Effects of COVID-19 mRNA vaccination on HIV viremia and reservoir size

Advances in antiretroviral therapy (ART) have made it possible for persons with human immunodeficiency virus (HIV) to live a lifespan approaching that of people without HIV, without progressing to AIDS or transmitting HIV to sexual partners or infants. There is, therefore, increasing emphasis on maintaining health throughout the lifespan. To receive optimal medical care and achieve desired outcomes, persons with HIV must be consistently engaged in care and able to access uninterrupted treatment, including ART. Comprehensive evidence-based HIV primary care guidance is, therefore, more important than ever. Creating a patient-centered, stigma-free care environment is essential for care engagement. Barriers to care must be decreased at the societal, health system, clinic, and individual levels. As the population ages and noncommunicable diseases arise, providing comprehensive health care for persons with HIV becomes increasingly complex, including management of multiple comorbidities and the associated challenges of polypharmacy, while also attending to HIV-specific health concerns. Clinicians must address issues specific to preventive health, including cancer screening, providing recommended vaccinations, as well as promoting sexual health, including sexually transmitted infection diagnosis, treatment, and prevention. Clinicians also must address issues for specific populations, including persons of childbearing potential, including during preconception and pregnancy; children; adolescents; and transgender and gender-diverse individuals. This guidance from an expert panel of the HIV Medicine Association of the Infectious Diseases Society of America updates the previous 2020 HIV Primary Care Guidance.

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Safety Profile of COVID-19 Vaccines in HIV Patients Undergoing ART and Their Impact on Immune Recovery and HIV Reservoirs

Song,

Wang,

Shen

et al. 2024

Infectious Diseases &Amp; Immunity

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Background: While some studies have reported the impact of COVID-19 vaccines on immune recovery and HIV reservoirs in persons living with the human immunodeficiency virus (PLWH), their findings remain inconsistent. Furthermore, limited data exist on the safety of multiple COVID-19 vaccines among PLWH. This study aimed to investigate the safety of heterological COVID-19 vaccine administration in PLWH receiving antiretroviral treatment (ART) and its effects on HIV reservoirs and immune recovery. Such an investigation can help provide a basis for vaccinations against COVID-19 in PLWH. Methods: In this cross-sectional study, PLWH receiving ART were recruited from the outpatient clinic of the Department of Infectious Diseases at the Fifth Medical Center of the Chinese PLA General Hospital from September 1, 2021 to December 31, 2021. Fifty-three PLWH receiving ART were vaccinated against COVID-19, with 35 receiving an inactivated vaccine (IN group) and 18 receiving a recombinant protein (CHO cells) vaccine (CHO group) as the third dose. We assessed the changes in liver and kidney functions, blood lipids, and other laboratory parameters postvaccination (at 0, 1, 2, 4, 7, 8, 10, and 13 months after the first vaccination dose). We also monitored CD4+ and CD8+ T cell counts using flow cytometry (at 0, 1, 2, 4, 7, 8, 10, and 13 months after the first vaccination dose), as well as levels of cell-associated HIV DNA (CA HIV DNA) and cell-associated HIV RNA (CA HIV RNA) in peripheral blood using the corresponding quantitative detection kits (at 0, 2, and 8 months after the first vaccination dose). Results: No severe adverse events related to either type of COVID-19 vaccine were observed in HIV patients, irrespective of their CD4+ T cell levels. Both the IN and CHO groups showed significant increases in CD4+ T cell counts during follow-up, CD4+ T cells increased from an average of 438 cells/μL to 557 cells/μL in the CHO group, while in the IN group, it increased from an average of 448 cells/μL to 572 cells/μL (both P < 0.001). CA HIV DNA initially decreased and then increased in both groups. CA HIV RNA levels showed significantly decreased in both group after three doses of vaccination (P < 0.01 in CHO group and P < 0.001 in IN group). CD8+ T cells increased from an average of 608 cells/μL to 812 cells/μL in the CHO group (P < 0.01), while in the IN group, it increased from an average of 702 cells/μL to 852 cells/μL(P < 0.001) from baseline to the 13 month of following up. Conclusion: Our data suggest that the SARS-CoV-2 booster vaccine is safe for PLWH on ART, although it may affect HIV reservoirs and CD8+ T cell counts.

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Effects of COVID-19 mRNA vaccination on HIV viremia and reservoir size

Cited by 5 publications

References 43 publications

SARS-CoV-2 mRNA vaccination and short-term changes in viral load and CD4/CD8 T-cell counts in people living with HIV

SARS-CoV-2 mRNA vaccination and short-term changes in viral load and CD4/CD8 T-cell counts in people living with HIV

Primary Care Guidance for Providers Who Care for Persons With Human Immunodeficiency Virus: 2024 Update by the HIV Medicine Association of the Infectious Diseases Society of America

Safety Profile of COVID-19 Vaccines in HIV Patients Undergoing ART and Their Impact on Immune Recovery and HIV Reservoirs

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