Safety and Immunogenicity of SARS-CoV-2 vaccines in people with HIV

Abstract

Objective:To evaluate the safety and the serological response after two doses of mRNA-based SARS-CoV-2 vaccination in people with HIV (PWH).Methods:Participants were evaluated 4 weeks after the second dose of mRNA-1273 or BNT162b2 vaccine. Tolerability was evaluated with a specific adverse event questionnaire. Patient's sera were analysed using LIAISON SARS-CoV-2 TrimericS IgG (DiaSorin).Results:One-hundred PWH were included, 75% of them men, with a mean age of 44 ± 11 years old, all receiving antiretroviral treatment and mostly with controlled viral loads (98% with HIV RNA <50 copies/ml) and 96% had >200 CD4+/μl. All patients seroconverted after vaccination (antibody concentration ≥33.8 binding antibody units [BAU]/ml). Only 3% of the patients had a low antibody concentration (<520 BAU/ml), whereas 67% of them had concentrations above the assay's detection range (>2080 BAU/ml). Fifty-six patients had local or systemic symptoms, with mild arthromyalgia being the most common systemic symptom. No severe adverse events were reported.Conclusions:Vaccination with two doses of mRNA-1273 or BNT162b2 is well tolerated in PWH under effective antiretroviral treatment and it leads to a successful antibody response.

Immunogenicity and efficacy of COVID-19 vaccines in people living with HIV: a systematic review and meta-analysis

“…Tables S1 and S2 present the serological antibody titers after a first and second dose of COVID-19 vaccines, respectively. In addition, one study that met the inclusion criteria for meta-analysis was excluded because seroconversion rates among healthy controls could not be obtained in time from the corresponding authors ( González de Aledo et al, 2022 ).

Figure 1 Flowchart of study selection.

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Serological Response Following COVID-19 Vaccines in Patients Living with HIV: A Dose-Response Meta-Analysis

“…Another 14 studies were further removed for failing to report seroconversion (n = 6), cross-sectional studies (n = 5), reviews (n = 2), and failing to provide HIV-infected patients (n = 1) (Table S3). Finally, 50 studies with a total of 7160 patients living with HIV were included for our meta-analysis 11,12, , 30 studies were included for qualitative analysis of serological antibody titers (Table S4 to 6); 46 studies 11,12,[17][18][19][20][21][22][23][24][25][27][28][29][30][31][32][34][35][36][37][38][39][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][58][59][60][61][62][63][64] were included for quantitative analysis of pooled seroconversion rates; 34 studies 11,…”

Efficacy of COVID-19 Vaccination in People Living with HIV: A Public Health Fundamental Tool for the Protection of Patients and the Correct Management of Infection

“…These studies showed a decrease both in humoral and cellular immunity at 6 months, despite no significant difference being found compared to a cohort of HIV-uninfected people vaccinated with the same vaccine. To date, only few observational studies were carried out about the effectiveness of mRNA vaccines in this group of patients, and all showed a good humoral and cellular immune response after the primary vaccination cycle in patients on HAART and with CD4+ cell counts >200 cell/mm 3 [ 41 , 42 , 43 ]. However, the response is significantly lower in PLWH with CD4+ cell counts <200/mm 3 compared to those with a count >500 cell/mm 3 and HIV-uninfected controls.…”