Immunogenicity and Safety of COVID-19 Vaccines among People Living with HIV: A Systematic Review and Meta-Analysis

Abstract

Background: The immunogenicity and safety of COVID-19 vaccines among people living with human immunodeficiency virus (PLWH) are unclear. We aimed to evaluate the immunogenicity and safety of COVID-19 vaccines among PLWH. Methods: We systematically searched PubMed, EMBASE, and Web of Science from 1 January 2020 to 28 April 2022 and included observational studies, randomized clinal trials, and non-randomized clinical trials reporting extractable data about the immunogenicity and safety of COVID-19 vaccines among PLWH. Results: A total of 34 eligible studies covering 4517 PLWH were included. The pooled seroconversion rates among PLWH after the first and second doses were 67.51% (95% confident interval (CI) 49.09–85.93%) and 96.65% (95%CI 95.56–97.75%), respectively. The seroconversion was similar between PLWH and healthy controls after the first (risk ratio (RR) = 0.89, 95%CI 0.76–1.04) and the second (RR = 0.97, 95%CI 0.93–1.00) dose. Moreover, the geometric mean titer (GMT) showed no significant difference between PLWH and healthy controls after the first dose (standardized mean difference (SMD) = 0.30, 95%CI -1.11, 1.70) and the second dose (SMD = -0.06, 95%CI -0.18, 0.05). Additionally, the pooled incidence rates of total adverse events among PLWH after the first and the second dose were 46.55% (95%CI 28.29–64.82%) and 30.96% (95%CI 13.23–48.70%), respectively. There was no significant difference in risks of total adverse events between PLWH and healthy controls after the first (RR = 0.86, 95%CI 0.67–1.10) and the second (RR = 0.88, 95%CI 0.68–1.14) dose. Conclusions: The available evidence suggested that the immunogenicity and safety of COVID-19 vaccines among PLWH were acceptable. There was no significant difference in the seroconversion rates and incidence rates of adverse events of COVID-19 vaccines between PLWH and healthy controls.

Humoral immune response to two doses of COVID‐19 mRNA‐based vaccines in people living with HIV: A systematic review and meta‐analysis

“…It is worth noting that this pooled median antibody response following mRNA vaccination in PLWH can be used to compare with the concentrations of antibodies in the general population after COVID‐19 vaccination. Kang et al in a systematic review and meta‐analysis evaluated the immunogenicity of different vaccines against COVID‐19 among PLWH and demonstrated compatible seroconversion of COVID‐19 vaccines between PLWH and healthy individuals after the second dose 34 . Also in their study the GMT of antibody showed no significant difference among PLWH and controls which is similar with our findings.…”

“…There are several studies and a meta‐analysis that demonstrated the immunogenicity and safety of different SARS‐CoV‐2 vaccines among PLWH 33–36 . However, humoral responses to the two doses schedule of mRNA‐based vaccines in individuals with well‐controlled HIV infection remain unclear.…”

The effect of HIV on COVID-19 vaccine responses

“…The results of the above-mentioned studies correspond with the results of three meta-analyses [26 ▪ ,27,28]. In the first meta-analysis, a total of 34 eligible studies covering 4517 PLWH were included.…”

Patients under medical conditions, immunogenicity and safety of covid-19 vaccines: a systematic review and meta-analysis

“…Among 14 study results, [19][20][21][22][23][24][25][26][27][28][29][30][31][32] there was acceptable for immunogenicity, a key response for the development of a vaccinationinduced immunogenicity both humoral and cellular immunity 2 or 3 doses of vaccination) 19 and acceptable safety in 11 studies (78.57 %). Acceptable potent immunogenicity was found in patients aged more than 40 years with chronic diseases, particularly, chronic respiratory diseases and coronary artery diseases.…”

“…20 Pooled seroconversion rate in people living with HIV (PLWH) after the first and second doses were 67.51 and 96.65 %, respectively. 21 In lung-cancer patients, number of doses (third dose, etc.) and intervals of mRNA-COVID-19 vaccination are suggested to maintain effective immunity.…”