Humoral response to SARS-CoV-2 vaccines in people living with HIV

Abstract

Purpose To describe the humoral immune response to COVID-19 vaccines in people living with HIV and identify factors associated with the magnitude of anti-SARS-CoV-2 antibody concentrations. Methods Retrospective analysis of electronic patient files in a big single HIV center in Munich, Germany. Non-parametric methods were used for descriptive and comparative statistics. Generalized linear models were used to analyze associations of general and HIV-specific variables with anti-SARS-CoV-2 antibody concentrations after standard vaccination. Result Overall, 665 people living with HIV were included into the analysis (median age: 53 [IQR: 43; 59]), 560 [84.2%] males). Median concentration of anti-SARS-CoV-2-antibodies was 1400 (IQR 664; 2130) BAU/mL. In 18 (2.7%) subjects, antibody concentrations below the threshold of 34 BAU/mL were found. Among PLWH with CD4 cell count < 200 cells/µL, median anti-SARS-CoV-2-Abs were 197 (IQR 44.6; 537.2) as compared to 1420 (IQR 687; 2216) for the group ≥ 200 cells/µL ( p < 0.001). In a cumulative logit model, a vaccination scheme including an mRNA vaccine [OR: 4.64 (3.58; 6.02)], being female [OR: 2.14 (1.76; 2.61)], and having higher CD4 cells [OR per 100 cells/µL: 1.06 (1.04; 1.08)] were significantly associated with anti-SARS-CoV-2 antibody concentrations in higher quartiles, when adjusted for the time after vaccination. Conclusion We found a robust antibody response in people living with HIV undergoing standard vaccination against SARS-CoV-2. mRNA-containing vaccination schemes, being female, and having a higher CD4 cell count was associated with a higher concentration of antibodies in people living with HIV in our study sample. Particularly in the subgroup with CD4 cell counts < 200 cells/µL, antibody response was poor.

Characterization of Serum and Mucosal SARS-CoV-2-Antibodies in HIV-1-Infected Subjects after BNT162b2 mRNA Vaccination or SARS-CoV-2 Infection

“…Our study is in line with several recent reports on HIV-1-infected individuals mounting robust spike-specific IgG antibody responses to vaccination with BNT162b2 mRNA, Moderna mRNA-1273 vaccine and ChAdOx1 nCoV-19 vaccines [ 5 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ] comparable to healthy control groups in the majority of studies. Apart from spike-specific IgG, we were also able to detect spike-specific IgA in the serum of all vaccinated study subjects, demonstrating that the intramuscular application of the BNT162b2 mRNA vaccine can induce both IgA and IgG antibodies in HIV-1-infected subjects and in HIV-1-uninfected controls although at lower levels than IgG.…”

Surrogate neutralization responses following severe acute respiratory syndrome coronavirus 2 vaccination in people with HIV: comparison between inactivated and mRNA vaccine

“…Similar association between low CD4 þ cell count and vaccine hyporesponsiveness was observed following immunization with other vaccines notably recombinant hepatitis B vaccines [20]. The negative impacts of HIV viraemia was also reported among HIV patients after adenovirus vectored recombinant SARS-CoV-2 vaccine [13], inactivated hepatitis A [21] and recombinant hepatitis B vaccines [20,22]. The lack of association between CD4 þ and viral load and the magnitude of sVNT after CoronaVac is unclear.…”

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

“…These two groups of patients did not significantly differ in terms of age and time since HIV diagnosis. Since others have reported no significant association between antibody response and nadir CD4 + in PWH immunized with anti-coronavirus disease 2019 (COVID-19) vaccines [6,7], caution is needed with regard to our results, especially given the low sample size. Nonetheless, it remains particularly important to establish whether and how nadir and current CD4 + counts may be predictors of anti-COVID-19 vaccination outcome.…”