Decay of coronavirus disease 2019 mRNA vaccine-induced immunity in people with HIV

Woldemeskel, Bezawit A.; Karaba, Andrew H; Garliss, Caroline C.; Beck, Elizabeth; Aytenfisu, Tihitina Y; Johnston, Trevor S; Laeyendecker, Oliver; Cox, Andrea L.; Blankson, Joel N.

doi:10.1097/qad.0000000000003263

Cited by 12 publications

(11 citation statements)

References 20 publications

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“…Lastly, similarly to HIV-negative individuals [ 121 , 122 ], PLWH show waning antibody immunity (especially against VOCs), yet persistent T-cell responses 6 months post-vaccination [ 123 •], pointing to a potential role of vaccine-elicited cellular immune memory in ensuring a long-term protection.…”

Section: Immune Responses To Sars-cov-2 Vaccines In Plwhmentioning

confidence: 99%

“…[ 101 •] BNT162b2 or mRNA-1273 (2 doses) Prospective observational single-center cohort study (Spain) 94 PLWH, described according to CD4 + T-cell count strata: < 200/μL: 79.3% males; median age: 52 years (IQR: 40–56) > 500/μL: 80.6% males; median age: 51 years (IQR: 40–56) 33 HIV-negative controls: 18 (54.5%) males; median age: 53 years (IQR: 35–57) CD4 + T-cell strata: - < 200/μL: n = 58 - > 500/μL: n = 36 Undetectable plasma HIV-RNA: - CD4 + < 200/μL group: n = 47 (81%) - CD4 + > 500/μL group: n = 35 (100%) Individuals with known history of SARS-CoV-2 infection excluded Anti-S IgG and anti-RBD IgG (ELISA) Neutralizing antibody activity (neutralization assay) SARS-CoV-2 specific T-cells (ELISpot after stimulation of PBMCs with a pool of overlapping SARS-CoV-2 peptides) Lower anti-S and anti-RBD IgG levels in PLWH with CD4 + T-cell counts < 200/μL Neutralizing capacity and specific T-cell responses (against wild-type SARS-CoV-2 and VOCs like Alpha, Delta, Kappa) absent or reduced in a higher percentage of PLWH with CD4 + T-cell counts < 200/μL Woldemeskel et al . [ 123 •] PLWH: BNT162b2 (2 doses) HIV-negative controls: mRNA-1273 (2 doses) Prospective observational study (USA) 8 PLWH: age range: 41–60 years 25 HIV-negative controls: age range: 21–60 years Median CD4 + T-cell count: 1044/μL (IQR: 468–1420) All PLWH on cART 6 PLWH had plasma HIV-RNA < 20 copies/mL, while 2 PPLWH had low level viremia (49 and 52 copies/mL, respectively) Not part of study criteria Anti-S1 IgG (ELISA) ACE2-inhibiting antibodies (spike-ACE2 binding inhibition assay) SARS-CoV-2 specific T-cells (ELISpot after stimulation of PBMCs with a pool of overlapping SARS-CoV-2 spike protein peptides) Time-points: 2 weeks and 6 months after the second dose of vaccination Similar to HIV-negative controls, waning antibody responses (especially to VOCs) but persistent T-cell responses 6 months post vaccination in PLWH Frater et al . [ 105 ••] ChAdOx1-S (2 doses) Single-arm substudy of a phase 2/3 clinical trial (UK) 54 PLWH: 54 (100%) males; median age: 42.5 years (IQR: 37.5–49.8) 50 HIV-negative controls: 26 (52%) males, 24 (48%) females; median age: 38.5 years (IQR: 29.2–45.0) Median CD4 + T-cell count: 694/μL (IQR: 574–860) All PLWH on cART for at least 3 months Plasma HIV-RNA < 50 copies/mL in all participants Participants wit...…”

Section: Immune Responses To Sars-cov-2 Vaccines In Plwhmentioning

confidence: 99%

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Immunologic Interplay Between HIV/AIDS and COVID-19: Adding Fuel to the Flames?

et al. 2023

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Purpose of Review HIV/AIDS and COVID-19 have been the major pandemics overwhelming our times. Given the enduring immune disfunction featuring people living with HIV (PLWH) despite combination antiretroviral therapy (cART), concerns for higher incidence and severity of SARS-CoV-2 infection as well as for suboptimal responses to the newly developed vaccines in this population arose early during the pandemics. Herein, we discuss the complex interplay between HIV and SARS-CoV-2, with a special focus on the immune responses to SARS-CoV-2 natural infection and vaccination in PLWH. Recent Findings Overall, current literature shows that COVID-19 severity and outcomes may be worse and immune responses to infection or vaccination lower in PLWH with poor CD4 + T-cell counts and/or uncontrolled HIV viremia. Data regarding the risk of post-acute sequelae of SARS-CoV-2 infection (PASC) among PLWH are extremely scarce, yet they seem to suggest a higher incidence of such condition. Summary Scarce immunovirological control appears to be the major driver of weak immune responses to SARS-CoV-2 infection/vaccination and worse COVID-19 outcomes in PLWH. Therefore, such individuals should be prioritized for vaccination and should receive additional vaccine doses. Furthermore, given the potentially higher risk of developing long-term sequelae, PLWH who experienced COVID-19 should be ensured a more careful and prolonged follow-up.

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Section: Immune Responses To Sars-cov-2 Vaccines In Plwhmentioning

confidence: 99%

Section: Immune Responses To Sars-cov-2 Vaccines In Plwhmentioning

confidence: 99%

Immunologic Interplay Between HIV/AIDS and COVID-19: Adding Fuel to the Flames?

et al. 2023

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“…Of note, analogous results could be obtained for immunization with the vector-based vaccine AZD1222 [ 130 ]. Finally, T cell responses seem to be preserved up to six months after the second vaccine dose, albeit a slight decrease over time becomes evident in PLWH irrespective of the underlying vaccine platform [ 129 , 131 , 132 ].…”

Section: Sars-cov-2-specific T Cells In People Living With Hiv (Plwh)mentioning

confidence: 99%

SARS-CoV-2-Specific T Cell Responses in Immunocompromised Individuals with Cancer, HIV or Solid Organ Transplants

et al. 2023

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Adaptive immune responses play an important role in the clinical course of SARS-CoV-2 infection. While evaluations of the virus-specific defense often focus on the humoral response, cellular immunity is crucial for the successful control of infection, with the early development of cytotoxic T cells being linked to efficient viral clearance. Vaccination against SARS-CoV-2 induces both CD4+ and CD8+ T cell responses and permits protection from severe COVID-19, including infection with the currently circulating variants of concern. Nevertheless, in immunocompromised individuals, first data imply significantly impaired SARS-CoV-2-specific immune responses after both natural infection and vaccination. Hence, these high-risk groups require particular consideration, not only in routine clinical practice, but also in the development of future vaccination strategies. In order to assist physicians in the guidance of immunocompromised patients, concerning the management of infection or the benefit of (booster) vaccinations, this review aims to provide a concise overview of the current knowledge about SARS-CoV-2-specific cellular immune responses in the vulnerable cohorts of cancer patients, people living with HIV (PLWH), and solid organ transplant recipients (SOT). Recent findings regarding the virus-specific cellular immunity in these differently immunocompromised populations might influence clinical decision-making in the future.

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“…In the general population, the effectiveness of two doses of mRNA vaccine wanes within 6 months [29,30]. The decay among PLWH was examined in a small study [31] that included eight PLWH and 25 healthy individuals. Six months after two doses of the vaccine, similar waning of antibody response was observed in both groups, while T-cell response persisted in both groups.…”

Section: Wanning Of Immunological Response Among People Living With H...mentioning

confidence: 99%

The effect of HIV on COVID-19 vaccine responses

Levy

Rahav

2023

Current Opinion in HIV and AIDS

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Purpose of reviewPersons living with HIV (PLWH) may have a moderately increased risk of morbidity and mortality from COVID-19 infection, especially if viral load is not controlled and if they are immunosuppressed. Vaccination against SARS-CoV-2 is the most effective measure to prevent morbidity and mortality. However, individuals with HIV/AIDS may have less protection after vaccination. The purpose of this review is to summarize some of the recent studies focused on examining the safety, immunogenicity and effectiveness of anti-SARS-CoV-2 vaccines.Recent findingsThe safety of all anti-SARS-CoV-2 vaccines among PLWH is not different from the safety of these vaccines among HIV-negative individuals and is acceptable. PLWH with viral suppression and immune reconstitution (CD4+ cell count > 350 cells/μl) may reach almost same immunogenicity such as people without HIV albeit antibody levels and neutralization may decline more rapidly than in people without HIV. PLWH with viremia or immunosuppressed, especially AIDS, have less immunogenicity.SummaryFull vaccination against SARS-CoV-2 is a well tolerated and efficient way to prevent mortality and morbidity from COVID-19 among PLWH and AIDS patients. It is very important to follow recommended booster vaccination for a continuous and prompt immunogenicity.

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Decay of coronavirus disease 2019 mRNA vaccine-induced immunity in people with HIV

Cited by 12 publications

References 20 publications

Immunologic Interplay Between HIV/AIDS and COVID-19: Adding Fuel to the Flames?

Immunologic Interplay Between HIV/AIDS and COVID-19: Adding Fuel to the Flames?

SARS-CoV-2-Specific T Cell Responses in Immunocompromised Individuals with Cancer, HIV or Solid Organ Transplants

The effect of HIV on COVID-19 vaccine responses

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