Immunogenicity to COVID-19 mRNA vaccine third dose in people living with HIV

Abstract

In order to investigate safety and immunogenicity of SARS-CoV-2 vaccine third dose in people living with HIV (PLWH), we analyze anti-RBD, microneutralization assay and IFN-γ production in 216 PLWH on ART with advanced disease (CD4 count <200 cell/mm3 and/or previous AIDS) receiving the third dose of a mRNA vaccine (BNT162b2 or mRNA-1273) after a median of 142 days from the second dose. Median age is 54 years, median CD4 nadir 45 cell/mm3 (20–122), 93% HIV-RNA < 50 c/mL. In 68% of PLWH at least one side-effect, generally mild, is recorded. Humoral response after the third dose was strong and higher than that achieved with the second dose (>2 log2 difference), especially when a heterologous combination with mRNA-1273 as third shot is used. In contrast, cell-mediated immunity remain stable. Our data support usefulness of third dose in PLWH currently receiving suppressive ART who presented with severe immune dysregulation.

Attenuated humoral responses in HIV infection after SARS-CoV-2 vaccination are linked to global B cell defects and cellular immune profiles

“…In contrast to previous work (Hassold et al, 2022; Nault et al, 2021; Noe et al, 2021; Touizer et al, 2021), we have found no association between the CD4 T cell count and serological outcome, which could be due to insufficient power in this study to detect differences. Moreover, few studies have addressed T cell activity after a third SARS-CoV-2 vaccine dose in this population, but in agreement with our findings a strong boosting effect of a third vaccine dose has been reported regardless of the CD4 T cell count (Vergori et al, 2022). Thus, the lower level of nAbs observed here in PLWH could be in part due to potential differences in boosting of memory responses to enable breadth against Omicron after three vaccine doses.…”

“…In contrast, T cell responses were comparable in the two groups and detectable, even in a small group of PLWH with very poor serological responses, suggesting a potentially important non-redundant immunological role for functional T cells. Overall, our data reinforce the beneficial effect of an additional vaccine dose in boosting adaptive immune responses (Vergori et al, 2022), especially against circulating VOCs in this patient group. Weaker humoral responses were observed in PLWH compared to HIV-negative controls after each dose of vaccine when matched by prior SARS-CoV-2 status.…”

“…Data after three vaccine doses are scarce, especially of evaluating efficacy against Omicron. However, the data available thus far suggest that the third vaccine dose provides a strong boost to antibody responses regardless of the CD4 T cell count, including in those who had previously not seroconverted (Vergori et al, 2022). Moreover, most studies on SARS-CoV-2 vaccine responses in PLWH to date have mostly focussed on evaluating humoral responses and generated limited data on functional T cell responses (Ogbe et al, 2022b) or cellular profiles of T or B cells.…”

Immunological signature in human cases of monkeypox infection in 2022 outbreak: an observational study

“… 27 An important concern has been raised about a possible poor functional response to MVA vaccination in people living with HIV, 28 according to previously reported data on vaccines for other viruses, such as influenza, 29 hepatitis B, 30 or even SARS-CoV-2. 31 , 32 Our observation that people living with HIV had a poxvirus-specific T-cell response after natural monkeypox virus infection might suggest a comparable response of people living with HIV also to MVA vaccine, avoiding a differentiated vaccination schedule for this target population.…”

Antibody response durability following three-dose COVID-19 vaccination in people with HIV receiving suppressive ART

“…Longitudinal monitoring of immune responses post-third dose in PLWH is critical to inform the timing of future immunizations in this group. Though some data are available on initial immunogenicity to third COVID-19 vaccine doses in PLWH [14, 15], no studies to our knowledge have assessed the longer-term durability of responses in this population. Furthermore, despite the high incidence of first-time SARS-CoV-2 infections after three vaccine doses, no studies to our knowledge have examined the impact of such infections on responses in PLWH.…”