High seroconversion rate after vaccination with mRNA BNT162b2 vaccine against SARS-CoV-2 among people with HIV – but HIV viremia matters?

Immunogenicity and Safety of BNT162b2 Homologous Booster Vaccination in People Living with HIV under Effective cART

“…The evidence of a greater humoral immunity elicited by the booster dose compared with primary vaccination alone was also confirmed by another study in PLWH that, however, used an inactivated COVID-19 booster vaccination [11]. In line with our previous observations on the HIV-infected subjects receiving the primary vaccination [13], we observed that neither age, sex, BMI, nadir CD4+, baseline CD4+ nor cART regimen significantly affected the humoral response after the third dose. These findings are consistent with what was reported by Jedicke et al with respect to nadir and current CD4+ [14] and by Lapointe et al with respect to nadir CD4+ [12].…”

“…Our study showed that the BNT162b2 booster dose is safe in HIV-infected subjects. Indeed, the adverse effects were mild and similar to those we observed after the primary vaccination [13]. The percentages of participants who reported local and systemic events are in accordance with those described in other populations who received a booster dose with BNT162b2 [10,18].…”

“…Differently from what emerged from our study, the ORCHESTRA project, which investigated the humoral immune response to the booster dose with our same vaccine in PLWH, demonstrated that a CD4+ count <200 cell/mm 3 at baseline was significantly associated with a lower antibody response in comparison with a CD4+ count >500 cell/mm 3 [15]. No changes in CD4+ or CD8+ counts were observed after the administration of the third dose, as we observed after the primary vaccination [13]. A significant decline of CD4+ count has been described by others, but this variation was observed only after the first and second doses of BNT162b2 [16].…”

“…Another study that used a primary mRNA vaccination for most of the participants, followed by a booster dose with an mRNA-based vaccine, reported that antibody levels after the third dose substantially exceeded those mounted after the primary series [12]. We have previously shown the immunogenicity and safety of primary vaccination (two doses) with the SARS-CoV-2 mRNA BNT162b2 vaccine [13]. Here, we report updated data about the immunogenicity and safety of the booster dose with the same vaccine.…”

Humoral Response after Two Doses of BNT162b2 mRNA Vaccine Has a Role in Predicting Response after Three Doses That Is Related to Plasma HIV Viremia and Nadir CD4+ Cell Count in HIV-Positive Patients

“…Previous studies reported no correlation between undetectable plasma HIV viremia, conventionally defined as plasma HIV RNA lower than 20 copies/mL [ 22 ] or 30 copies/mL [ 23 ], and humoral response, so we planned to separately evaluate the impact of persistent plasma HIV RNA complete suppression, defined as confirmed undetectable plasma HIV RNA versus low level HIV viremia, to show if absence of clinically quantifiable ongoing viremia could influence response to the COVID-19 vaccine.…”