Safety and immunogenicity of inactivated SARS-CoV-2 vaccines in people living with HIV

Abstract

It is important to know the safety and efficacy of vaccination in immunocompromised people living with HIV (PLWH), but currently, there is limited data on the inactivated SARS-CoV-2 vaccines’ safety and immune responses in PLWH. In this prospective observational study, 139 PLWH and 120 healthy controls were enrolled and monitored for 21–105 days after a two-dose vaccination. The safety, anti-receptor binding domain IgG (anti-RBD-IgG) and anti-spike-IgG responses, and RBD-specific memory B cell (MBC) responses were evaluated. The overall adverse events within seven days were reported in 12.9% (18/139) of PLWH and 13.3% (16/120) of healthy controls. No serious adverse events occurred in both groups. Overall, the seroprevalence of anti-RBD-IgG in PLWH was significantly decreased (87.1% vs. 99.2%; p <0.001). The geometric mean end-point titer (GMT) of anti-RBD-IgG in PLWH was also reduced, especially in patients with CD4 counts <200 cells/µL, regardless of age, gender, or HIV viral load. GMTs of anti-RBD-IgG in both PLWH and healthy controls declined gradually over time. Similar results were also observed in the anti-spike-IgG response. The frequency of RBD-specific MBCs in PLWH decreased ( p <0.05), and then remained stable over time. Lastly, through multivariate analysis, we found the factors that predicted a less robust response to inactivated vaccines in PLWH were a low CD4 count and long time interval after vaccination. In conclusion, inactivated vaccines are well-tolerated in PLWH but with low immunogenicity. Therefore, SARS-CoV-2 vaccines and booster doses should be given priority in PLWH, especially in patients with low CD4 counts. Trial registration: .

Six-month humoral immune response to inactivated COVID-19 vaccine among people living with HIV

“…Our results were consistent with previous studies showing that PLWH had a lower immune response to inactivated COVID-19 vaccines than HNC ( 11 , 17 ). Studies by cross-sectional analysis showed that the level of nAbs in PLWH was lower than the levels in HNC at different time points after the second dose of the inactivated COVID-19 vaccination ( 17 , 18 ). However, no studies have compared peak humoral immune response in PLWH and HNC groups.…”

Safety and immunogenicity of inactivated SARS-CoV-2 vaccines in people with gastrointestinal cancer

“…Memory B cells (MBCs) are considered to play an essential role in durable humoral immunity (Ao et al, 2022), and we next evaluated the frequency of RBD-specific MBCs in each group. The gating strategy and representative results are shown in Supplementary Figure 3.…”

“…When the first dose of vaccine was given, RBD-specific memory B cells were generated and differentiated into antibody-secreting plasma cells when the second dose of vaccine was administered (Oliviero et al, 2020a). Our previous study found that the frequency of RBD-specific MBCs in immunocompromised people was decreased, which may lead to a lower seroprevalence of anti-RBD-IgG (Ao et al, 2022). For cancer patients, however, the frequency of MBCs and its correlation with antibody titer have not been fully studied.…”

Advances in Research on COVID-19 Vaccination for People Living with HIV

“…[ 66 ] Several studies have shown that immunogenicity after inactivated booster vaccination (BBIBP-CorV or CoronaVac) is negatively affected by low CD4 + T cell counts. [ 67 , 68 ] Recently, a new study evaluated the immune response to the CoronaVac vaccine in immunocompromised patients, and the proportion of PLWH who achieved neutralizing antibody positivity and total anti-SARS-CoV-2 IgG antibodies was significantly lower than that in the control group. PLWH with CD4 + T cell counts >500 cells/μL had higher seroconversion rates, neutralizing antibody positivity, and functional activity.…”

“…[ 71 ] For vaccination with inactivated virus, the overall incidence of adverse events within 7 days was similar between PLWH and healthy controls. [ 67 ] Currently, inactivated vaccines do not induce serious adverse events in PLWH. Indeed, the proportion of adverse reactions in PLWH inoculated with inactivated vaccines was significantly lower than that in PLWH that received mRNA vaccines.…”