced IgG response. Conclusion:Vaccine-induced IgG was elicited in the vast majority of PWH and was overall similar between groups. A slightly lower proportion of PWH vs. controls maintained vaccine-induced anti-S IgG immunity 6 months post 2nd dose demonstrating the importance of timely boosting in this population.

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Section: Discussionmentioning

confidence: 99%

“…Cossu et al found reduced anti-S response to vaccination in PWH vs. HIV-negative controls, despite most PWH in their study having CD4 + cell count of more than 500 cells/μl [ 27 ]. They attributed this discrepancy to multi-morbidity burden in older adults [ 27 ]. In our study, age did not influence COVID-19 vaccine response.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 vaccine immunogenicity in people with HIV

Costiniuk

Singer

Lee

et al. 2022

Aids

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“…We previously did not observe differences in antibody titres in PWH with CD4 + T-cell counts less than 350 cells/μl vs. higher counts. However, other groups have reported diminished anti-S vaccine response and neutralization capacity in PWH vs. HIV-uninfected controls [ 27 , 28 ]. Differences amongst findings in PWH may be because of discrepancies in multimorbidity burden in older adults, type and number of vaccines received and time interval between vaccinations [ 27 – 30 ].…”

Section: Discussionmentioning

confidence: 99%

Antibody neutralization capacity after COVID-19 vaccination in people with HIV (CIHR Canadian HIV trials network 328)

Costiniuk,

Singer,

Lee

et al. 2023

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Objectives: Many vaccines require higher/additional doses or adjuvants to provide adequate protection for people living with HIV (PLWH). Here, we compare COVID-19 vaccine-induced antibody neutralization capacity in PLWH vs. HIV-negative individuals following two vaccine doses. Design: In Canadian prospective observational cohorts, inlcuding a multi-centre study of PLWH receiving ≥2 COVID-19 vaccinations (mRNA or ChAdOx1-S), and a parallel study of HIV-negative controls (Stop the Spread Ottawa Cohort), we measured vaccine-induced neutralization capacity 3 months post-dose 2 (± 1 month). Methods: COVID-19 neutralization efficiency was measured by calculating the half maximal inhibitory dilution(ID50) using a high-throughput protein based neutralization assay for Ancestral(Wuhan), Delta and Omicron (BA.1) spike variants. Univariable and multivariable quantile regression were used to compareCOVID-19-specific antibody neutralization capacity by HIV status. Results: Neutralization assays were performed on 256 PLWH and 256 controls based on specimen availability at the timepoint of interest, having received 2 vaccines and known date of vaccination. There was a significant interaction between HIV status and previous COVID-19 infection status in median ID50. There were no differences in median ID50 for HIV+ vs HIV-negative persons without past COVID-19 infection.For participants with past COVID-19 infection, median ICD50 was significantly higher in controls than in PLWH for Ancestral SARS-CoV-2 and Omicron variants, with a trend for the Delta variant in the same direction. Conclusion: Vaccine-induced SARS-CoV-2 neutralization capacity was similar between PLWH vs HIV-negative persons without past COVID-19 infection, demonstrating favourable humoral-mediated immunogenicity. Both HIV+ and HIV-negative persons demonstrated hybrid immunity. Funding: Public Health Agency of Canada, through the Vaccine Surveillance Reference group, the COVID-19 Immunity Task Force (2122-HQ-000075) and the CTN. Production of COVID-19 reagents was financially supported by National Research Council of Canada (NRC) Pandemic Response Challenge Program. Trial registration: clinicaltrials.gov NCT04894448

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“…Likewise, Hefdtal et al and Xu et al showed that PWH had a lower level of IgG than PWoH [ 179 , 180 ]. Several studies confirmed these data [ 178 , 181 ].…”

Section: Vaccinesmentioning

confidence: 58%

Living with HIV and Getting Vaccinated: A Narrative Review

et al. 2023

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After 40 years of its appearance, human immunodeficiency virus (HIV) infection remains a leading public health challenge worldwide. Since the introduction of antiretroviral treatment (ART), HIV infection has become a chronic condition, and people living with HIV could have life expectancies close to those of the general population. People with HIV often have an increased risk of infection or experience more severe morbidity following exposure to vaccine-preventable diseases. Nowadays, several vaccines are available against bacteria and viruses. However, national and international vaccination guidelines for people with HIV are heterogeneous, and not every vaccine is included. For these reasons, we aimed to perform a narrative review about the vaccinations available for adults living with HIV, reporting the most updated studies performed for each vaccine among this population. We performed a comprehensive literature search through electronic databases (Pubmed—MEDLINE and Embase) and search engines (Google Scholar). We included English peer-reviewed publications (articles and reviews) on HIV and vaccination. Despite widespread use and guideline recommendations, few vaccine trials have been conducted in people with HIV. In addition, not all vaccines are recommended for people with HIV, especially for those with low CD4 cells count. Clinicians should carefully collect the history of vaccinations and patients’ acceptance and preferences and regularly check the presence of antibodies for vaccine-preventable pathogens.

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Comorbidity Burden and Suboptimal Immunological Responses to Coronavirus Disease 2019 Vaccination in People Living with Human Immunodeficiency Virus

Cited by 8 publications

References 5 publications

COVID-19 vaccine immunogenicity in people with HIV

COVID-19 vaccine immunogenicity in people with HIV

Antibody neutralization capacity after COVID-19 vaccination in people with HIV (CIHR Canadian HIV trials network 328)

Living with HIV and Getting Vaccinated: A Narrative Review

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