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Loubet P, Lelievre JD, François A, Botelho-Nevers E, Chidiac C, Chirio D, Dubee V, Dussol B, Galtier F, Hessamfar M, Hodaj E, Jaffuel S, Lacombe K, Laine F, Lefebvre M, Maakaroun-Vermesse Z, Makinson A, Portefaix A, Pourcher V, Rey D, Zucman D, Longobardi J, Bertheau M, Tartour E, de Lamballerie X, Launay O, Wittkop L. Humoral response after mRNA COVID-19 primary vaccination and single booster dose in people living with HIV compared to controls: A French nationwide multicenter cohort study-ANRS0001s COV-POPART. Int J Infect Dis 2024; 146:107110. [PMID: 38825164 DOI: 10.1016/j.ijid.2024.107110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/21/2024] [Accepted: 05/21/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND This study aimed to compare the humoral responses to mRNA COVID-19 vaccination in people living with HIV (PWH) and HIV-negative individuals. METHODS We included PWH with an undetectable viral load under ART and HIV-negative participants from the French nationwide ANRS COV-POPART cohort who had received two doses of vaccine as a primary vaccination. We compared humoral response between controls and PWH, stratified by CD4 cell count (<200/mm3 and ≥200/mm3 CD4 cell counts) at 1, 6, and 12 months after primary vaccination. RESULTS A total of 1776 participants were included in this analysis, 684 PWH (99% were on ART, median CD4 counts 673 cells/mm3) and 1092 controls. At 1 month, after adjustment on age, sex, and BMI, PWH had lower seroneutralization titers than controls, and PWH with <200 CD4 cell/mm3 had lower anti-Spike SARS-CoV-2 IgG antibodies. Same results were found at 6 months. However, in participants who received a booster dose between 6 and 12 months postprimary vaccination, we did not observe differences between PWH and controls at 12 months. CONCLUSION PWH had high responses to primary mRNA COVID-19 vaccination. In those who received a booster dose after 6 months, the humoral response at 12 months increased to similar levels to controls, even in those with low CD4 counts at baseline.
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Affiliation(s)
- Paul Loubet
- INSERM, F-CRIN, Reseau Innovative Clinical Research in Vaccinology (IREIVAC), Paris, France; Service des Maladies Infectieuses et Tropicales, CHU de Nîmes, Nîmes, France; INSERM U1047 - Université de Montpellier, Nîmes, France.
| | | | | | | | - Christian Chidiac
- Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France, Lyon, France; Université Claude Bernard Lyon 1, Centre International de Recherche en Infectiologie, Lyon, France
| | - David Chirio
- Département de Médecine Infectiologique, Hôpital de L'archet, Centre Hospitalier Universitaire, Université Côte d'Azur, Nice, France
| | - Vincent Dubee
- Service des maladies infectieuses et tropicales, CHU d'Angers, Angers, France
| | - Bertrand Dussol
- Centre d'Investigation Clinique 1415, AP-HM, Marseille, France
| | - Florence Galtier
- INSERM CIC 1411, Centre Hospitalier Universitaire de Montpellier, Hôpital Saint-Eloi, Montpellier, France
| | - Mojgan Hessamfar
- Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint André, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France; Univ. Bordeaux, INSERM, BPH, Bordeaux, France
| | - Enkelejda Hodaj
- Inserm Centre d'Investigation Clinique 1406, Centre Hospitalier Grenoble-Alpes, Grenoble, France
| | - Sylvain Jaffuel
- Service des Maladies Infectieuses et Tropicales, Brest, France
| | - Karine Lacombe
- Sorbonne Université, Inserm IPLESP, Service de maladies infectieuses et tropicales Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Fabrice Laine
- Université de Rennes, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Maeva Lefebvre
- Service de maladies infectieuses et tropicales, Centre Hospitalier Universitaire Hôtel-Dieu, Nantes, France
| | - Zoha Maakaroun-Vermesse
- Centre Hospitalier Régional Universitaire Tours, Institut National de la Santé et de la Recherche Médicale CIC 1415, Tours, France
| | - Alain Makinson
- Département des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Montpellier & Université de Montpellier, Montpellier, France
| | - Aurelie Portefaix
- Hospices civils de Lyon, Centre Investigation Clinique, Bron, France
| | - Valerie Pourcher
- Service de Maladies Infectieuses et tropicales, Hôpital de la Pitié Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université de Paris Sorbonne, Paris, France; Sorbonne Université, Inserm, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - David Rey
- Le Trait d'Union, Centre de Soins de l'Infection par le VIH, NHC, Hôpitaux Universitaires, Strasbourg, France
| | - David Zucman
- Réseau Ville-Hôpital, Service de Médecine Interne, Hôpital Foch, Suresnes, France
| | | | | | - Eric Tartour
- Service d'Immunologie biologique, Hôpital européen Georges Pompidou/APHP, Paris, France
| | - Xavier de Lamballerie
- Unité des Virus Emergents, Aix-Marseille Université, Institut de Recherche pour le Développement 190, Marseille, France
| | - Odile Launay
- INSERM, F-CRIN, Reseau Innovative Clinical Research in Vaccinology (IREIVAC), Paris, France; Centre d'Investigation Clinique Cochin Pasteur, Paris, France; Université de Paris, Paris, France
| | - Linda Wittkop
- Univ. Bordeaux, INSERM, MART, Bordeaux, France; INRIA SISTM Team, Talence, France; CHU de Bordeaux, Service d'information médicale, INSERM, Bordeaux, France
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Wang X, Li Y, Jin J, Chai X, Ma Z, Duan J, Zhang G, Huang T, Zhang X, Zhang T, Wu H, Cao Y, Su B. SARS-CoV-2-specific T-cell responses are induced in people living with human immunodeficiency virus after booster vaccination. Chin Med J (Engl) 2024:00029330-990000000-01148. [PMID: 39028115 DOI: 10.1097/cm9.0000000000003176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND T-cell-mediated immunity is crucial for the effective clearance of viral infection, but the T-cell-mediated immune responses that are induced by booster doses of inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in people living with human immunodeficiency virus (PLWH) remain unclear. METHODS Forty-five PLWH who had received antiretroviral therapy (ART) for more than two years and 29 healthy controls (HCs) at Beijing Youan Hospital were enrolled to assess the dynamic changes in T-cell responses between the day before the third vaccine dose (week 0) and 4 or 12 weeks (week 4 or week 12) after receiving the third dose of inactivated SARS-CoV-2 vaccine. Flow cytometry, enzyme-linked immunospot (ELISpot), and multiplex cytokines profiling were used to assess T-cell responses at the three timepoints in this study. RESULTS The results of the ELISpot and activation-induced marker (AIM) assays showed that SARS-CoV-2-specific T-cell responses were increased in both PLWH and HCs after the third dose of the inactivated SARS-CoV-2 vaccine, and a similar magnitude of immune response was induced against the Omicron (B.1.1.529) variant compared to the wild-type strain. In detail, spike-specific T-cell responses (measured by the ELISpot assay for interferon γ [IFN-γ] release) in both PLWH and HCs significantly increased in week 4, and the spike-specific T-cell responses in HCs were significantly stronger than those in PLWH 4 weeks after the third vaccination. In the AIM assay, spike-specific CD4+ T-cell responses peaked in both PLWH and HCs in week 12. Additionally, significantly higher spike-specific CD8+ T-cell responses were induced in PLWH than in HCs in week 12. In PLWH, the release of the cytokines interleukin-2 (IL-2), tumour necrosis factor-alpha (TNF-α), and IL-22 by peripheral blood mononuclear cells (PBMCs) that were stimulated with spike peptides increased in week 12. In addition, the levels of IL-4 and IL-5 were higher in PLWH than in HCs in week 12. Interestingly, the magnitude of SARS-CoV-2-specific T-cell responses in PLWH was negatively associated with the extent of CD8+ T-cell activation and exhaustion. In addition, positive correlations were observed between the magnitude of spike-specific T-cell responses (determined by measuring IFN-γ release by ELISpot) and the amounts of IL-4, IL-5, IL-2 and IL-17F. CONCLUSIONS Our findings suggested that SARS-CoV-2-specific T-cell responses could be enhanced by the booster dose of inactivated COVID-19 vaccines and further illustrate the importance of additional vaccination for PLWH.
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Affiliation(s)
- Xiuwen Wang
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Yongzheng Li
- Biomedical Pioneering Innovation Center (BIOPIC), Peking University, Beijing 100069, China
| | - Junyan Jin
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Xiaoran Chai
- Biomedical Pioneering Innovation Center (BIOPIC), Peking University, Beijing 100069, China
- Cancer and Stem Cell Biology Program, Duke-NUS Medical School, Singapore
| | - Zhenglai Ma
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Junyi Duan
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Guanghui Zhang
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Tao Huang
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Xin Zhang
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Tong Zhang
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Hao Wu
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Yunlong Cao
- Biomedical Pioneering Innovation Center (BIOPIC), Peking University, Beijing 100069, China
- Changping Laboratory, Beijing 102299, China
| | - Bin Su
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
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Griffin DWJ, Dymock M, Wong G, Morrissey CO, Lewin SR, Cheng AC, Howard K, Marsh JA, Subbarao K, Hagenauer M, Roney J, Cunningham A, Snelling T, McMahon JH. Bringing optimised COVID-19 vaccine schedules to immunocompromised populations (BOOST-IC): study protocol for an adaptive randomised controlled clinical trial. Trials 2024; 25:485. [PMID: 39020446 PMCID: PMC11253462 DOI: 10.1186/s13063-024-08315-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 07/03/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Immunocompromised hosts (ICH) experience more breakthrough infections and worse clinical outcomes following infection with COVID-19 than immunocompetent people. Prophylactic monoclonal antibody therapies can be challenging to access, and escape variants emerge rapidly. Immunity conferred through vaccination remains a central prevention strategy for COVID-19. COVID-19 vaccines do not elicit optimal immunity in ICH but boosting, through additional doses of vaccine improves humoral and cellular immune responses. This trial aims to assess the immunogenicity and safety of different COVID-19 vaccine booster strategies against SARS-CoV-2 for ICH in Australia. METHODS Bringing optimised COVID-19 vaccine schedules to immunocompromised populations (BOOST-IC) is an adaptive randomised trial of one or two additional doses of COVID-19 vaccines 3 months apart in people living with HIV, solid organ transplant (SOT) recipients, or those who have haematological malignancies (chronic lymphocytic leukaemia, non-Hodgkin lymphoma or multiple myeloma). Key eligibility criteria include having received 3 to 7 doses of Australian Therapeutic Goods Administration (TGA)-approved COVID-19 vaccines at least 3 months earlier, and having not received SARS-CoV-2-specific monoclonal antibodies in the 3 months prior to receiving the study vaccine. The primary outcome is the geometric mean concentration of anti-spike SARS-CoV-2 immunoglobulin G (IgG) 28 days after the final dose of the study vaccine. Key secondary outcomes include anti-spike SARS-CoV-2 IgG titres and the proportion of people seroconverting 6 and 12 months after study vaccines, local and systemic reactions in the 7 days after vaccination, adverse events of special interest, COVID-19 infection, mortality and quality of life. DISCUSSION This study will enhance the understanding of COVID-19 vaccine responses in ICH, and enable the development of safe, and optimised vaccine schedules in people with HIV, SOT, or haematological malignancy. TRIAL REGISTRATION ClinicalTrials.gov NCT05556720. Registered on 23rd August 2022.
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Affiliation(s)
- David W J Griffin
- Department of Infectious Diseases, Alfred Hospital and School of Translational Medicine, Monash University, Melbourne, Australia.
| | - Michael Dymock
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia
| | - Germaine Wong
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
- Department of Renal Medicine, Westmead Hospital, Westmead, NSW, Australia
- Sydney School of Public Health, Faculty of Medicine & Health, University of Sydney, Sydney, NSW, Australia
| | - C Orla Morrissey
- Department of Infectious Diseases, Alfred Hospital and School of Translational Medicine, Monash University, Melbourne, Australia
| | - Sharon R Lewin
- Department of Infectious Diseases, Alfred Hospital and School of Translational Medicine, Monash University, Melbourne, Australia
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Allen C Cheng
- Department of Infectious Diseases, Monash Medical Centre, Melbourne, Australia
- Monash University School of Clinical Sciences at Monash Health, Clayton, Australia
| | - Kirsten Howard
- Sydney School of Public Health, Faculty of Medicine & Health, University of Sydney, Sydney, NSW, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Julie A Marsh
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia
- Centre for Child Health Research, School of Medicine, The University of Western Australia, Perth, Australia
| | - Kanta Subbarao
- WHO Collaborating Centre for Reference and Research On Influenza at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Michelle Hagenauer
- Department of Infectious Diseases, Alfred Hospital and School of Translational Medicine, Monash University, Melbourne, Australia
| | - Janine Roney
- Department of Infectious Diseases, Alfred Hospital and School of Translational Medicine, Monash University, Melbourne, Australia
| | - Anthony Cunningham
- Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
| | - Tom Snelling
- Sydney School of Public Health, Faculty of Medicine & Health, University of Sydney, Sydney, NSW, Australia
| | - James H McMahon
- Department of Infectious Diseases, Alfred Hospital and School of Translational Medicine, Monash University, Melbourne, Australia
- Department of Infectious Diseases, Monash Medical Centre, Melbourne, Australia
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Verburgh ML, Boyd A, Schim van der Loeff MF, Bakker M, Wit FWNM, van der Valk M, Grobben M, van Pul L, Tejjani K, van Rijswijk J, van Gils MJ, Kootstra NA, van der Hoek L, Reiss P. Similar Limited Protection Against Severe Acute Respiratory Syndrome Coronavirus 2 Omicron Infection in Vaccinated Individuals With HIV and Comparable Controls. Open Forum Infect Dis 2024; 11:ofae380. [PMID: 39070044 PMCID: PMC11273239 DOI: 10.1093/ofid/ofae380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 07/04/2024] [Indexed: 07/30/2024] Open
Abstract
Background Little is known about the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron infection in people with human immunodeficiency virus (HIV; PWH) with vaccine-induced or hybrid immunity. We assessed the incidence of Omicron infection in 209 AGEhIV coronavirus disease 2019 substudy participants with well-controlled HIV on antiretroviral therapy and 280 comparable controls, who had received at least the primary vaccination series. Methods From September 2020 onward, participants were assessed every 6 months for the incidence of SARS-CoV-2 infection, per SARS-CoV-2 nucleocapsid antibody assay or self-reported positive antigen or polymerase chain reaction test. Between 1 January and 31 October 2022, the cumulative incidence of Omicron infection and associated risk factors were estimated using a conditional risk-set Cox proportional hazards model. Results The cumulative incidence of a first Omicron infection was 58.3% by 31 October 2022, not significantly different between groups. HIV status was not independently associated with acquiring Omicron infection. Former and current smoking, as well as an increased predicted anti-spike immunoglobulin G titer were significantly associated with a lower risk of Omicron infection. The majority of infections were symptomatic, but none required hospitalization. Conclusions People with well-controlled HIV and controls in our cohort experienced a similarly high proportion of Omicron infections. More booster vaccinations significantly reduced the risk of infection. Clinical Trial Registration. NCT01466582.
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Affiliation(s)
- Myrthe L Verburgh
- Amsterdam University Medical Centers, University of Amsterdam, Infectious Diseases, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, The Netherlands
- Amsterdam University Medical Centers, University of Amsterdam, Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | - Anders Boyd
- Amsterdam University Medical Centers, University of Amsterdam, Infectious Diseases, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, The Netherlands
- HIV Monitoring Foundation, Amsterdam, the Netherlands
- Public Health Service of Amsterdam, Infectious Diseases, Amsterdam, The Netherlands
| | - Maarten F Schim van der Loeff
- Amsterdam University Medical Centers, University of Amsterdam, Infectious Diseases, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, The Netherlands
- Public Health Service of Amsterdam, Infectious Diseases, Amsterdam, The Netherlands
| | - Margreet Bakker
- Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, The Netherlands
- Amsterdam University Medical Centers, University of Amsterdam, Medical Microbiology and Infection Prevention, Laboratory of Experimental Virology, Amsterdam, The Netherlands
| | - Ferdinand W N M Wit
- Amsterdam University Medical Centers, University of Amsterdam, Infectious Diseases, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, The Netherlands
- HIV Monitoring Foundation, Amsterdam, the Netherlands
| | - Marc van der Valk
- Amsterdam University Medical Centers, University of Amsterdam, Infectious Diseases, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, The Netherlands
- HIV Monitoring Foundation, Amsterdam, the Netherlands
| | - Marloes Grobben
- Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, The Netherlands
- Amsterdam University Medical Centers, University of Amsterdam, Medical Microbiology and Infection Prevention, Laboratory of Experimental Virology, Amsterdam, The Netherlands
| | - Lisa van Pul
- Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, The Netherlands
- Amsterdam University Medical Centers, University of Amsterdam, Experimental Immunology, Amsterdam, The Netherlands
| | - Khadija Tejjani
- Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, The Netherlands
- Amsterdam University Medical Centers, University of Amsterdam, Medical Microbiology and Infection Prevention, Laboratory of Experimental Virology, Amsterdam, The Netherlands
| | - Jacqueline van Rijswijk
- Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, The Netherlands
- Amsterdam University Medical Centers, University of Amsterdam, Medical Microbiology and Infection Prevention, Laboratory of Experimental Virology, Amsterdam, The Netherlands
| | - Marit J van Gils
- Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, The Netherlands
- Amsterdam University Medical Centers, University of Amsterdam, Medical Microbiology and Infection Prevention, Laboratory of Experimental Virology, Amsterdam, The Netherlands
| | - Neeltje A Kootstra
- Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, The Netherlands
- Amsterdam University Medical Centers, University of Amsterdam, Experimental Immunology, Amsterdam, The Netherlands
| | - Lia van der Hoek
- Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, The Netherlands
- Amsterdam University Medical Centers, University of Amsterdam, Medical Microbiology and Infection Prevention, Laboratory of Experimental Virology, Amsterdam, The Netherlands
| | - Peter Reiss
- Amsterdam University Medical Centers, University of Amsterdam, Infectious Diseases, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, The Netherlands
- Amsterdam University Medical Centers, University of Amsterdam, Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
- Amsterdam University Medical Centers, University of Amsterdam, Global Health, Amsterdam, The Netherlands
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Duncan MC, Omondi FH, Kinloch NN, Lapointe HR, Speckmaier S, Moran-Garcia N, Lawson T, DeMarco ML, Simons J, Holmes DT, Lowe CF, Bacani N, Sereda P, Barrios R, Harris M, Romney MG, Montaner JS, Brumme CJ, Brockman MA, Brumme ZL. Effects of COVID-19 mRNA vaccination on HIV viremia and reservoir size. AIDS 2024; 38:1120-1130. [PMID: 38224350 PMCID: PMC11139238 DOI: 10.1097/qad.0000000000003841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 01/03/2024] [Accepted: 01/07/2024] [Indexed: 01/16/2024]
Abstract
OBJECTIVE The immunogenic nature of coronavirus disease 2019 (COVID-19) mRNA vaccines led to some initial concern that these could stimulate the HIV reservoir. We analyzed changes in plasma HIV loads (pVL) and reservoir size following COVID-19 mRNA vaccination in 62 people with HIV (PWH) receiving antiretroviral therapy (ART), and analyzed province-wide trends in pVL before and after the mass vaccination campaign. DESIGN Longitudinal observational cohort and province-wide analysis. METHODS Sixty-two participants were sampled prevaccination, and one month after their first and second COVID-19 immunizations. Vaccine-induced anti-SARS-CoV-2-Spike antibodies in serum were measured using the Roche Elecsys Anti-S assay. HIV reservoirs were quantified using the intact proviral DNA assay; pVL were measured using the cobas 6800 (lower limit of quantification: 20 copies/ml). The province-wide analysis included all 290 401 pVL performed in British Columbia, Canada between 2012 and 2022. RESULTS Prevaccination, the median intact reservoir size was 77 [interquartile range (IQR): 20-204] HIV copies/million CD4 + T-cells, compared to 74 (IQR: 27-212) and 65 (IQR: 22-174) postfirst and -second dose, respectively (all comparisons P > 0.07). Prevaccination, 82% of participants had pVL <20 copies/ml (max: 110 copies/ml), compared to 79% postfirst dose (max: 183 copies/ml) and 85% postsecond dose (max: 79 copies/ml) ( P > 0.4). There was no evidence that the magnitude of the vaccine-elicited anti-SARS-CoV-2-Spike immune response influenced pVL nor changes in reservoir size ( P > 0.6). We found no evidence linking the COVID-19 mass vaccination campaign to population-level increases in detectable pVL frequency among all PWH in the province, nor among those who maintained pVL suppression on ART. CONCLUSION We found no evidence that COVID-19 mRNA vaccines induced changes in HIV reservoir size nor plasma viremia.
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Affiliation(s)
- Maggie C. Duncan
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - F. Harrison Omondi
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Natalie N. Kinloch
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Hope R. Lapointe
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Sarah Speckmaier
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | | | - Tanya Lawson
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
| | - Mari L. DeMarco
- Department of Pathology and Laboratory Medicine, Providence Healthcare, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Janet Simons
- Department of Pathology and Laboratory Medicine, Providence Healthcare, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Daniel T. Holmes
- Department of Pathology and Laboratory Medicine, Providence Healthcare, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Christopher F. Lowe
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, Providence Healthcare, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Nic Bacani
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Paul Sereda
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Rolando Barrios
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Marianne Harris
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Marc G. Romney
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, Providence Healthcare, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Julio S.G. Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Chanson J. Brumme
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Mark A. Brockman
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, Canada
| | - Zabrina L. Brumme
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
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Kavikondala S, Haeussler K, Wang X, Spellman A, Bausch-Jurken MT, Sharma P, Amiri M, Krivelyova A, Vats S, Nassim M, Kumar N, Van de Velde N. Immunogenicity of mRNA-1273 and BNT162b2 in Immunocompromised Patients: Systematic Review and Meta-analysis Using GRADE. Infect Dis Ther 2024; 13:1419-1438. [PMID: 38802704 PMCID: PMC11219657 DOI: 10.1007/s40121-024-00987-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 04/30/2024] [Indexed: 05/29/2024] Open
Abstract
INTRODUCTION Immunocompromised (IC) patients mount poor immune responses to vaccination. Higher-dose coronavirus disease 2019 (COVID-19) vaccines may offer increased immunogenicity. METHODS A pairwise meta-analysis of 98 studies reporting comparisons of mRNA-1273 (50 or 100 mcg/dose) and BNT162b2 (30 mcg/dose) in IC adults was performed. Outcomes were seroconversion, total and neutralizing antibody titers, and cellular immune responses. RESULTS mRNA-1273 was associated with a significantly higher seroconversion likelihood [relative risk, 1.11 (95% CI, 1.08, 1.14); P < 0.0001; I2 = 66.8%] and higher total antibody titers [relative increase, 50.45% (95% CI, 34.63%, 66.28%); P < 0.0001; I2 = 89.5%] versus BNT162b2. mRNA-1273 elicited higher but statistically nonsignificant relative increases in neutralizing antibody titers and cellular immune responses versus BNT162b2. CONCLUSION Higher-dose mRNA-1273 had increased immunogenicity versus BNT162b2 in IC patients.
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Jalloh MF, Tinuga F, Dahoma M, Rwebembera A, Kapologwe NA, Magesa D, Mukurasi K, Rwabiyago OE, Kazitanga J, Miller A, Sando D, Maruyama H, Mbatia R, Temu F, Matiko E, Kazaura K, Njau P, Imaa J, Pinto T, Nur SA, Schaad N, Malero A, Damian D, Grund J, Mgomella GS, Johnson A, Cole G, Mmari E, Gatei W, Swaminathan M. Accelerating COVID-19 Vaccination Among People Living With HIV and Health Care Workers in Tanzania: A Case Study. GLOBAL HEALTH, SCIENCE AND PRACTICE 2024; 12:e2300281. [PMID: 38806223 PMCID: PMC11216698 DOI: 10.9745/ghsp-d-23-00281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 04/30/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND There is limited evidence on COVID-19 vaccination uptake among people living with HIV (PLHIV) and health care workers (HCWs), with the current evidence concentrated in high-income countries. There is also limited documentation in the published literature regarding the feasibility and lessons from implementing targeted vaccination strategies to reach PLHIV and HCWs in low- and middle-income countries. PROGRAM DEVELOPMENT, PILOTING, AND IMPLEMENTATION We designed and implemented multifaceted strategies to scale up targeted COVID-19 vaccination among PLHIV and HCWs in 11 administrative regions on the mainland of Tanzania plus Zanzibar. An initial 6-week intensification strategy was implemented using a diverse partnership model comprising key stakeholders at the national- and subnational levels. A layered package of strategies included expanding the number of certified vaccinators, creating vaccination points within HIV clinics, engaging HCWs to address their concerns, and building the capacity of HCWs as "champions" to promote and facilitate vaccination. We then closely monitored COVID-19 vaccination uptake in 562 high-volume HIV clinics. Between September 2021 and September 2022, the proportion of fully vaccinated adult PLHIV increased from <1% to 97% and fully vaccinated HCWs increased from 23% to 80%. LESSONS AND IMPLICATIONS Our intra-action review highlighted the importance of leveraging a strong foundation of existing partnerships and platforms, integrating COVID-19 vaccination points within HIV clinics, and refining strategies to increase vaccination demand while ensuring continuity of vaccine supply to meet the increased demand. Lessons from Tanzania can inform targeted vaccination of vulnerable groups in future health emergencies.
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Affiliation(s)
- Mohamed F Jalloh
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
| | - Florian Tinuga
- Immunization and Vaccine Development, Tanzania Ministry of Health, Dar es Salaam, Tanzania
| | - Mohamed Dahoma
- Zanzibar Integrated HIV, Hepatitis, TB and Leprosy Program, Zanzibar, Tanzania
| | - Anath Rwebembera
- National AIDS Control Programme, Tanzania Ministry of Health, Dodoma, Tanzania
| | - Ntuli A Kapologwe
- President's Office - Regional Administration and Local Government, Dodoma, Tanzania
| | - Daniel Magesa
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Kokuhabwa Mukurasi
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Oscar Ernest Rwabiyago
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Jaiving Kazitanga
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Angela Miller
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - David Sando
- Management and Development for Health, Dar es Salaam, Tanzania
| | - Haruka Maruyama
- Tanzania Country Office, ICAP at Columbia University, Dar es Salaam, Tanzania
| | | | - Florence Temu
- Tanzania Country Office, Amref Health Africa, Dar es Salaam, Tanzania
| | - Eva Matiko
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Kokuhumbya Kazaura
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Prosper Njau
- National AIDS Control Programme, Tanzania Ministry of Health, Dodoma, Tanzania
| | - Jennifer Imaa
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Tara Pinto
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Sophia A Nur
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Nicolas Schaad
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Augustine Malero
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Damian Damian
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Jonathan Grund
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - George S Mgomella
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Alison Johnson
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Gbolahan Cole
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Eunice Mmari
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Wangeci Gatei
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Mahesh Swaminathan
- Tanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
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Ruta S, Popescu CP, Matei L, Grancea C, Paun AM, Oprea C, Sultana C. SARS-CoV-2 Humoral and Cellular Immune Responses in People Living with HIV. Vaccines (Basel) 2024; 12:663. [PMID: 38932392 PMCID: PMC11209143 DOI: 10.3390/vaccines12060663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
Immunosuppressed individuals, such as people living with HIV (PLWH), remain vulnerable to severe COVID-19. We analyzed the persistence of specific SARS-CoV-2 humoral and cellular immune responses in a retrospective, cross-sectional study in PLWH on antiretroviral therapy. Among 104 participants, 70.2% had anti-S IgG antibodies, and 55.8% had significant neutralizing activity against the Omicron variant in a surrogate virus neutralization test. Only 38.5% were vaccinated (8.76 ± 4.1 months prior), all displaying anti-S IgG, 75% with neutralizing antibodies and anti-S IgA. Overall, 29.8% of PLWH had no SARS-CoV-2 serologic markers; they displayed significantly lower CD4 counts and higher HIV viral load. Severe immunosuppression (present in 12.5% of participants) was linked to lower levels of detectable anti-S IgG (p = 0.0003), anti-S IgA (p < 0.0001) and lack of neutralizing activity against the Omicron variant (p < 0.0001). T-cell responses were present in 86.7% of tested participants, even in those lacking serological markers. In PLWH without severe immunosuppression, neutralizing antibodies and T-cell responses persisted for up to 9 months post-infection or vaccination. Advanced immunosuppression led to diminished humoral immune responses but retained specific cellular immunity.
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Affiliation(s)
- Simona Ruta
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.R.); (C.O.); (C.S.)
- Stefan S. Nicolau Institute of Virology, 030304 Bucharest, Romania; (L.M.); (C.G.)
| | - Corneliu Petru Popescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.R.); (C.O.); (C.S.)
- Dr. Victor Babes Hospital of Infectious and Tropical Diseases, 030303 Bucharest, Romania;
| | - Lilia Matei
- Stefan S. Nicolau Institute of Virology, 030304 Bucharest, Romania; (L.M.); (C.G.)
| | - Camelia Grancea
- Stefan S. Nicolau Institute of Virology, 030304 Bucharest, Romania; (L.M.); (C.G.)
| | - Adrian Marius Paun
- Dr. Victor Babes Hospital of Infectious and Tropical Diseases, 030303 Bucharest, Romania;
| | - Cristiana Oprea
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.R.); (C.O.); (C.S.)
- Dr. Victor Babes Hospital of Infectious and Tropical Diseases, 030303 Bucharest, Romania;
| | - Camelia Sultana
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.R.); (C.O.); (C.S.)
- Stefan S. Nicolau Institute of Virology, 030304 Bucharest, Romania; (L.M.); (C.G.)
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Zhang X, Han D, Wu N. Serum SARS-CoV-2 antibodies in HIV-1-infected patients after inactivated vaccination and SARS-CoV-2 infection. Heliyon 2024; 10:e31731. [PMID: 38828333 PMCID: PMC11140786 DOI: 10.1016/j.heliyon.2024.e31731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 04/19/2024] [Accepted: 05/21/2024] [Indexed: 06/05/2024] Open
Abstract
Objective To monitor post-vaccination antibody production, neutralizing activity, and their dynamics over time in people living with HIV (PLWH). Methods We collected sera from 147 PLWH and 94 healthy controls after vaccination at different time points and examined changes in antibody levels and neutralizing activity using enzyme-linked immunosorbent assay (ELISA) and pseudovirus neutralization assay. Results IgG levels were substantially increased in both PLWH and healthy controls after the booster injection. Antibody levels decreased significantly in both PLWH and controls five months after the booster injection. However, the rate of decrease was not significantly different between the two groups. The generated antibodies demonstrated protective efficacy against the wild-type SARS-CoV-2 strain, but very low protection against the mutant strains. Furthermore, the protection decreased over time. The vaccine was less effective in PLWH with <200/μl CD4 T cells. During the SARS-CoV-2 recovery period, participants had substantially increased serum antibody levels and protective efficacy compared with those who received the booster. Conclusion Both PLWH and controls demonstrated comparable antibody production ability. Vaccines and booster development against SARS-CoV-2 mutant strains should be prioritized in PLWH, especially in those with low CD4 counts.
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Affiliation(s)
- Xiaodi Zhang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
| | - Dating Han
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
| | - Nanping Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
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Montesi G, Augello M, Polvere J, Marchetti G, Medaglini D, Ciabattini A. Predicting humoral responses to primary and booster SARS-CoV-2 mRNA vaccination in people living with HIV: a machine learning approach. J Transl Med 2024; 22:432. [PMID: 38715088 PMCID: PMC11077794 DOI: 10.1186/s12967-024-05147-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/31/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND SARS-CoV-2 mRNA vaccines are highly immunogenic in people living with HIV (PLWH) on effective antiretroviral therapy (ART). However, whether viro-immunologic parameters or other factors affect immune responses to vaccination is debated. This study aimed to develop a machine learning-based model able to predict the humoral response to mRNA vaccines in PLWH and to assess the impact of demographic and clinical variables on antibody production over time. METHODS Different machine learning algorithms have been compared in the setting of a longitudinal observational study involving 497 PLWH, after primary and booster SARS-CoV-2 mRNA vaccination. Both Generalized Linear Models and non-linear Models (Tree Regression and Random Forest) were trained and tested. RESULTS Non-linear algorithms showed better ability to predict vaccine-elicited humoral responses. The best-performing Random Forest model identified a few variables as more influential, within 39 clinical, demographic, and immunological factors. In particular, previous SARS-CoV-2 infection, BMI, CD4 T-cell count and CD4/CD8 ratio were positively associated with the primary cycle immunogenicity, yet their predictive value diminished with the administration of booster doses. CONCLUSIONS In the present work we have built a non-linear Random Forest model capable of accurately predicting humoral responses to SARS-CoV-2 mRNA vaccination, and identifying relevant factors that influence the vaccine response in PLWH. In clinical contexts, the application of this model provides promising opportunities for predicting individual vaccine responses, thus facilitating the development of vaccination strategies tailored for PLWH.
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Affiliation(s)
- Giorgio Montesi
- Laboratory of Molecular Microbiology and Biotechnology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Matteo Augello
- Clinic of Infectious Diseases and Tropical Medicine, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Jacopo Polvere
- Laboratory of Molecular Microbiology and Biotechnology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Giulia Marchetti
- Clinic of Infectious Diseases and Tropical Medicine, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Donata Medaglini
- Laboratory of Molecular Microbiology and Biotechnology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
| | - Annalisa Ciabattini
- Laboratory of Molecular Microbiology and Biotechnology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
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11
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Datwani S, Kalikawe R, Waterworth R, Mwimanzi FM, Liang R, Sang Y, Lapointe HR, Cheung PK, Omondi FH, Duncan MC, Barad E, Speckmaier S, Moran-Garcia N, DeMarco ML, Hedgcock M, Costiniuk CT, Hull M, Harris M, Romney MG, Montaner JSG, Brumme ZL, Brockman MA. T-Cell Responses to COVID-19 Vaccines and Breakthrough Infection in People Living with HIV Receiving Antiretroviral Therapy. Viruses 2024; 16:661. [PMID: 38793543 PMCID: PMC11125792 DOI: 10.3390/v16050661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/18/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024] Open
Abstract
People living with HIV (PLWH) can exhibit impaired immune responses to vaccines. Accumulating evidence indicates that PLWH, particularly those receiving antiretroviral therapy, mount strong antibody responses to COVID-19 vaccines, but fewer studies have examined cellular immune responses to the vaccinations. Here, we used an activation-induced marker (AIM) assay to quantify SARS-CoV-2 spike-specific CD4+ and CD8+ T cells generated by two and three doses of COVID-19 vaccines in 50 PLWH receiving antiretroviral therapy, compared to 87 control participants without HIV. In a subset of PLWH, T-cell responses were also assessed after post-vaccine breakthrough infections and/or receipt of a fourth vaccine dose. All participants remained SARS-CoV-2 infection-naive until at least one month after their third vaccine dose. SARS-CoV-2 infection was determined by seroconversion to a Nucleocapsid (N) antigen, which occurred in 21 PLWH and 38 control participants after the third vaccine dose. Multivariable regression analyses were used to investigate the relationships between sociodemographic, health- and vaccine-related variables, vaccine-induced T-cell responses, and breakthrough infection risk. We observed that a third vaccine dose boosted spike-specific CD4+ and CD8+ T-cell frequencies significantly above those measured after the second dose (all p < 0.0001). Median T-cell frequencies did not differ between PLWH and controls after the second dose (p > 0.1), but CD8+ T-cell responses were modestly lower in PLWH after the third dose (p = 0.02), an observation that remained significant after adjusting for sociodemographic, health- and vaccine-related variables (p = 0.045). In PLWH who experienced a breakthrough infection, median T-cell frequencies increased even higher than those observed after three vaccine doses (p < 0.03), and CD8+ T-cell responses in this group remained higher even after a fourth vaccine dose (p = 0.03). In multivariable analyses, the only factor associated with an increased breakthrough infection risk was younger age, which is consistent with the rapid increase in SARS-CoV-2 seropositivity that was seen among younger adults in Canada after the initial appearance of the Omicron variant. These results indicate that PLWH receiving antiretroviral therapy mount strong T-cell responses to COVID-19 vaccines that can be enhanced by booster doses or breakthrough infection.
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Affiliation(s)
- Sneha Datwani
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V6A 1S6, Canada; (S.D.); (R.K.); (R.W.); (F.M.M.); (Y.S.); (P.K.C.); (F.H.O.); (M.C.D.); (E.B.)
| | - Rebecca Kalikawe
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V6A 1S6, Canada; (S.D.); (R.K.); (R.W.); (F.M.M.); (Y.S.); (P.K.C.); (F.H.O.); (M.C.D.); (E.B.)
| | - Rachel Waterworth
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V6A 1S6, Canada; (S.D.); (R.K.); (R.W.); (F.M.M.); (Y.S.); (P.K.C.); (F.H.O.); (M.C.D.); (E.B.)
| | - Francis M. Mwimanzi
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V6A 1S6, Canada; (S.D.); (R.K.); (R.W.); (F.M.M.); (Y.S.); (P.K.C.); (F.H.O.); (M.C.D.); (E.B.)
| | - Richard Liang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (R.L.); (H.R.L.); (N.M.-G.); (M.H.); (M.H.); (J.S.G.M.)
| | - Yurou Sang
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V6A 1S6, Canada; (S.D.); (R.K.); (R.W.); (F.M.M.); (Y.S.); (P.K.C.); (F.H.O.); (M.C.D.); (E.B.)
| | - Hope R. Lapointe
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (R.L.); (H.R.L.); (N.M.-G.); (M.H.); (M.H.); (J.S.G.M.)
| | - Peter K. Cheung
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V6A 1S6, Canada; (S.D.); (R.K.); (R.W.); (F.M.M.); (Y.S.); (P.K.C.); (F.H.O.); (M.C.D.); (E.B.)
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (R.L.); (H.R.L.); (N.M.-G.); (M.H.); (M.H.); (J.S.G.M.)
| | - Fredrick Harrison Omondi
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V6A 1S6, Canada; (S.D.); (R.K.); (R.W.); (F.M.M.); (Y.S.); (P.K.C.); (F.H.O.); (M.C.D.); (E.B.)
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (R.L.); (H.R.L.); (N.M.-G.); (M.H.); (M.H.); (J.S.G.M.)
| | - Maggie C. Duncan
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V6A 1S6, Canada; (S.D.); (R.K.); (R.W.); (F.M.M.); (Y.S.); (P.K.C.); (F.H.O.); (M.C.D.); (E.B.)
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (R.L.); (H.R.L.); (N.M.-G.); (M.H.); (M.H.); (J.S.G.M.)
| | - Evan Barad
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V6A 1S6, Canada; (S.D.); (R.K.); (R.W.); (F.M.M.); (Y.S.); (P.K.C.); (F.H.O.); (M.C.D.); (E.B.)
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (R.L.); (H.R.L.); (N.M.-G.); (M.H.); (M.H.); (J.S.G.M.)
| | - Sarah Speckmaier
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (R.L.); (H.R.L.); (N.M.-G.); (M.H.); (M.H.); (J.S.G.M.)
| | - Nadia Moran-Garcia
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (R.L.); (H.R.L.); (N.M.-G.); (M.H.); (M.H.); (J.S.G.M.)
| | - Mari L. DeMarco
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, BC V6Z 1Y6, Canada (M.G.R.)
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | | | - Cecilia T. Costiniuk
- Division of Infectious Diseases Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
- Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Mark Hull
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (R.L.); (H.R.L.); (N.M.-G.); (M.H.); (M.H.); (J.S.G.M.)
- Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Marianne Harris
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (R.L.); (H.R.L.); (N.M.-G.); (M.H.); (M.H.); (J.S.G.M.)
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Marc G. Romney
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, BC V6Z 1Y6, Canada (M.G.R.)
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Julio S. G. Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (R.L.); (H.R.L.); (N.M.-G.); (M.H.); (M.H.); (J.S.G.M.)
- Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Zabrina L. Brumme
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V6A 1S6, Canada; (S.D.); (R.K.); (R.W.); (F.M.M.); (Y.S.); (P.K.C.); (F.H.O.); (M.C.D.); (E.B.)
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (R.L.); (H.R.L.); (N.M.-G.); (M.H.); (M.H.); (J.S.G.M.)
| | - Mark A. Brockman
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V6A 1S6, Canada; (S.D.); (R.K.); (R.W.); (F.M.M.); (Y.S.); (P.K.C.); (F.H.O.); (M.C.D.); (E.B.)
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (R.L.); (H.R.L.); (N.M.-G.); (M.H.); (M.H.); (J.S.G.M.)
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC V6A 1S6, Canada
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Springer DN, Daller S, Knappik M, Prüger K, Hartl S, Breyer-Kohansal R, Puchhammer-Stöckl E, Aberle JH, Weseslindtner L, Breyer MK. A Multivariant Surrogate Virus Neutralization Test Demonstrates Distinct SARS-CoV-2-Specific Antibody Responses in People Living with HIV after a Fourth Monovalent mRNA Vaccination or an Omicron Breakthrough Infection. Diagnostics (Basel) 2024; 14:822. [PMID: 38667468 PMCID: PMC11049121 DOI: 10.3390/diagnostics14080822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/30/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
While neutralizing antibodies (nAbs) induced by monovalent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations are primarily directed against the wildtype (WT), subsequent exposure to the Omicron variants may increase the breadth of the antibodies' cross-neutralizing activity. Here, we analyzed the impact of an Omicron breakthrough infection (BTI) or a fourth monovalent mRNA vaccination on nAb profiles in people living with human immunodeficiency virus (PLWH). Using a multivariant surrogate virus neutralization test (sVNT), we quantified nAbs in 36 three-times vaccinated PLWH, of whom 9 acquired a serologically confirmed Omicron BTI, 8 received a fourth vaccine dose, and 19 were neither infected nor additionally vaccinated. While nAbs against WT and Delta increased after the BTI and a fourth vaccination, a significant increase against BA.1, BA.2, and BA.5 was only observed after the BTI. However, there was no significant difference in nAb concentrations between the samples obtained after the BTI and fourth vaccination. In contrast, nAb levels were significantly lower in PLWH, who were neither infected nor additionally vaccinated after three vaccinations. Thus, our study demonstrates the suitability of a multivariant sVNT to assess hybrid humoral immunity after Omicron BTIs in PLWH vaccinated against SARS-CoV-2.
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Affiliation(s)
- David Niklas Springer
- Center for Virology, Medical University of Vienna, 1090 Vienna, Austria; (D.N.S.); (K.P.); (E.P.-S.); (J.H.A.)
| | - Simon Daller
- Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Penzing, 1140 Vienna, Austria; (S.D.); (M.K.); (S.H.); (R.B.-K.); (M.K.B.)
| | - Michael Knappik
- Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Penzing, 1140 Vienna, Austria; (S.D.); (M.K.); (S.H.); (R.B.-K.); (M.K.B.)
| | - Katja Prüger
- Center for Virology, Medical University of Vienna, 1090 Vienna, Austria; (D.N.S.); (K.P.); (E.P.-S.); (J.H.A.)
| | - Sylvia Hartl
- Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Penzing, 1140 Vienna, Austria; (S.D.); (M.K.); (S.H.); (R.B.-K.); (M.K.B.)
- Ludwig Boltzmann Institute for Lung Health, 1140 Vienna, Austria
- Faculty of Medicine, Sigmund Freud University, 1020 Vienna, Austria
| | - Robab Breyer-Kohansal
- Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Penzing, 1140 Vienna, Austria; (S.D.); (M.K.); (S.H.); (R.B.-K.); (M.K.B.)
- Ludwig Boltzmann Institute for Lung Health, 1140 Vienna, Austria
| | - Elisabeth Puchhammer-Stöckl
- Center for Virology, Medical University of Vienna, 1090 Vienna, Austria; (D.N.S.); (K.P.); (E.P.-S.); (J.H.A.)
| | - Judith Helene Aberle
- Center for Virology, Medical University of Vienna, 1090 Vienna, Austria; (D.N.S.); (K.P.); (E.P.-S.); (J.H.A.)
| | - Lukas Weseslindtner
- Center for Virology, Medical University of Vienna, 1090 Vienna, Austria; (D.N.S.); (K.P.); (E.P.-S.); (J.H.A.)
| | - Marie Kathrin Breyer
- Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Penzing, 1140 Vienna, Austria; (S.D.); (M.K.); (S.H.); (R.B.-K.); (M.K.B.)
- Ludwig Boltzmann Institute for Lung Health, 1140 Vienna, Austria
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13
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Riou C, Bhiman JN, Ganga Y, Sawry S, Ayres F, Baguma R, Balla SR, Benede N, Bernstein M, Besethi AS, Cele S, Crowther C, Dhar M, Geyer S, Gill K, Grifoni A, Hermanus T, Kaldine H, Keeton RS, Kgagudi P, Khan K, Lazarus E, Le Roux J, Lustig G, Madzivhandila M, Magugu SFJ, Makhado Z, Manamela NP, Mkhize Q, Mosala P, Motlou TP, Mutavhatsindi H, Mzindle NB, Nana A, Nesamari R, Ngomti A, Nkayi AA, Nkosi TP, Omondi MA, Panchia R, Patel F, Sette A, Singh U, van Graan S, Venter EM, Walters A, Moyo-Gwete T, Richardson SI, Garrett N, Rees H, Bekker LG, Gray G, Burgers WA, Sigal A, Moore PL, Fairlie L. Safety and immunogenicity of booster vaccination and fractional dosing with Ad26.COV2.S or BNT162b2 in Ad26.COV2.S-vaccinated participants. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002703. [PMID: 38603677 PMCID: PMC11008839 DOI: 10.1371/journal.pgph.0002703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/18/2024] [Indexed: 04/13/2024]
Abstract
We report the safety and immunogenicity of fractional and full dose Ad26.COV2.S and BNT162b2 in an open label phase 2 trial of participants previously vaccinated with a single dose of Ad26.COV2.S, with 91.4% showing evidence of previous SARS-CoV-2 infection. A total of 286 adults (with or without HIV) were enrolled >4 months after an Ad26.COV2.S prime and randomized 1:1:1:1 to receive either a full or half-dose booster of Ad26.COV2.S or BNT162b2 vaccine. B cell responses (binding, neutralization and antibody dependent cellular cytotoxicity-ADCC), and spike-specific T-cell responses were evaluated at baseline, 2, 12 and 24 weeks post-boost. Antibody and T-cell immunity targeting the Ad26 vector was also evaluated. No vaccine-associated serious adverse events were recorded. The full- and half-dose BNT162b2 boosted anti-SARS-CoV-2 binding antibody levels (3.9- and 4.5-fold, respectively) and neutralizing antibody levels (4.4- and 10-fold). Binding and neutralizing antibodies following half-dose Ad26.COV2.S were not significantly boosted. Full-dose Ad26.COV2.S did not boost binding antibodies but slightly enhanced neutralizing antibodies (2.1-fold). ADCC was marginally increased only after a full-dose BNT162b2. T-cell responses followed a similar pattern to neutralizing antibodies. Six months post-boost, antibody and T-cell responses had waned to baseline levels. While we detected strong anti-vector immunity, there was no correlation between anti-vector immunity in Ad26.COV2.S recipients and spike-specific neutralizing antibody or T-cell responses post-Ad26.COV2.S boosting. Overall, in the context of hybrid immunity, boosting with heterologous full- or half-dose BNT162b2 mRNA vaccine demonstrated superior immunogenicity 2 weeks post-vaccination compared to homologous Ad26.COV2.S, though rapid waning occurred by 12 weeks post-boost. Trial Registration: The study has been registered to the South African National Clinical Trial Registry (SANCTR): DOH-27-012022-7841. The approval letter from SANCTR has been provided in the up-loaded documents.
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Affiliation(s)
- Catherine Riou
- Division of Medical Virology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, Cape Town, South Africa
| | - Jinal N. Bhiman
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Yashica Ganga
- Africa Health Research Institute, Durban, South Africa
| | - Shobna Sawry
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Frances Ayres
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Richard Baguma
- Division of Medical Virology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Sashkia R. Balla
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Ntombi Benede
- Division of Medical Virology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Asiphe S. Besethi
- Division of Medical Virology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Sandile Cele
- Africa Health Research Institute, Durban, South Africa
| | - Carol Crowther
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Mrinmayee Dhar
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sohair Geyer
- Division of Medical Virology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Katherine Gill
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Alba Grifoni
- Center for Vaccine Innovation, La Jolla Institute for Immunology, La Jolla, California, United States of America
| | - Tandile Hermanus
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Haajira Kaldine
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Roanne S. Keeton
- Division of Medical Virology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Prudence Kgagudi
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Khadija Khan
- Africa Health Research Institute, Durban, South Africa
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Erica Lazarus
- Perinatal HIV Research Unit, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Jean Le Roux
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Gila Lustig
- Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa
| | - Mashudu Madzivhandila
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Siyabulela F. J. Magugu
- Division of Medical Virology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Zanele Makhado
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Nelia P. Manamela
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Qiniso Mkhize
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Paballo Mosala
- Division of Medical Virology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Thopisang P. Motlou
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Hygon Mutavhatsindi
- Division of Medical Virology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Nonkululeko B. Mzindle
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Anusha Nana
- Perinatal HIV Research Unit, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Rofhiwa Nesamari
- Division of Medical Virology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Amkele Ngomti
- Division of Medical Virology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Anathi A. Nkayi
- Division of Medical Virology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Thandeka P. Nkosi
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Millicent A. Omondi
- Division of Medical Virology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Ravindre Panchia
- Perinatal HIV Research Unit, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Faeezah Patel
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alessandro Sette
- Center for Vaccine Innovation, La Jolla Institute for Immunology, La Jolla, California, United States of America
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego (UCSD), La Jolla, California, United States of America
| | - Upasna Singh
- Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa
| | - Strauss van Graan
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Elizabeth M. Venter
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Avril Walters
- Division of Medical Virology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Thandeka Moyo-Gwete
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Simone I. Richardson
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Nigel Garrett
- Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Helen Rees
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Linda-Gail Bekker
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Glenda Gray
- South African Medical Research Council, Cape Town, South Africa
| | - Wendy A. Burgers
- Division of Medical Virology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, Cape Town, South Africa
| | - Alex Sigal
- Africa Health Research Institute, Durban, South Africa
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
- Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa
| | - Penny L. Moore
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
- Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa
| | - Lee Fairlie
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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14
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Ferrari L, Ruggiero A, Stefani C, Benedetti L, Piermatteo L, Andreassi E, Caldara F, Zace D, Pagliari M, Ceccherini-Silberstein F, Jones C, Iannetta M, Geretti AM. Utility of accessible SARS-CoV-2 specific immunoassays in vaccinated adults with a history of advanced HIV infection. Sci Rep 2024; 14:8337. [PMID: 38594459 PMCID: PMC11003986 DOI: 10.1038/s41598-024-58597-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/01/2024] [Indexed: 04/11/2024] Open
Abstract
Accessible SARS-CoV-2-specific immunoassays may inform clinical management in people with HIV, particularly in case of persisting immunodysfunction. We prospectively studied their application in vaccine recipients with HIV, purposely including participants with a history of advanced HIV infection. Participants received one (n = 250), two (n = 249) or three (n = 42) doses of the BNT162b2 vaccine. Adverse events were documented through questionnaires. Sample collection occurred pre-vaccination and a median of 4 weeks post-second dose and 14 weeks post-third dose. Anti-spike and anti-nucleocapsid antibodies were measured with the Roche Elecsys chemiluminescence immunoassays. Neutralising activity was evaluated using the GenScript cPass surrogate virus neutralisation test, following validation against a Plaque Reduction Neutralization Test. T-cell reactivity was assessed with the Roche SARS-CoV-2 IFNγ release assay. Primary vaccination (2 doses) was well tolerated and elicited measurable anti-spike antibodies in 202/206 (98.0%) participants. Anti-spike titres varied widely, influenced by previous SARS-CoV-2 exposure, ethnicity, intravenous drug use, CD4 counts and HIV viremia as independent predictors. A third vaccine dose significantly boosted anti-spike and neutralising responses, reducing variability. Anti-spike titres > 15 U/mL correlated with neutralising activity in 136/144 paired samples (94.4%). Three participants with detectable anti-S antibodies did not develop cPass neutralising responses post-third dose, yet displayed SARS-CoV-2 specific IFNγ responses. SARS-CoV-2 vaccination is well-tolerated and immunogenic in adults with HIV, with responses improving post-third dose. Anti-spike antibodies serve as a reliable indicator of neutralising activity. Discordances between anti-spike and neutralising responses were accompanied by detectable IFN-γ responses, underlining the complexity of the immune response in this population.
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Affiliation(s)
- Ludovica Ferrari
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Department of Infectious Diseases, Fondazione PTV, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Alessandra Ruggiero
- Department of Neurosciences, Biomedicine and Movement Sciences, School of Medicine, University of Verona, Verona, Italy
| | - Chiara Stefani
- Department of Neurosciences, Biomedicine and Movement Sciences, School of Medicine, University of Verona, Verona, Italy
| | - Livia Benedetti
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Eleonora Andreassi
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Federica Caldara
- Department of Infectious Diseases, Fondazione PTV, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Drieda Zace
- Department of Infectious Diseases, Fondazione PTV, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Matteo Pagliari
- Laboratory of Experimental Animal Models, Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | | | - Christopher Jones
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Falmer, UK
| | - Marco Iannetta
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Department of Infectious Diseases, Fondazione PTV, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Anna Maria Geretti
- Department of Infectious Diseases, Fondazione PTV, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
- Department of Infection, North Middlesex University Hospital, London, UK.
- School of Immunity & Microbial Sciences, King's College London, London, UK.
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15
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Ngare I, Tan TS, Toyoda M, Kuwata T, Takahama S, Nakashima E, Yamasaki N, Motozono C, Fujii T, Minami R, Barabona G, Ueno T. Factors Associated with Neutralizing Antibody Responses following 2-Dose and 3rd Booster Monovalent COVID-19 Vaccination in Japanese People Living with HIV. Viruses 2024; 16:555. [PMID: 38675897 PMCID: PMC11053946 DOI: 10.3390/v16040555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/08/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
People living with HIV (PLWH) could be at risk of blunted immune responses to COVID-19 vaccination. We investigated factors associated with neutralizing antibody (NAb) responses against SARS-CoV-2 and variants of concern (VOCs), following two-dose and third booster monovalent COVID-19 mRNA vaccination in Japanese PLWH. NAb titers were assessed in polyclonal IgG fractions by lentiviral-based pseudovirus assays. Overall, NAb titers against Wuhan, following two-dose vaccination, were assessed in 82 PLWH on treatment, whereby 17/82 (20.73%) were classified as low-NAb participants. Within the low-NAb participants, the third booster vaccination enhanced NAb titers against Wuhan and VOCs, albeit to a significantly lower magnitude than the rest. In the multivariate analysis, NAb titers against Wuhan after two-dose vaccination correlated with age and days since vaccination, but not with CD4+ count, CD4+/CD8+ ratio, and plasma high-sensitivity C-Reactive protein (hsCRP). Interestingly, an extended analysis within age subgroups revealed NAb titers to correlate positively with the CD4+ count and negatively with plasma hsCRP in younger, but not older, participants. In conclusion, a third booster vaccination substantially enhances NAb titers, but the benefit may be suboptimal in subpopulations of PLWH exhibiting low titers at baseline. Considering clinical and immune parameters could provide a nuanced understanding of factors associated with vaccine responses in PLWH.
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Affiliation(s)
- Isaac Ngare
- Joint Research Center for Human Retrovirus Infection, Kumamoto University, 2-2-1 Honjo, Chuo-ku, Kumamoto 860-8555, Japan; (I.N.); (T.S.T.); (M.T.); (T.K.); (C.M.); (G.B.)
- Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-0811, Japan
| | - Toong Seng Tan
- Joint Research Center for Human Retrovirus Infection, Kumamoto University, 2-2-1 Honjo, Chuo-ku, Kumamoto 860-8555, Japan; (I.N.); (T.S.T.); (M.T.); (T.K.); (C.M.); (G.B.)
| | - Mako Toyoda
- Joint Research Center for Human Retrovirus Infection, Kumamoto University, 2-2-1 Honjo, Chuo-ku, Kumamoto 860-8555, Japan; (I.N.); (T.S.T.); (M.T.); (T.K.); (C.M.); (G.B.)
| | - Takeo Kuwata
- Joint Research Center for Human Retrovirus Infection, Kumamoto University, 2-2-1 Honjo, Chuo-ku, Kumamoto 860-8555, Japan; (I.N.); (T.S.T.); (M.T.); (T.K.); (C.M.); (G.B.)
| | - Soichiro Takahama
- NHO, Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563, Japan; (S.T.); (E.N.); (R.M.)
| | - Eriko Nakashima
- NHO, Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563, Japan; (S.T.); (E.N.); (R.M.)
| | - Naoya Yamasaki
- Division of Transfusion Medicine, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (N.Y.); (T.F.)
| | - Chihiro Motozono
- Joint Research Center for Human Retrovirus Infection, Kumamoto University, 2-2-1 Honjo, Chuo-ku, Kumamoto 860-8555, Japan; (I.N.); (T.S.T.); (M.T.); (T.K.); (C.M.); (G.B.)
| | - Teruhisa Fujii
- Division of Transfusion Medicine, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (N.Y.); (T.F.)
| | - Rumi Minami
- NHO, Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563, Japan; (S.T.); (E.N.); (R.M.)
| | - Godfrey Barabona
- Joint Research Center for Human Retrovirus Infection, Kumamoto University, 2-2-1 Honjo, Chuo-ku, Kumamoto 860-8555, Japan; (I.N.); (T.S.T.); (M.T.); (T.K.); (C.M.); (G.B.)
| | - Takamasa Ueno
- Joint Research Center for Human Retrovirus Infection, Kumamoto University, 2-2-1 Honjo, Chuo-ku, Kumamoto 860-8555, Japan; (I.N.); (T.S.T.); (M.T.); (T.K.); (C.M.); (G.B.)
- Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-0811, Japan
- Joint Research Center for Human Retrovirus Infection, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan
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16
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Matusali G, Vergori A, Cimini E, Mariotti D, Mazzotta V, Lepri AC, Colavita F, Gagliardini R, Notari S, Meschi S, Fusto M, Tartaglia E, Girardi E, Maggi F, Antinori A. Poor durability of the neutralizing response against XBB sublineages after a bivalent mRNA COVID-19 booster dose in persons with HIV. J Med Virol 2024; 96:e29598. [PMID: 38624044 DOI: 10.1002/jmv.29598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/18/2024] [Accepted: 04/01/2024] [Indexed: 04/17/2024]
Abstract
We estimated the dynamics of the neutralizing response against XBB sublineages and T cell response in persons with HIV (PWH) with previous AIDS and/or CD4 < 200/mm3 receiving the bivalent original strain/BA.4-5 booster dose in fall 2022. Samples were collected before the shot (Day 0), 15 days, 3, and 6 months after. PWH were stratified by immunization status: hybrid immunity (HI; vaccination plus COVID-19) versus nonhybrid immunity (nHI; vaccination only). Fifteen days after the booster, 16% and 30% of PWH were nonresponders in terms of anti-XBB.1.16 or anti-EG.5.1 nAbs, respectively. Three months after, a significant waning of anti-XBB.1.16, EG.5.1 and -XBB.1 nAbs was observed both in HI and nHI but nAbs in HI were higher than in nHI. Six months after both HI and nHI individuals displayed low mean levels of anti-XBB.1.16 and EG.5.1 nAbs. Regarding T cell response, IFN-γ values were stable over time and similar in HI and nHI. Our data showed that in PWH, during the prevalent circulation of the XBB.1.16, EG.5.1, and other XBB sublineages, a mRNA bivalent vaccine might not confer broad protection against them. With a view to the 2023/2024 vaccination campaign, the use of the monovalent XBB.1.5 mRNA vaccine should be urgently warranted in PWH to provide adequate protection.
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Affiliation(s)
- Giulia Matusali
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
| | - Alessandra Vergori
- Viral Immunodeficiency Unit, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
| | - Eleonora Cimini
- Immunology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
| | - Davide Mariotti
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
| | - Valentina Mazzotta
- Viral Immunodeficiency Unit, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
| | - Alessandro Cozzi Lepri
- Institute for Global Health, University College of London, Centre for Clinical Research, Epidemiology, Modeling and Evaluation (CREME), London, UK
| | - Francesca Colavita
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
| | - Roberta Gagliardini
- Viral Immunodeficiency Unit, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
| | - Stefania Notari
- Immunology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
| | - Silvia Meschi
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
| | - Marisa Fusto
- Viral Immunodeficiency Unit, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
| | - Eleonora Tartaglia
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
| | - Enrico Girardi
- Scientific Direction, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
| | - Fabrizio Maggi
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
| | - Andrea Antinori
- Viral Immunodeficiency Unit, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
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17
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Knudsen ML, Nielsen SD, Heftdal LD. Immune responses to mRNA-based vaccines given as a third COVID-19 vaccine dose in people living with HIV-a literature review. APMIS 2024; 132:236-244. [PMID: 38275143 DOI: 10.1111/apm.13379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 01/03/2024] [Indexed: 01/27/2024]
Abstract
People living with HIV (PLWH) were not included in the first efficacy studies of mRNA vaccines against SARS-CoV-2. In this literature review, we investigate evidence of humoral and cellular immunity after a third dose of an mRNA vaccine in PLWH. We performed a literature search in PubMed, Embase, Web of Science and SCOPUS published between 1 January 2020 and 31 December 2022. Selection criteria were studies on immunological responses in PLWH, who were given an mRNA-based vaccine as a third vaccine dose against SARS-CoV-2. Eight articles complied with our selection criteria. All studies found a strong humoral response after the third dose. Five studies investigated cellular immunity and found an increased cellular response after the third vaccine dose in PLWH. No difference in humoral response was observed between PLWH and controls after three doses. However, some of the studies suggested a weaker cellular response among PLWH than in controls, which was associated with lower nadir or current CD4+ T-cell counts. In conclusion, we found evidence of strong humoral immunity in PLWH after receiving an mRNA-based COVID-19 vaccine as a third dose, while the cellular immunity may be impaired compared to controls.
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Affiliation(s)
- Maria Lodberg Knudsen
- Viro-Immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Dam Nielsen
- Viro-Immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Surgical Gastroenterology and Transplantation, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Line Dam Heftdal
- Viro-Immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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18
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Karim F, Riou C, Bernstein M, Jule Z, Lustig G, van Graan S, Keeton RS, Upton JL, Ganga Y, Khan K, Reedoy K, Mazibuko M, Govender K, Thambu K, Ngcobo N, Venter E, Makhado Z, Hanekom W, von Gottberg A, Hoque M, Karim QA, Abdool Karim SS, Manickchund N, Magula N, Gosnell BI, Lessells RJ, Moore PL, Burgers WA, de Oliveira T, Moosa MYS, Sigal A. Clearance of persistent SARS-CoV-2 associates with increased neutralizing antibodies in advanced HIV disease post-ART initiation. Nat Commun 2024; 15:2360. [PMID: 38491050 PMCID: PMC10943233 DOI: 10.1038/s41467-024-46673-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 02/27/2024] [Indexed: 03/18/2024] Open
Abstract
SARS-CoV-2 clearance requires adaptive immunity but the contribution of neutralizing antibodies and T cells in different immune states is unclear. Here we ask which adaptive immune responses associate with clearance of long-term SARS-CoV-2 infection in HIV-mediated immunosuppression after suppressive antiretroviral therapy (ART) initiation. We assembled a cohort of SARS-CoV-2 infected people in South Africa (n = 994) including participants with advanced HIV disease characterized by immunosuppression due to T cell depletion. Fifty-four percent of participants with advanced HIV disease had prolonged SARS-CoV-2 infection (>1 month). In the five vaccinated participants with advanced HIV disease tested, SARS-CoV-2 clearance associates with emergence of neutralizing antibodies but not SARS-CoV-2 specific CD8 T cells, while CD4 T cell responses were not determined due to low cell numbers. Further, complete HIV suppression is not required for clearance, although it is necessary for an effective vaccine response. Persistent SARS-CoV-2 infection led to SARS-CoV-2 evolution, including virus with extensive neutralization escape in a Delta variant infected participant. The results provide evidence that neutralizing antibodies are required for SARS-CoV-2 clearance in HIV-mediated immunosuppression recovery, and that suppressive ART is necessary to curtail evolution of co-infecting pathogens to reduce individual health consequences as well as public health risk linked with generation of escape mutants.
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Affiliation(s)
- Farina Karim
- Africa Health Research Institute, Durban, South Africa
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Catherine Riou
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa
- Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, Observatory, South Africa
| | | | - Zesuliwe Jule
- Africa Health Research Institute, Durban, South Africa
| | - Gila Lustig
- Centre for the AIDS Programme of Research in South Africa, Durban, South Africa
| | - Strauss van Graan
- SAMRC Antibody Immunity Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Roanne S Keeton
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa
| | | | - Yashica Ganga
- Africa Health Research Institute, Durban, South Africa
| | - Khadija Khan
- Africa Health Research Institute, Durban, South Africa
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Kajal Reedoy
- Africa Health Research Institute, Durban, South Africa
| | | | | | | | | | - Elizabeth Venter
- SAMRC Antibody Immunity Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Zanele Makhado
- SAMRC Antibody Immunity Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Willem Hanekom
- Africa Health Research Institute, Durban, South Africa
- Division of Infection and Immunity, University College London, London, UK
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, a division of the National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Monjurul Hoque
- KwaDabeka Community Health Centre, KwaDabeka, South Africa
| | - Quarraisha Abdool Karim
- Centre for the AIDS Programme of Research in South Africa, Durban, South Africa
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Salim S Abdool Karim
- Centre for the AIDS Programme of Research in South Africa, Durban, South Africa
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Nithendra Manickchund
- Department of Infectious Diseases, Nelson R. Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Nombulelo Magula
- Department of Internal Medicine, Nelson R. Mandela School of Medicine, University of Kwa-Zulu Natal, Durban, South Africa
| | - Bernadett I Gosnell
- Department of Infectious Diseases, Nelson R. Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Richard J Lessells
- Centre for the AIDS Programme of Research in South Africa, Durban, South Africa
- KwaZulu-Natal Research Innovation and Sequencing Platform, Durban, South Africa
| | - Penny L Moore
- SAMRC Antibody Immunity Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Wendy A Burgers
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa
- Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, Observatory, South Africa
| | - Tulio de Oliveira
- Centre for the AIDS Programme of Research in South Africa, Durban, South Africa
- KwaZulu-Natal Research Innovation and Sequencing Platform, Durban, South Africa
- Centre for Epidemic Response and Innovation, School of Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Mahomed-Yunus S Moosa
- Department of Infectious Diseases, Nelson R. Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Alex Sigal
- Africa Health Research Institute, Durban, South Africa.
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa.
- Centre for the AIDS Programme of Research in South Africa, Durban, South Africa.
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19
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Khawcharoenporn T, Hanvivattanakul S. Safety profiles of homologous and heterologous regimens containing three major types of COVID-19 vaccine among people living with HIV. Int J STD AIDS 2024; 35:262-273. [PMID: 38048705 DOI: 10.1177/09564624231220090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
BACKGROUND Existing data on adverse effects (AEs) of homologous and heterologous COVID-19 vaccine regimens among people living with HIV (PLHIV) are limited. METHODS A prospective cohort study was conducted among Thai PLHIV during 2021-2022. Vaccine types and AEs were collected using an online survey. RESULTS Of the 398 vaccinated PLHIV, 92% had CD4 count ≥200 cells/µL and 96% were virologically suppressed at enrolment; 38% received two doses and 62% received three doses of COVID-19 vaccines. Inactivated, viral vector and mRNA were the most common vaccine types received as the first, second, and booster doses, respectively. For the first and second vaccine doses, the most common AEs were fever (15% and 11%) and injection site pain (11% and 11%). The mRNA vaccine significantly caused more overall AEs, injection pain, fatigue, and rashes than the other two types. For a booster dose, viral vector vaccine significantly caused more injection site pain and headache than the other two types. The majority of AEs of the first, second and booster doses spontaneously recovered without treatment. By multivariable analysis, receipt of viral vector or mRNA vaccine and age less than 40 years were independently associated with AEs of the primary series vaccines, while having AEs from the previous dose and female sex were independent factors associated with AEs of a booster vaccine. CONCLUSIONS Our study suggested the safety of homologous and heterologous regimens containing the three types of COVID-19 vaccines among PLHIV and identified those who required close monitoring for vaccine AEs.
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Affiliation(s)
- Thana Khawcharoenporn
- Division of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
- HIV/AIDS Care Unit of Thammasat University Hospital, Pathumthani, Thailand
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20
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Jassat W, Mudara C, Ozougwu L, Welch R, Arendse T, Masha M, Blumberg L, Kufa T, Puren A, Groome M, Govender N, Pisa P, Govender S, Sanne I, Brahmbhatt H, Parmley L, Wolmarans M, Rousseau P, Selikow A, Burgess M, Hankel L, Parker A, Cohen C. Trends in COVID-19 admissions and deaths among people living with HIV in South Africa: analysis of national surveillance data. Lancet HIV 2024; 11:e96-e105. [PMID: 38296365 DOI: 10.1016/s2352-3018(23)00266-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 10/02/2023] [Accepted: 10/13/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND In 2021, the HIV prevalence among South African adults was 18% and more than 2 million people had uncontrolled HIV and, therefore, had increased risk of poor outcomes with SARS-CoV-2 infection. We investigated trends in COVID-19 admissions and factors associated with in-hospital COVID-19 mortality among people living with HIV and people without HIV. METHODS In this analysis of national surveillance data, we linked and analysed data collected between March 5, 2020, and May 28, 2022, from the DATCOV South African national COVID-19 hospital surveillance system, the SARS-CoV-2 case line list, and the Electronic Vaccination Data System. All analyses included patients hospitalised with SARS-CoV-2 with known in-hospital outcomes (ie, who were discharged alive or had died) at the time of data extraction. We used descriptive statistics for admissions and mortality trends. Using post-imputation random-effect multivariable logistic regression models, we compared characteristics and the case fatality ratio of people with HIV and people without HIV. Using modified Poisson regression models, we compared factors associated with mortality among all people with COVID-19 admitted to hospital and factors associated with mortality among people with HIV. FINDINGS Among 397 082 people with COVID-19 admitted to hospital, 301 407 (75·9%) were discharged alive, 89 565 (22·6%) died, and 6110 (1·5%) had no recorded outcome. 270 737 (68·2%) people with COVID-19 had documented HIV status (22 858 with HIV and 247 879 without). Comparing characteristics of people without HIV and people with HIV in each COVID-19 wave, people with HIV had increased odds of mortality in the D614G (adjusted odds ratio 1·19, 95% CI 1·09-1·29), beta (1·08, 1·01-1·16), delta (1·10, 1·03-1·18), omicron BA.1 and BA.2 (1·71, 1·54-1·90), and omicron BA.4 and BA.5 (1·81, 1·41-2·33) waves. Among all COVID-19 admissions, mortality was lower among people with previous SARS-CoV-2 infection (adjusted incident rate ratio 0·32, 95% CI 0·29-0·34) and with partial (0·93, 0·90-0·96), full (0·70, 0·67-0·73), or boosted (0·50, 0·41-0·62) COVID-19 vaccination. Compared with people without HIV who were unvaccinated, people without HIV who were vaccinated had lower risk of mortality (0·68, 0·65-0·71) but people with HIV who were vaccinated did not have any difference in mortality risk (1·08, 0·96-1·23). In-hospital mortality was higher for people with HIV with CD4 counts less than 200 cells per μL, irrespective of viral load and vaccination status. INTERPRETATION HIV and immunosuppression might be important risk factors for mortality as COVID-19 becomes endemic. FUNDING South African National Institute for Communicable Diseases, the South African National Government, and the United States Agency for International Development.
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Affiliation(s)
- Waasila Jassat
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Right to Care, Pretoria, South Africa.
| | - Caroline Mudara
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Lovelyn Ozougwu
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Right to Care, Pretoria, South Africa
| | - Richard Welch
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Right to Care, Pretoria, South Africa
| | - Tracy Arendse
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Right to Care, Pretoria, South Africa
| | - Maureen Masha
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Right to Care, Pretoria, South Africa
| | - Lucille Blumberg
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Right to Care, Pretoria, South Africa
| | - Tendesayi Kufa
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Adrian Puren
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Michelle Groome
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Nevashan Govender
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Pedro Pisa
- Right to Care, Pretoria, South Africa; Department of Human Nutrition and Dietetics, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Ian Sanne
- Right to Care, Pretoria, South Africa; School of Pathology (M Groome), Clinical HIV Research Unit, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Heena Brahmbhatt
- United States Agency for International Development, Pretoria, South Africa; Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lauren Parmley
- United States Agency for International Development, Pretoria, South Africa
| | | | | | - Anthony Selikow
- Council for Scientific and Industrial Research, Pretoria, South Africa
| | - Melissa Burgess
- Council for Scientific and Industrial Research, Pretoria, South Africa
| | - Lauren Hankel
- Council for Scientific and Industrial Research, Pretoria, South Africa
| | - Arifa Parker
- Tygerberg Hospital and Division of Infectious Disease, University of Stellenbosch, Cape Town, South Africa
| | - Cheryl Cohen
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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21
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Höft MA, Burgers WA, Riou C. The immune response to SARS-CoV-2 in people with HIV. Cell Mol Immunol 2024; 21:184-196. [PMID: 37821620 PMCID: PMC10806256 DOI: 10.1038/s41423-023-01087-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 09/12/2023] [Indexed: 10/13/2023] Open
Abstract
This review examines the intersection of the HIV and SARS-CoV-2 pandemics. People with HIV (PWH) are a heterogeneous group that differ in their degree of immune suppression, immune reconstitution, and viral control. While COVID-19 in those with well-controlled HIV infection poses no greater risk than that for HIV-uninfected individuals, people with advanced HIV disease are more vulnerable to poor COVID-19 outcomes. COVID-19 vaccines are effective and well tolerated in the majority of PWH, though reduced vaccine efficacy, breakthrough infections and faster waning of vaccine effectiveness have been demonstrated in PWH. This is likely a result of suboptimal humoral and cellular immune responses after vaccination. People with advanced HIV may also experience prolonged infection that may give rise to new epidemiologically significant variants, but initiation or resumption of antiretroviral therapy (ART) can effectively clear persistent infection. COVID-19 vaccine guidelines reflect these increased risks and recommend prioritization for vaccination and additional booster doses for PWH who are moderately to severely immunocompromised. We recommend continued research and monitoring of PWH with SARS-CoV-2 infection, especially in areas with a high HIV burden.
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Affiliation(s)
- Maxine A Höft
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Division of Medical Virology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Wendy A Burgers
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
- Division of Medical Virology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
- Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, Cape Town, South Africa.
| | - Catherine Riou
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
- Division of Medical Virology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
- Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, Cape Town, South Africa.
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22
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Forero-Peña DA, Carrión-Nessi FS, Forero-Peña JL, Camejo-Ávila NA, Mendoza-Millán DL, Omaña-Ávila ÓD, Maricuto AL, Velásquez VL, Mejía-Bernard MD, Rodriguez-Saavedra CM, Marcano-Rojas MV, Contreras Y, Guerra LJ, Alvarado MF, Carballo M, Caldera J, Guevara RN, Redondo MC, Landaeta ME. The impact of the COVID-19 pandemic on people living with HIV: a cross-sectional study in Caracas, Venezuela. BMC Infect Dis 2024; 24:87. [PMID: 38225550 PMCID: PMC10789023 DOI: 10.1186/s12879-023-08967-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/29/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has disrupted multiple health services, including human immunodeficiency virus (HIV) testing, care, and treatment services, jeopardizing the achievement of the Joint United Nations Programme on HIV/AIDS 90-90-90 global target. While there are limited studies assessing the impact of the COVID-19 pandemic on people living with HIV (PLHIV) in Latin America, there are none, to our knowledge, in Venezuela. This study aims to assess the impact of the COVID-19 pandemic among PLHIV seen at the outpatient clinic of a reference hospital in Venezuela. METHODS We conducted a cross-sectional study among PLHIV aged 18 years and over seen at the Infectious Diseases Department of the University Hospital of Caracas, Venezuela between March 2021 and February 2022. RESULTS A total of 238 PLHIV were included in the study. The median age was 43 (IQR 31-55) years, and the majority were male (68.9%). Most patients (88.2%, n = 210) came for routine check-ups, while 28 (11.3%) were newly diagnosed. The majority of patients (96.1%) were on antiretroviral therapy (ART), but only 67.8% had a viral load test, with almost all (95.6%) being undetectable. Among those who attended regular appointments, 11.9% reported missing at least one medical consultation, and 3.3% reported an interruption in their ART refill. More than half of the patients (55.5%) had received at least one dose of the COVID-19 vaccine, while the rest expressed hesitancy to get vaccinated. Most patients with COVID-19 vaccine hesitancy were male (65.1%), younger than 44 years (57.5%), employed (47.2%), and had been diagnosed with HIV for less than one year (33%). However, no statistically significant differences were found between vaccinated patients and those with COVID-19 vaccine hesitancy. Older age was a risk factor for missing consultations, while not having an alcoholic habit was identified as a protective factor against missing consultations. CONCLUSION This study found that the COVID-19 pandemic had a limited impact on adherence to medical consultations and interruptions in ART among PLHIV seen at the University Hospital of Caracas, Venezuela.
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Affiliation(s)
- David A Forero-Peña
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela.
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela.
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela.
| | - Fhabián S Carrión-Nessi
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela.
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela.
| | - José L Forero-Peña
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
| | | | - Daniela L Mendoza-Millán
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - Óscar D Omaña-Ávila
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - Andrea L Maricuto
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
| | - Viledy L Velásquez
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
| | - Mario D Mejía-Bernard
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | | | | | - Yoesmir Contreras
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
| | - Luis J Guerra
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
| | - María F Alvarado
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
| | - Martín Carballo
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
| | - Jocays Caldera
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
| | - Rafael N Guevara
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
| | - María C Redondo
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
| | - María E Landaeta
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
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23
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Vanetti C, Stracuzzi M, Crivellaro E, Ciciliano F, Garziano M, Fenizia C, Biasin M, Rubinacci V, Amendola A, Tanzi E, Zuccotti GV, Clerici M, Giacomet V, Trabattoni D. Humoral and cell-mediated immune responses in HIV-vertically infected young patients after three doses of the BNT162b2 mRNA SARS-CoV-2 vaccine. Front Immunol 2024; 14:1301766. [PMID: 38250079 PMCID: PMC10797701 DOI: 10.3389/fimmu.2023.1301766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/13/2023] [Indexed: 01/23/2024] Open
Abstract
Background Data on the efficacy of three SARS-CoV-2 mRNA BNT162b2 vaccine doses and the role of previous SARS-CoV-2-infection in enhancing vaccine immunogenicity in HIV-vertically-infected people living with HIV (PLWH) are limited, as is the duration of vaccine-induced responses. Methods SARS-CoV-2 plasma neutralizing activity (NA) against the European (B.1), Delta (B.1.617.2) and Omicron (B.1.1.529) variants and cell-mediated immunity (CMI) were analyzed in 29 ART-treated young PLWH (mean age 27.9 years) and 30 healthy controls (HC) who received three BNT162b2 vaccine doses. Individuals were stratified based on the presence/absence of previous SARS-CoV-2 infection (infected and vaccinated -SIV-; uninfected and vaccinated -SV-). Analyses were performed before vaccination (T0), 25 days from the second dose (T1), the day the third dose was administered (T2), and 3 months after the third dose (T3). Results In PLWH: i) NA against all variants was higher in SIV compared to SV at T2 and was increased at T3; ii) switched-memory plasmablasts were augmented in SIV alone at T2 and T3; iii) a SARS-CoV-2 specific T cell memory was generated; iv) IFN-γ-secreting CD4+ and CD8+ T lymphocytes were boosted at T3 mainly in SV. CMI magnitude was reduced in PLWH compared to HC. Notably, after the third dose of vaccine viremia was unmodified, but CD4 T cell counts were reduced>20% in 3/29 PHLW. Conclusion A third dose of BNT162b2 vaccine induces strong humoral and CMI responses in young ART-treated PLWH independently from a previous SARS-CoV-2 natural infection. The lower magnitude of CMI responses should be considered when planning mRNA vaccine booster doses in PLWH.
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Affiliation(s)
- Claudia Vanetti
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Marta Stracuzzi
- Pediatric Infectious Disease Unit, Ospedale L. Sacco, University of Milan, Milan, Italy
| | - Elisa Crivellaro
- Pediatric Infectious Disease Unit, Ospedale L. Sacco, University of Milan, Milan, Italy
| | - Federica Ciciliano
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Micaela Garziano
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Claudio Fenizia
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Mara Biasin
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Valeria Rubinacci
- Pediatric Infectious Disease Unit, Ospedale L. Sacco, University of Milan, Milan, Italy
| | | | - Elisabetta Tanzi
- Department of Health Sciences, University of Milan, Milan, Italy
| | | | - Mario Clerici
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Vania Giacomet
- Pediatric Infectious Disease Unit, Ospedale L. Sacco, University of Milan, Milan, Italy
| | - Daria Trabattoni
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
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Qu MM, Song B, Yang BP, Wang Z, Yu M, Zhang Y, Zhang C, Song JW, Fan X, Xu R, Zhang JY, Zhou CB, Du F, Wang FS, Huang HH, Jiao YM. Effect of SARS-CoV-2 Breakthrough Infection on HIV Reservoirs and T-Cell Immune Recovery in 3-Dose Vaccinated People Living with HIV. Viruses 2023; 15:2427. [PMID: 38140668 PMCID: PMC10748120 DOI: 10.3390/v15122427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
People living with human immunodeficiency virus (PLWH) are a vulnerable population with a higher risk of severe coronavirus disease 2019 (COVID-19); therefore, vaccination is recommended as a priority. Data on viral reservoirs and immunologic outcomes for PLWH breakthrough infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are currently limited. In this study, we investigated the effects of SARS-CoV-2 breakthrough infection on hematological parameters, human immunodeficiency virus (HIV) reservoir size, and T-cell recovery in PLWH receiving antiretroviral therapy (ART) after SARS-CoV-2 booster vaccination. The results indicated that during breakthrough infection, booster vaccination with homologous and heterologous vaccines was safe in PLWH after receiving two doses of inactivated vaccination. The absolute CD4 counts decreased in the heterologous group, whereas the CD8 counts decreased in the homologous booster group after breakthrough infection in PLWH. Breakthrough infection increased HIV reservoirs and was associated with increased T-cell activation in PLWH who received virally suppressed ART and a 3-dose vaccination. According to our data, the breakthrough infection of SARS-CoV-2 may put PLWH at a greater risk for increased HIV reservoirs, even if these individuals were virally suppressed with ART after 3-dose SARS-CoV-2 vaccination.
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Affiliation(s)
- Meng-Meng Qu
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China; (M.-M.Q.)
| | - Bing Song
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China; (M.-M.Q.)
| | - Bao-Peng Yang
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China; (M.-M.Q.)
| | - Zerui Wang
- Department of Gastroenterology, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Minrui Yu
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China; (M.-M.Q.)
| | - Yi Zhang
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China; (M.-M.Q.)
| | - Chao Zhang
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China; (M.-M.Q.)
| | - Jin-Wen Song
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China; (M.-M.Q.)
| | - Xing Fan
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China; (M.-M.Q.)
| | - Ruonan Xu
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China; (M.-M.Q.)
| | - Ji-Yuan Zhang
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China; (M.-M.Q.)
| | - Chun-Bao Zhou
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China; (M.-M.Q.)
| | - Fengxia Du
- Department of Pharmacy, Medical Supplies Center of PLA General Hospital, Beijing 100039, China
| | - Fu-Sheng Wang
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China; (M.-M.Q.)
| | - Hui-Huang Huang
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China; (M.-M.Q.)
| | - Yan-Mei Jiao
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China; (M.-M.Q.)
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25
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Riou C, Bhiman JN, Ganga Y, Sawry S, Ayres F, Baguma R, Balla SR, Benede N, Bernstein M, Besethi AS, Cele S, Crowther C, Dhar M, Geyer S, Gill K, Grifoni A, Hermanus T, Kaldine H, Keeton RS, Kgagudi P, Khan K, Lazarus E, Roux JL, Lustig G, Madzivhandila M, Magugu SFJ, Makhado Z, Manamela NP, Mkhize Q, Mosala P, Motlou TP, Mutavhatsindi H, Mzindle NB, Nana A, Nesamari R, Ngomti A, Nkayi AA, Nkosi TP, Omondi MA, Panchia R, Patel F, Sette A, Singh U, van Graan S, Venter EM, Walters A, Moyo-Gwete T, Richardson SI, Garrett N, Rees H, Bekker LG, Gray G, Burgers WA, Sigal A, Moore PL, Fairlie L. Safety and immunogenicity of booster vaccination and fractional dosing with Ad26.COV2.S or BNT162b2 in Ad26.COV2.S-vaccinated participants. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.20.23298785. [PMID: 38045321 PMCID: PMC10690356 DOI: 10.1101/2023.11.20.23298785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background We report the safety and immunogenicity of fractional and full dose Ad26.COV2.S and BNT162b2 in an open label phase 2 trial of participants previously vaccinated with a single dose of Ad26.COV2.S, with 91.4% showing evidence of previous SARS-CoV-2 infection. Methods A total of 286 adults (with or without HIV) were enrolled >4 months after an Ad26.COV2.S prime and randomized 1:1:1:1 to receive either a full or half-dose booster of Ad26.COV2.S or BNT162b2 vaccine. B cell responses (binding, neutralization and antibody dependent cellular cytotoxicity-ADCC), and spike-specific T-cell responses were evaluated at baseline, 2, 12 and 24 weeks post-boost. Antibody and T-cell immunity targeting the Ad26 vector was also evaluated. Results No vaccine-associated serious adverse events were recorded. The full- and half-dose BNT162b2 boosted anti-SARS-CoV-2 binding antibody levels (3.9- and 4.5-fold, respectively) and neutralizing antibody levels (4.4- and 10-fold). Binding and neutralizing antibodies following half-dose Ad26.COV2.S were not significantly boosted. Full-dose Ad26.COV2.S did not boost binding antibodies but slightly enhanced neutralizing antibodies (2.1-fold). ADCC was marginally increased only after a full-dose BNT162b2. T-cell responses followed a similar pattern to neutralizing antibodies. Six months post-boost, antibody and T-cell responses had waned to baseline levels. While we detected strong anti-vector immunity, there was no correlation between anti-vector immunity in Ad26.COV2.S recipients and spike-specific neutralizing antibody or T-cell responses post-Ad26.COV2.S boosting. Conclusion In the context of hybrid immunity, boosting with heterologous full- or half-dose BNT162b2 mRNA vaccine demonstrated superior immunogenicity 2 weeks post-vaccination compared to homologous Ad26.COV2.S, though rapid waning occurred by 12 weeks post-boost. Trial Registration South African National Clinical Trial Registry (SANCR): DOH-27-012022-7841. Funding South African Medical Research Council (SAMRC) and South African Department of Health (SA DoH).
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Affiliation(s)
- Catherine Riou
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa
- Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, Observatory, South Africa
| | - Jinal N Bhiman
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Yashica Ganga
- Africa Health Research Institute, Durban, South Africa
| | - Shobna Sawry
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Frances Ayres
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Richard Baguma
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa
| | - Sashkia R Balla
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Ntombi Benede
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa
| | | | - Asiphe S Besethi
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa
| | - Sandile Cele
- Africa Health Research Institute, Durban, South Africa
| | - Carol Crowther
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Mrinmayee Dhar
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sohair Geyer
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa
| | - Katherine Gill
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Alba Grifoni
- Center for Vaccine Innovation, La Jolla Institute for Immunology, La Jolla, California, USA
| | - Tandile Hermanus
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Haajira Kaldine
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Roanne S Keeton
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa
| | - Prudence Kgagudi
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Khadija Khan
- Africa Health Research Institute, Durban, South Africa
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Erica Lazarus
- Perinatal HIV Research Unit, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Jean Le Roux
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Gila Lustig
- Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa
| | - Mashudu Madzivhandila
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Siyabulela FJ Magugu
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa
| | - Zanele Makhado
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Nelia P Manamela
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Qiniso Mkhize
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Paballo Mosala
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa
| | - Thopisang P Motlou
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Hygon Mutavhatsindi
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa
| | - Nonkululeko B Mzindle
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Anusha Nana
- Perinatal HIV Research Unit, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Rofhiwa Nesamari
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa
| | - Amkele Ngomti
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa
| | - Anathi A Nkayi
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa
| | - Thandeka P Nkosi
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Millicent A Omondi
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa
| | - Ravindre Panchia
- Perinatal HIV Research Unit, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Faeezah Patel
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alessandro Sette
- Center for Vaccine Innovation, La Jolla Institute for Immunology, La Jolla, California, USA
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego (UCSD), La Jolla, California, USA
| | - Upasna Singh
- Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa
| | - Strauss van Graan
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Elizabeth M. Venter
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Avril Walters
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa
| | - Thandeka Moyo-Gwete
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Simone I. Richardson
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Nigel Garrett
- Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Helen Rees
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Linda-Gail Bekker
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Glenda Gray
- South African Medical Research Council, Cape Town, South Africa
| | - Wendy A. Burgers
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa
- Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, Observatory, South Africa
| | - Alex Sigal
- Africa Health Research Institute, Durban, South Africa
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
- Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa
| | - Penny L Moore
- SA MRC Antibody Immunity Research Unit, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Center for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
- Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa
| | - Lee Fairlie
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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26
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Alrubayyi A, Touizer E, Hameiri-Bowen D, Charlton B, Gea-Mallorquí E, Hussain N, da Costa KAS, Ford R, Rees-Spear C, Fox TA, Williams I, Waters L, Barber TJ, Burns F, Kinloch S, Morris E, Rowland-Jones S, McCoy LE, Peppa D. Natural killer cell responses during SARS-CoV-2 infection and vaccination in people living with HIV-1. Sci Rep 2023; 13:18994. [PMID: 37923825 PMCID: PMC10624865 DOI: 10.1038/s41598-023-45412-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 10/19/2023] [Indexed: 11/06/2023] Open
Abstract
Natural killer (NK) cell subsets with adaptive properties are emerging as regulators of vaccine-induced T and B cell responses and are specialized towards antibody-dependent functions contributing to SARS-CoV-2 control. Although HIV-1 infection is known to affect the NK cell pool, the additional impact of SARS-CoV-2 infection and/or vaccination on NK cell responses in people living with HIV (PLWH) has remained unexplored. Our data show that SARS-CoV-2 infection skews NK cells towards a more differentiated/adaptive CD57+FcεRIγ- phenotype in PLWH. A similar subset was induced following vaccination in SARS-CoV-2 naïve PLWH in addition to a CD56bright population with cytotoxic potential. Antibody-dependent NK cell function showed robust and durable responses to Spike up to 148 days post-infection, with responses enriched in adaptive NK cells. NK cell responses were further boosted by the first vaccine dose in SARS-CoV-2 exposed individuals and peaked after the second dose in SARS-CoV-2 naïve PLWH. The presence of adaptive NK cells associated with the magnitude of cellular and humoral responses. These data suggest that features of adaptive NK cells can be effectively engaged to complement and boost vaccine-induced adaptive immunity in potentially more vulnerable groups such as PLWH.
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Affiliation(s)
- Aljawharah Alrubayyi
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Division of Infection and Immunity, Institute for Immunity and Transplantation, University College London, London, UK
| | - Emma Touizer
- Division of Infection and Immunity, Institute for Immunity and Transplantation, University College London, London, UK
| | | | - Bethany Charlton
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Noshin Hussain
- Division of Infection and Immunity, Institute for Immunity and Transplantation, University College London, London, UK
| | - Kelly A S da Costa
- Division of Infection and Immunity, Institute for Immunity and Transplantation, University College London, London, UK
| | - Rosemarie Ford
- Division of Infection and Immunity, Institute for Immunity and Transplantation, University College London, London, UK
| | - Chloe Rees-Spear
- Division of Infection and Immunity, Institute for Immunity and Transplantation, University College London, London, UK
| | - Thomas A Fox
- Division of Infection and Immunity, Institute for Immunity and Transplantation, University College London, London, UK
| | - Ian Williams
- Department of HIV, Mortimer Market Centre, Central and North West London NHS Trust, London, UK
| | - Laura Waters
- Department of HIV, Mortimer Market Centre, Central and North West London NHS Trust, London, UK
| | - Tristan J Barber
- Institute for Global Health, University College London, London, UK
- The Ian Charleson Day Centre, Royal Free Hospital NHS Foundation Trust, London, UK
| | - Fiona Burns
- Institute for Global Health, University College London, London, UK
- The Ian Charleson Day Centre, Royal Free Hospital NHS Foundation Trust, London, UK
| | - Sabine Kinloch
- Division of Infection and Immunity, Institute for Immunity and Transplantation, University College London, London, UK
- The Ian Charleson Day Centre, Royal Free Hospital NHS Foundation Trust, London, UK
| | - Emma Morris
- Division of Infection and Immunity, Institute for Immunity and Transplantation, University College London, London, UK
| | | | - Laura E McCoy
- Division of Infection and Immunity, Institute for Immunity and Transplantation, University College London, London, UK
| | - Dimitra Peppa
- Division of Infection and Immunity, Institute for Immunity and Transplantation, University College London, London, UK.
- Department of HIV, Mortimer Market Centre, Central and North West London NHS Trust, London, UK.
- The Ian Charleson Day Centre, Royal Free Hospital NHS Foundation Trust, London, UK.
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27
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Vergori A, Tavelli A, Matusali G, Azzini AM, Augello M, Mazzotta V, Pellicanò GF, Costantini A, Cascio A, De Vito A, Marconi L, Righi E, Sartor A, Pinnetti C, Maggi F, Bai F, Lanini S, Piconi S, Levy Hara G, Marchetti G, Giannella M, Tacconelli E, d’Arminio Monforte A, Antinori A, Cozzi-Lepri A. SARS-CoV-2 mRNA Vaccine Response in People Living with HIV According to CD4 Count and CD4/CD8 Ratio. Vaccines (Basel) 2023; 11:1664. [PMID: 38005996 PMCID: PMC10675416 DOI: 10.3390/vaccines11111664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/19/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Our aim was to estimate the rates of not achieving a robust/above-average humoral response to the COVID-19 mRNA vaccine in people living with HIV (PLWH) who received ≥2 doses and to investigate the role of the CD4 and CD4/CD8 ratio in predicting the humoral response. METHODS We evaluated the humoral anti-SARS-CoV-2 response 1-month after the second and third doses of COVID-19 mRNA vaccine as a proportion of not achieving a robust/above-average response using two criteria: (i) a humoral threshold identified as a correlate of protection against SARS-CoV-2 (<90% vaccine efficacy): anti-RBD < 775 BAU/mL or anti-S < 298 BAU/mL, (ii) threshold of binding antibodies equivalent to average neutralization activity from the levels of binding (nAb titer < 1:40): anti-RBD < 870 BAU/mL or anti-S < 1591 BAU/mL. PLWH were stratified according to the CD4 count and CD4/CD8 ratio at first dose. Logistic regression was used to compare the probability of not achieving robust/above-average responses. A mixed linear model was used to estimate the mean anti-RBD titer at various time points across the exposure groups. RESULTS a total of 1176 PLWH were included. The proportions of participants failing to achieve a robust/above-average response were significantly higher in participants with a lower CD4 and CD4/CD8 ratio, specifically, a clearer gradient was observed for the CD4 count. The CD4 count was a better predictor of the humoral response of the primary cycle than ratio. The third dose was pivotal in achieving a robust/above-average humoral response, at least for PLWH with CD4 > 200 cells/mm3 and a ratio > 0.6. CONCLUSIONS A robust humoral response after a booster dose has not been reached by 50% of PLWH with CD4 < 200 cells mm3. In the absence of a validated correlate of protections in the Omicron era, the CD4 count remains the most solid marker to guide vaccination campaigns in PLWH.
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Affiliation(s)
- Alessandra Vergori
- HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (A.V.); (V.M.); (C.P.); (S.L.); (A.A.)
| | | | - Giulia Matusali
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.M.); (F.M.)
| | - Anna Maria Azzini
- Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (A.M.A.); (E.R.); (E.T.)
| | - Matteo Augello
- Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (M.A.); (F.B.); (G.M.)
| | - Valentina Mazzotta
- HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (A.V.); (V.M.); (C.P.); (S.L.); (A.A.)
| | - Giovanni Francesco Pellicanò
- Department of Human Pathology of the Adult and the Developmental Age “G. Barresi”, University of Messina, 98121 Messina, Italy;
| | - Andrea Costantini
- Clinical Immunology Unit, Azienda Ospedaliero Universitaria delle Marche, Marche Polytechnic University, 60126 Ancona, Italy;
| | - Antonio Cascio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy;
| | - Andrea De Vito
- Unit of Infectious Diseases, Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy;
| | - Lorenzo Marconi
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy; (L.M.); (M.G.)
| | - Elda Righi
- Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (A.M.A.); (E.R.); (E.T.)
| | - Assunta Sartor
- Microbiology Unit, Udine University Hospital, 33100 Udine, Italy;
| | - Carmela Pinnetti
- HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (A.V.); (V.M.); (C.P.); (S.L.); (A.A.)
| | - Fabrizio Maggi
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.M.); (F.M.)
| | - Francesca Bai
- Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (M.A.); (F.B.); (G.M.)
| | - Simone Lanini
- HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (A.V.); (V.M.); (C.P.); (S.L.); (A.A.)
| | - Stefania Piconi
- Infectious Diseases Unit, Alessandro Manzoni Hospital, ASST Lecco, 23900 Lecco, Italy;
| | - Gabriel Levy Hara
- Instituto Alberto Taquini de Investigación en Medicina Traslacional, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires C1122AAJ, Argentina;
| | - Giulia Marchetti
- Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (M.A.); (F.B.); (G.M.)
| | - Maddalena Giannella
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy; (L.M.); (M.G.)
| | - Evelina Tacconelli
- Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (A.M.A.); (E.R.); (E.T.)
| | - Antonella d’Arminio Monforte
- Icona Foundation, 20142 Milan, Italy;
- Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (M.A.); (F.B.); (G.M.)
| | - Andrea Antinori
- HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (A.V.); (V.M.); (C.P.); (S.L.); (A.A.)
| | - Alessandro Cozzi-Lepri
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, UCL, London NW3 2PF, UK;
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Cheng MQ, Li R, Weng ZY, Song G. Immunogenicity and effectiveness of COVID-19 booster vaccination among people living with HIV: a systematic review and meta-analysis. Front Med (Lausanne) 2023; 10:1275843. [PMID: 37877024 PMCID: PMC10591097 DOI: 10.3389/fmed.2023.1275843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/18/2023] [Indexed: 10/26/2023] Open
Abstract
Background The effect of booster vaccinations with the coronavirus virus disease (COVID-19) vaccine on people living with HIV (PLWH) remains unknown. In this study, we aimed to investigate the immunogenicity and effectiveness of booster doses of the COVID-19 vaccine in PLWH. Methods Literature research was done through the PubMed, Embase, Cochrane Review, and Web of Science databases up to 4 July 2023. Pooled estimates were calculated and compared using the DerSimonian and Laird method for a random effects model. Randomized control trials and observational studies were both considered for inclusion. Results We included 35 eligible studies covering 30,154 PLWH. The pooled immune response rate (IRR) of PLWH after the COVID-19 booster vaccination was 97.25% (95% confidence interval [CI], 93.81-99.49), and similar to healthy control (HC) (risk ratio [RR] = 0.98, 95% CI, 0.96-1.00). The pooled IRR for PLWH with CD4+ T-cell counts ≤ 200 was 86.27 (95% CI, 65.35-99.07). For Omicron variants, the pooled IRR for PLWH after booster dose was 74.07% (95% CI, 58.83-89.30), and the risk of IRR was reduced by 10% in PLWH compared with HC (RR = 0.90, 95% CI, 0.80-1.00). The T-cell immune response of PLWH was found to be comparable to HC (p ≥ 0.05). Subgroup analyses revealed that mRNA vaccines produced a relatively high IRR in PLWH compared to other vaccines. In addition, the results showed that booster vaccination appeared to further reduce the risk of COVID-19-related infections, hospitalizations, and deaths compared with the primary vaccination. Conclusion It was shown that booster vaccination with the COVID-19 vaccine provided a high IRR in PLWH and still produced a desirable moderate IRR in PLWH with a CD4+ T-cell count of ≤ 200. Importantly, the humoral and T-cell responses to booster vaccination in PLWH were comparable to HC, and similar results were observed with the SARS-CoV-2 Omicron variant. Our review strongly emphasizes the effect of mRNA vaccine booster vaccination in PLWH on eliciting desirable protective IRR. Furthermore, booster vaccination appears to further reduce the risk of COVID-19 infection, hospitalization, and death in PLWH compared to primary vaccination. However, more evidence is needed to confirm its effectiveness.
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Affiliation(s)
- Meng-Qun Cheng
- Department of Reproductive Medicine, The Puer People's Hospital, Pu'er, China
| | - Rong Li
- Department of Pharmacy, The Puer People's Hospital, Pu'er, China
| | - Zhi-Ying Weng
- School of Pharmaceutical Science and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, China
| | - Gao Song
- Department of Pharmacy, The Puer People's Hospital, Pu'er, China
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Duncan MC, Omondi FH, Kinloch NN, Lapointe HR, Speckmaier S, Moran-Garcia N, Lawson T, DeMarco ML, Simons J, Holmes DT, Lowe CF, Bacani N, Sereda P, Barrios R, Harris M, Romney MG, Montaner JSG, Brumme CJ, Brockman MA, Brumme ZL. Effects of COVID-19 mRNA vaccination on HIV viremia and reservoir size. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.08.23296718. [PMID: 37873490 PMCID: PMC10593027 DOI: 10.1101/2023.10.08.23296718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Objective The immunogenic nature of COVID-19 mRNA vaccines led to some initial concern that these could stimulate the HIV reservoir. We analyzed changes in plasma HIV loads (pVL) and reservoir size following COVID-19 mRNA vaccination in 62 people with HIV (PWH) receiving antiretroviral therapy (ART), and analyzed province-wide trends in pVL before and after the mass vaccination campaign. Design Longitudinal observational cohort and province-wide analysis. Methods 62 participants were sampled pre-vaccination, and one month after their first and second COVID-19 immunizations. Vaccine-induced anti-SARS-CoV-2-Spike antibodies in serum were measured using the Roche Elecsys Anti-S assay. HIV reservoirs were quantified using the Intact Proviral DNA Assay; pVL were measured using the cobas 6800 (LLOQ:20 copies/mL). The province-wide analysis included all 290,401 pVL performed in British Columbia, Canada between 2012-2022. Results Pre-vaccination, the median intact reservoir size was 77 (IQR:20-204) HIV copies/million CD4+ T-cells, compared to 74 (IQR:27-212) and 65 (IQR:22-174) post-first and -second dose, respectively (all comparisons p>0.07). Pre-vaccination, 82% of participants had pVL<20 copies/mL (max:110 copies/mL), compared to 79% post-first dose (max:183 copies/mL) and 85% post-second dose (max:79 copies/mL) (p>0.4). The magnitude of the vaccine-elicited anti-SARS-CoV-2-Spike antibody response did not correlate with changes in reservoir size nor detectable pVL frequency (p>0.6). We found no evidence linking the COVID-19 mass vaccination campaign to population-level increases in detectable pVL frequency among all PWH in the province, nor among those who maintained pVL suppression on ART. Conclusion We found no evidence that COVID-19 mRNA vaccines induced changes in HIV reservoir size nor plasma viremia.
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Affiliation(s)
- Maggie C Duncan
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - F Harrison Omondi
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Natalie N Kinloch
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Hope R Lapointe
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Sarah Speckmaier
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | | | - Tanya Lawson
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
| | - Mari L DeMarco
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Janet Simons
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Daniel T Holmes
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Christopher F Lowe
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Nic Bacani
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Paul Sereda
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Rolando Barrios
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Marianne Harris
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Marc G Romney
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Julio S G Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Chanson J Brumme
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Mark A Brockman
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, Canada
| | - Zabrina L Brumme
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
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Marchitto L, Chatterjee D, Ding S, Gendron-Lepage G, Tauzin A, Boutin M, Benlarbi M, Medjahed H, Sylla M, Lanctôt H, Durand M, Finzi A, Tremblay C. Humoral Responses Elicited by SARS-CoV-2 mRNA Vaccine in People Living with HIV. Viruses 2023; 15:2004. [PMID: 37896781 PMCID: PMC10612047 DOI: 10.3390/v15102004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/22/2023] [Accepted: 09/23/2023] [Indexed: 10/29/2023] Open
Abstract
While mRNA SARS-CoV-2 vaccination elicits strong humoral responses in the general population, humoral responses in people living with HIV (PLWH) remain to be clarified. Here, we conducted a longitudinal study of vaccine immunogenicity elicited after two and three doses of mRNA SARS-CoV-2 vaccine in PLWH stratified by their CD4 count. We measured the capacity of the antibodies elicited by vaccination to bind the Spike glycoprotein of different variants of concern (VOCs). We also evaluated the Fc-mediated effector functions of these antibodies by measuring their ability to eliminate CEM.NKr cells stably expressing SARS-CoV-2 Spikes. Finally, we measured the relative capacity of the antibodies to neutralize authentic SARS-CoV-2 virus after the third dose of mRNA vaccine. We found that after two doses of SARS-CoV-2 mRNA vaccine, PLWH with a CD4 count < 250/mm3 had lower levels of anti-RBD IgG antibodies compared to PLWH with a CD4 count > 250/mm3 (p < 0.05). A third dose increased these levels and importantly, no major differences were observed in their capacity to mediate Fc-effector functions and neutralize authentic SARS-CoV-2. Overall, our work demonstrates the importance of mRNA vaccine boosting in immuno-compromised individuals presenting low levels of CD4.
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Affiliation(s)
- Lorie Marchitto
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | | | - Shilei Ding
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada
| | | | - Alexandra Tauzin
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Marianne Boutin
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Mehdi Benlarbi
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | | | - Mohamed Sylla
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada
| | - Hélène Lanctôt
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada
| | | | - Andrés Finzi
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Cécile Tremblay
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H3C 3J7, Canada
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Zhao T, Yang Z, Wu Y, Yang J. Immunogenicity and safety of COVID-19 vaccines among people living with HIV: A systematic review and meta-analysis. Epidemiol Infect 2023; 151:e176. [PMID: 37704371 PMCID: PMC10600909 DOI: 10.1017/s095026882300153x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 08/20/2023] [Accepted: 09/07/2023] [Indexed: 09/15/2023] Open
Abstract
Available data suggest that the immunogenicity of COVID-19 vaccines might decrease in the immunocompromised population, but data on vaccine immunogenicity and safety among people living with HIV (PLWH) are still lacking. The purpose of this meta-analysis is to compare the immunogenicity and safety of COVID-19 vaccines in PLWH with healthy controls. We comprehensively searched the following databases: PubMed, Cochrane Library, and EMBASE. The risk ratio (RR) of seroconversion after the first and second doses of a COVID-19 vaccine was separately pooled using random-effects meta-analysis. Seroconversion rate was lower among PLWH compared with healthy individuals after the first (RR = 0.77, 95% confident interval (CI) 0.64-0.92) and second doses (RR = 0.97, 95%CI 0.95-0.99). The risk of total adverse reactions among PLWH is similar to the risk in the healthy group, after the first (RR = 0.87, 95%CI 0.70-1.10) and second (RR = 0.83, 95%CI 0.65-1.07) doses. This study demonstrates that the immunogenicity and safety of SARS-CoV-2 vaccine in fully vaccinated HIV-infected patients were generally satisfactory. A second dose was related to seroconversion enhancement. Therefore, we considered that a booster dose may provide better seroprotection for PLWH. On the basis of a conventional two-dose regimen for COVID-19 vaccines, the booster dose is very necessary.
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Affiliation(s)
- Tianyu Zhao
- Institute of Hepatology and Metabolic Diseases, Hangzhou Normal University, Hangzhou, China
| | - Zongxing Yang
- The Second Department of Infectious Disease, Xixi Hospital of Hangzhou, The Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuxia Wu
- Institute of Hepatology and Metabolic Diseases, Hangzhou Normal University, Hangzhou, China
| | - Jin Yang
- Institute of Hepatology and Metabolic Diseases, Hangzhou Normal University, Hangzhou, China
- Department of Translational Medicine Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
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32
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Vergori A, Matusali G, Lepri AC, Cimini E, Fusto M, Colavita F, Gagliardini R, Notari S, Mazzotta V, Mariotti D, Cicalini S, Girardi E, Vaia F, Maggi F, Antinori A. Neutralizing activity and T-cell response after bivalent fifth dose of messenger RNA vaccine in people living with HIV. Int J Infect Dis 2023; 134:195-199. [PMID: 37343783 PMCID: PMC10277256 DOI: 10.1016/j.ijid.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/26/2023] [Accepted: 06/12/2023] [Indexed: 06/23/2023] Open
Abstract
OBJECTIVES To investigate immunogenicity of SARS-CoV-2 vaccine third booster dose (3BD; fifth dose) with bivalent vaccine original/BA4/5 vaccine in people living with HIV (PLWH). METHODS This is an observational cohort study to evaluate the outcomes of SARS-CoV-2 vaccination (HIV-VAC study). We analyzed microneutralization assay and interferon-γ production in 48 PLWH on antiretroviral therapy with clusters of differentiation (CD4) count <200 cell/mm3 and/or previous AIDS according to immunization status: vaccinated PLWH who had a previous SARS-CoV-2 infection (hybrid immunization, HI) vs those only vaccinated (non-hybrid immunization, nHI) and current CD4 count. RESULTS After 15 days from its administration (T1), the 3BD bivalent messenger RNA vaccine elicited a statistically significant increase of neutralizing antibodies (nAbs) geometric mean titers from T0 to T1 against W-D614G (fold increase 4.8; P <0.0001), BA.5 (8.6 P <0.0001), BQ.1.1 (6.4, P <0.0001) and XBB.1 (6.5, P <0.0001). When compared to BA.5, nAbs geometric mean titers against BQ.1.1 and XBB.1 decreased by 3.5 and 4.1-fold, respectively. After controlling for age, years from AIDS diagnosis, CD4 count at administration and CD4 count nadir, the fold change reduction in nAbs response to other variants of concerns as compared to BA.1, was larger in participants with HI vs those nHI: 0.59 lower (95% confidence interval 0.36-0.97, P = 0.04) for BQ.1.1 and 0.67 lower (95% confidence interval: 0.47-0.96, P = 0.03) for XBB.1. In contrast, the analysis carried little evidence for an association between current CD4 count and response to the fifth dose of bivalent vaccine. Furthermore, cell-mediated immunity remained stable. CONCLUSION Our data support the current recommendation of offering bivalent mRNA vaccine booster doses to PLWH with low CD4 count or previous AIDS at first vaccination, especially in those who never previously acquired SARS-CoV-2 and regardless of current CD4 count.
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Affiliation(s)
- Alessandra Vergori
- National Institute for Infectious Diseases Lazzaro Spallanzani, Scientific Hospital and Care Institutions, HIV/AIDS Unit, Rome, Italy.
| | - Giulia Matusali
- National Institute for Infectious Diseases Lazzaro Spallanzani, Scientific Hospital and Care Institutions, Laboratory of Virology, Rome, Italy
| | - Alessandro Cozzi Lepri
- Institute for Global Health, University College of London, Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), London, UK
| | - Eleonora Cimini
- National Institute for Infectious Diseases Lazzaro Spallanzani, Scientific Hospital and Care Institutions, Immunology Unit, Rome, Italy
| | - Marisa Fusto
- National Institute for Infectious Diseases Lazzaro Spallanzani, Scientific Hospital and Care Institutions, HIV/AIDS Unit, Rome, Italy
| | - Francesca Colavita
- National Institute for Infectious Diseases Lazzaro Spallanzani, Scientific Hospital and Care Institutions, Laboratory of Virology, Rome, Italy
| | - Roberta Gagliardini
- National Institute for Infectious Diseases Lazzaro Spallanzani, Scientific Hospital and Care Institutions, HIV/AIDS Unit, Rome, Italy
| | - Stefania Notari
- National Institute for Infectious Diseases Lazzaro Spallanzani, Scientific Hospital and Care Institutions, Immunology Unit, Rome, Italy
| | - Valentina Mazzotta
- National Institute for Infectious Diseases Lazzaro Spallanzani, Scientific Hospital and Care Institutions, HIV/AIDS Unit, Rome, Italy
| | - Davide Mariotti
- National Institute for Infectious Diseases Lazzaro Spallanzani, Scientific Hospital and Care Institutions, Laboratory of Virology, Rome, Italy
| | - Stefania Cicalini
- National Institute for Infectious Diseases Lazzaro Spallanzani, Scientific Hospital and Care Institutions, HIV/AIDS Unit, Rome, Italy
| | - Enrico Girardi
- National Institute for Infectious Diseases Lazzaro Spallanzani, Scientific Hospitaller and Care Institutions, Scientific Direction, Rome, Italy
| | - Francesco Vaia
- National Institute for Infectious Diseases Lazzaro Spallanzani, Scientific Hospital and Care Institutions, General Direction, Rome, Italy
| | - Fabrizio Maggi
- National Institute for Infectious Diseases Lazzaro Spallanzani, Scientific Hospital and Care Institutions, Laboratory of Virology, Rome, Italy
| | - Andrea Antinori
- National Institute for Infectious Diseases Lazzaro Spallanzani, Scientific Hospital and Care Institutions, HIV/AIDS Unit, Rome, Italy
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Tortellini E, Fosso Ngangue YC, Dominelli F, Guardiani M, Falvino C, Mengoni F, Carraro A, Marocco R, Pasculli P, Mastroianni CM, Ciardi MR, Lichtner M, Zingaropoli MA. Immunogenicity and Efficacy of Vaccination in People Living with Human Immunodeficiency Virus. Viruses 2023; 15:1844. [PMID: 37766251 PMCID: PMC10534440 DOI: 10.3390/v15091844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
People living with HIV (PLWH) remain at high risk of mortality and morbidity from vaccine-preventable diseases, even though antiretroviral therapy (ART) has restored life expectancy and general well-being. When, which, and how many doses of vaccine should be administered over the lifetime of PLWH are questions that have become clinically relevant. Immune responses to most vaccines are known to be impaired in PLWH. Effective control of viremia with ART and restored CD4+ T-cell count are correlated with an improvement in responsiveness to routine vaccines. However, the presence of immune alterations, comorbidities and co-infections may alter it. In this article, we provide a comprehensive review of the literature on immune responses to different vaccines in the setting of HIV infection, emphasizing the potential effect of HIV-related factors and presence of comorbidities in modulating such responses. A better understanding of these issues will help guide vaccination and prevention strategies for PLWH.
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Affiliation(s)
- Eeva Tortellini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (Y.C.F.N.); (F.D.); (M.G.); (C.F.); (F.M.); (A.C.); (P.P.); (C.M.M.); (M.R.C.); (M.A.Z.)
| | - Yann Collins Fosso Ngangue
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (Y.C.F.N.); (F.D.); (M.G.); (C.F.); (F.M.); (A.C.); (P.P.); (C.M.M.); (M.R.C.); (M.A.Z.)
| | - Federica Dominelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (Y.C.F.N.); (F.D.); (M.G.); (C.F.); (F.M.); (A.C.); (P.P.); (C.M.M.); (M.R.C.); (M.A.Z.)
| | - Mariasilvia Guardiani
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (Y.C.F.N.); (F.D.); (M.G.); (C.F.); (F.M.); (A.C.); (P.P.); (C.M.M.); (M.R.C.); (M.A.Z.)
| | - Carmen Falvino
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (Y.C.F.N.); (F.D.); (M.G.); (C.F.); (F.M.); (A.C.); (P.P.); (C.M.M.); (M.R.C.); (M.A.Z.)
| | - Fabio Mengoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (Y.C.F.N.); (F.D.); (M.G.); (C.F.); (F.M.); (A.C.); (P.P.); (C.M.M.); (M.R.C.); (M.A.Z.)
| | - Anna Carraro
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (Y.C.F.N.); (F.D.); (M.G.); (C.F.); (F.M.); (A.C.); (P.P.); (C.M.M.); (M.R.C.); (M.A.Z.)
| | - Raffaella Marocco
- Infectious Diseases Unit, SM Goretti Hospital, Sapienza University of Rome, 00185 Latina, Italy; (R.M.); (M.L.)
| | - Patrizia Pasculli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (Y.C.F.N.); (F.D.); (M.G.); (C.F.); (F.M.); (A.C.); (P.P.); (C.M.M.); (M.R.C.); (M.A.Z.)
| | - Claudio Maria Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (Y.C.F.N.); (F.D.); (M.G.); (C.F.); (F.M.); (A.C.); (P.P.); (C.M.M.); (M.R.C.); (M.A.Z.)
| | - Maria Rosa Ciardi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (Y.C.F.N.); (F.D.); (M.G.); (C.F.); (F.M.); (A.C.); (P.P.); (C.M.M.); (M.R.C.); (M.A.Z.)
| | - Miriam Lichtner
- Infectious Diseases Unit, SM Goretti Hospital, Sapienza University of Rome, 00185 Latina, Italy; (R.M.); (M.L.)
- Department of Neurosciences, Mental Health, and Sense Organs, NESMOS, Sapienza University of Rome, 00185 Rome, Italy
| | - Maria Antonella Zingaropoli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (Y.C.F.N.); (F.D.); (M.G.); (C.F.); (F.M.); (A.C.); (P.P.); (C.M.M.); (M.R.C.); (M.A.Z.)
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Cernera G, Gelzo M, De Placido P, Ottaviano M, Pietroluongo E, Raia M, Scalia G, Tortora M, Castaldo G, Formisano P, Palmieri G, Giuliano M. Immunocytometric analysis of patients with thymic epithelial tumors revealed that COVID-19 vaccine booster strongly enhanced the immune response. Front Immunol 2023; 14:1233056. [PMID: 37705978 PMCID: PMC10495582 DOI: 10.3389/fimmu.2023.1233056] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/15/2023] [Indexed: 09/15/2023] Open
Abstract
Background Thymic epithelial tumors (TETs) are rare malignancies with heterogeneous clinical manifestations. The high frequency of autoimmune paraneoplastic disorders observed in such patients requires caution when using COVID-19 vaccines. Furthermore, TETs are often associated with severe immunodeficiency, making it difficult to predict vaccine immunization. Therefore, we aimed to evaluate immune response to COVID-19 vaccine in patients with TETs. Methods We conducted a prospective study enrolling patients who underwent the SARS-Cov-2 mRNA full vaccine cycle (two doses plus a booster after 6 months of BNT162b2). All patients were enrolled before receiving 1st vaccine dose and were followed over the vaccination cycle for up to 6 months after the booster dose to i) assess humoral and cellular responses, ii) define biomarkers predictive of effective immunization, and iii) evaluate the safety of the vaccine. Results At the end of the full vaccine cycle, 27 (61.4%) patients developed humoral and 38 (86.4%) cellular responses (IFN γ release by stimulated cells) and showed an increase in activated TH1 and TH17 cells, particularly significant after the booster dose. The number of B and T lymphocytes at baseline was predictive of humoral and cellular responses, respectively. Patients with no evidence of tumor lesions had a higher probability of achieving a humoral response than those with evidence of the disease. Furthermore, the percentage of patients with immune-related disorders (75%), particularly Good's syndrome (47.7%) and myasthenia gravis (29.5%), did not change over the entire vaccine cycle. Overall, 19 of the 44 enrolled patients (43.2%) had COVID-19 during the observation period; none required hospitalization or oxygen support, and no fatalities were observed. Conclusion SARS-Cov-2 mRNA vaccine determines the immune responses in patients with TET, particularly after the booster dose, and in patients with no evidence of tumor lesions. Preliminary analysis of B and T lymphocytes may help identify patients who have a lower probability of achieving effective humoral and cellular responses and thus may need passive immunization. The vaccine prevented severe COVID-19 infection and is safe.
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Affiliation(s)
- Gustavo Cernera
- CEINGE-Biotecnologie avanzate, scarl, Naples, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy
| | - Monica Gelzo
- CEINGE-Biotecnologie avanzate, scarl, Naples, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy
| | - Pietro De Placido
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli Federico II, Naples, Italy
| | - Margaret Ottaviano
- Dipartimento di Melanoma, Immunoterapia Oncologica e Terapie Innovative, IRCCS Fondazione G. Pascale, Naples, Italy
- Centro Regionale di Coordinamento Tumori Rari Regione Campania (CRCTR), Naples, Italy
| | - Erica Pietroluongo
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli Federico II, Naples, Italy
| | | | | | - Marianna Tortora
- Centro Regionale di Coordinamento Tumori Rari Regione Campania (CRCTR), Naples, Italy
| | - Giuseppe Castaldo
- CEINGE-Biotecnologie avanzate, scarl, Naples, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy
| | - Pietro Formisano
- Dipartimento di Scienze Mediche Traslazionali, Università di Napoli Federico II, Naples, Italy
| | - Giovannella Palmieri
- Centro Regionale di Coordinamento Tumori Rari Regione Campania (CRCTR), Naples, Italy
| | - Mario Giuliano
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli Federico II, Naples, Italy
- Centro Regionale di Coordinamento Tumori Rari Regione Campania (CRCTR), Naples, Italy
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Lan X, Su B, Liang S, Yu M, Qiao Y, Wang L, Song M, Wang Y, Xu J. Willingness of people living with HIV to receive a second COVID-19 booster dose: a multicenter cross-sectional study in China. Front Public Health 2023; 11:1227277. [PMID: 37680268 PMCID: PMC10480566 DOI: 10.3389/fpubh.2023.1227277] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/10/2023] [Indexed: 09/09/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has significantly affected the global population, with People Living with HIV (PLWH) being particularly vulnerable due to their compromised immune systems. Although vaccination is a crucial preventative measure against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, little is understood about the willingness of PLWH to receive a second COVID-19 booster dose and the factors that may influence this decision. This study investigates the willingness of PLWH in China to receive a second COVID-19 booster dose and its influencing factors, comparing these with a group of healthy individuals. Methods A multicenter cross-sectional study was conducted across five Chinese cities, namely, Beijing, Tianjin, Zhengzhou, Hohhot, and Harbin. Participants were recruited through five community-based organizations. Data were collected via participant self-administered questionnaires included demographic information, willingness to receive a second COVID-19 booster dose, and knowledge about HIV and COVID-19 vaccination. Factors influencing vaccination willingness were identified using multivariable logistic regression analyzes. Results A total of 156 PLWH and 151 healthy individuals were included in the study. After adjusting for potential confounders, it was found that PLWH demonstrated a lower willingness to receive a second COVID-19 booster dose compared to healthy individuals (77.6% vs. 88.7%, p = 0.009). Lower willingness was associated with HIV positive status (Adjusted Odds Ratio [AOR]: 0.39, 95%CI: 0.20, 0.75), perceived barriers (AOR: 0.05, 95%CI: 0.01, 0.26), and perceived severity (AOR: 0.32, 95%CI: 0.12, 0.90). Conclusion PLWH in China demonstrated a lower willingness to receive a second COVID-19 booster dose compared to healthy individuals. The findings suggest that perceptions and understanding of the COVID-19 vaccination and its necessity for protection against SARS-CoV-2 could influence this willingness. Efforts should be made to strengthen and disseminate knowledge about HIV and COVID-19 vaccinations among this population. In addition, developing interventions and policies that target specific subgroups and address misconceptions about vaccination could be instrumental in improving vaccination rates among PLWH.
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Affiliation(s)
- Xinquan Lan
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Bin Su
- Beijing Key Laboratory for HIV/AIDS Research, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Shijie Liang
- Department of Infection, Zhengzhou Center for Disease Control and Prevention, Zhengzhou, China
| | - Maohe Yu
- Department of AIDS/STD Control and Prevention, Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - Ying Qiao
- Department of Infection, The Second Hospital of Hohhot, Hohhot, China
| | - Li Wang
- Department of Infection, Heilongjiang Provincial Hospital, Harbin, China
| | - Moxin Song
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Yuxiao Wang
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Junjie Xu
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
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Antinori A, Bausch-Jurken M. The Burden of COVID-19 in the Immunocompromised Patient: Implications for Vaccination and Needs for the Future. J Infect Dis 2023; 228:S4-S12. [PMID: 37539764 PMCID: PMC10401620 DOI: 10.1093/infdis/jiad181] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023] Open
Abstract
Approximately 3% of US adults are immunocompromised and less capable of fighting infections such as SARS-CoV-2 (the causative agent of COVID-19). Individuals may be immunocompromised for reasons related to an underlying medical condition or to immunomodulatory therapies that alter the immune response. In general, vaccination with mRNA-based vaccines is effective at reducing COVID-19-associated hospitalization and death among immunocompromised populations, particularly after 3 or more doses. However, the immunocompromised population is heterogeneous, with COVID-19 vaccine-elicited immune responses and risk for severe COVID-19 existing on a continuum. Therefore, understanding the impact of vaccination and the complexity of immune responses across heterogeneous immunocompromised individuals is essential for guiding effective vaccination regimens including additional (booster) doses. In this article, we provide an overview of the immunocompromised population and the burden of disease attributable to COVID-19, while discussing key opportunities and challenges of vaccinating immunocompromised individuals.
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Affiliation(s)
- Andrea Antinori
- Correspondence: Andrea Antinori, MD, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Via Portuense, 292, 00149 Roma RM, Italy (); Mary Bausch-Jurken, PhD, Moderna, Inc., 200 Technology Square, Cambridge, MA 02139, USA ()
| | - Mary Bausch-Jurken
- Correspondence: Andrea Antinori, MD, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Via Portuense, 292, 00149 Roma RM, Italy (); Mary Bausch-Jurken, PhD, Moderna, Inc., 200 Technology Square, Cambridge, MA 02139, USA ()
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Motsoeneng BM, Manamela NP, Kaldine H, Kgagudi P, Hermanus T, Ayres F, Makhado Z, Moyo-Gwete T, van der Mescht MA, Abdullah F, Boswell MT, Ueckermann V, Rossouw TM, Madhi SA, Moore PL, Richardson SI. Despite delayed kinetics, people living with HIV achieve equivalent antibody function after SARS-CoV-2 infection or vaccination. Front Immunol 2023; 14:1231276. [PMID: 37600825 PMCID: PMC10435738 DOI: 10.3389/fimmu.2023.1231276] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
The kinetics of Fc-mediated functions following SARS-CoV-2 infection or vaccination in people living with HIV (PLWH) are not known. We compared SARS-CoV-2 spike-specific Fc functions, binding, and neutralization in PLWH and people without HIV (PWOH) during acute infection (without prior vaccination) with either the D614G or Beta variants of SARS-CoV-2, or vaccination with ChAdOx1 nCoV-19. Antiretroviral treatment (ART)-naïve PLWH had significantly lower levels of IgG binding, neutralization, and antibody-dependent cellular phagocytosis (ADCP) compared with PLWH on ART. The magnitude of antibody-dependent cellular cytotoxicity (ADCC), complement deposition (ADCD), and cellular trogocytosis (ADCT) was differentially triggered by D614G and Beta. The kinetics of spike IgG-binding antibodies, ADCC, and ADCD were similar, irrespective of the infecting variant between PWOH and PLWH overall. However, compared with PWOH, PLWH infected with D614G had delayed neutralization and ADCP. Furthermore, Beta infection resulted in delayed ADCT, regardless of HIV status. Despite these delays, we observed improved coordination between binding and neutralizing responses and Fc functions in PLWH. In contrast to D614G infection, binding responses in PLWH following ChAdOx-1 nCoV-19 vaccination were delayed, while neutralization and ADCP had similar timing of onset, but lower magnitude, and ADCC was significantly higher than in PWOH. Overall, despite delayed and differential kinetics, PLWH on ART develop comparable responses to PWOH, supporting the prioritization of ART rollout and SARS-CoV-2 vaccination in PLWH.
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Affiliation(s)
- Boitumelo M. Motsoeneng
- South African Medical Research Council Antibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- HIV Virology Section, Centre for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Nelia P. Manamela
- South African Medical Research Council Antibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- HIV Virology Section, Centre for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Haajira Kaldine
- South African Medical Research Council Antibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- HIV Virology Section, Centre for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Prudence Kgagudi
- South African Medical Research Council Antibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- HIV Virology Section, Centre for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Tandile Hermanus
- South African Medical Research Council Antibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- HIV Virology Section, Centre for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Frances Ayres
- South African Medical Research Council Antibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- HIV Virology Section, Centre for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Zanele Makhado
- South African Medical Research Council Antibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- HIV Virology Section, Centre for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Thandeka Moyo-Gwete
- South African Medical Research Council Antibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- HIV Virology Section, Centre for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
| | - Mieke A. van der Mescht
- Department of Immunology, Faculty of Health Science, University of Pretoria, Pretoria, South Africa
| | - Fareed Abdullah
- Division for Infectious Diseases, Department of Internal Medicine, Steve Biko Academic Hospital and University of Pretoria, Pretoria, South Africa
- South African Medical Research Council Office of AIDS and TB Research, Pretoria, South Africa
| | - Michael T. Boswell
- Division for Infectious Diseases, Department of Internal Medicine, Steve Biko Academic Hospital and University of Pretoria, Pretoria, South Africa
| | - Veronica Ueckermann
- Division for Infectious Diseases, Department of Internal Medicine, Steve Biko Academic Hospital and University of Pretoria, Pretoria, South Africa
| | - Theresa M. Rossouw
- Department of Immunology, Faculty of Health Science, University of Pretoria, Pretoria, South Africa
| | - Shabir A. Madhi
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- African Leadership in Vaccinology Expertise, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Infectious Diseases and Oncology Research Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Penny L. Moore
- South African Medical Research Council Antibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- HIV Virology Section, Centre for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu Natal, Durban, South Africa
| | - Simone I. Richardson
- South African Medical Research Council Antibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- HIV Virology Section, Centre for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa
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Ahmad A, Samarani S, Costiniuk CT. Antibody and T-cell responses elicited by coronavirus disease 2019 vaccination in people with HIV-1: the case of late presenters. AIDS 2023; 37:1625-1627. [PMID: 37450628 PMCID: PMC10355331 DOI: 10.1097/qad.0000000000003624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Ali Ahmad
- Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada
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Tau L, Hagin D, Freund T, Halperin T, Adler A, Marom R, Ahsanov S, Matus N, Levi I, Gerber G, Lev S, Ziv-Baran T, Turner D. Humoral and Cellular Immune Responses of People Living With Human Immunodeficiency Virus After 3 Doses of Messenger RNA BNT162b2 Severe Acute Respiratory Syndrome Coronavirus 2 Vaccine: A Prospective Cohort Study. Open Forum Infect Dis 2023; 10:ofad347. [PMID: 37539062 PMCID: PMC10394980 DOI: 10.1093/ofid/ofad347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/07/2023] [Indexed: 08/05/2023] Open
Abstract
Background Recent studies have shown good serological and cellular immune responses in people living with human immunodeficiency virus (PLWH) after receipt of 2 doses of messenger RNAA (mRNA) severe acute respiratory syndrome coronavirus 2 vaccine. Data are missing regarding the response after 3 vaccine doses. Methods We followed up a group of PLWH who received 3 doses of the mRNA BNT162b2 vaccine and for whom data of humoral immune response after 2 vaccine doses were available. Patients provided a blood sample 4-6 months after the booster dose. The aim of the study was to measure the serological and cellular response after the third dose and to evaluate factors associated with the vaccine response. Results Fifty patients have provided a serum sample for serological evaluation after the booster. The anti-receptor-binding domain (RBD) immunoglobulin (Ig) G titers were higher after the booster with a median delta of 3240 arbitrary units/mL. The median CD4+ T-cell count was 660/μL (interquartile range, 515-958/μL) and had no influence on the antibody level. Factors associated with lower delta included higher CD8+ T-cell count (P = .02) and longer time between the third dose and the blood test (P = .01). Higher anti-RBD IgG titer after the second vaccine (P = .03), as well as a longer interval between second and third doses (P = .031) were associated with higher delta. There was no increase in the median number of activated interferon γ+ and tumor necrosis factor α+ CD4+ T cells after the booster (n = 8). Conclusions The anti-RBD IgG level after 3 doses of mRNA BNT162b2 vaccine was higher than the level after 2 doses, suggesting additional value of the booster. Cellular response did not further increase after a booster.
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Affiliation(s)
- Luba Tau
- Crusaid Kobler AIDS Center, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - David Hagin
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Department of Allergy and Clinical Immunology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Tal Freund
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Department of Allergy and Clinical Immunology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Tamar Halperin
- Microbiological Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Amos Adler
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Microbiological Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Rotem Marom
- Microbiological Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Svetlana Ahsanov
- Microbiological Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Natasha Matus
- Microbiological Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Inbar Levi
- Microbiological Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Gal Gerber
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shir Lev
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Dan Turner
- Crusaid Kobler AIDS Center, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Bordry N, Mamez AC, Fedeli C, Cantero C, Jaksic C, Alonso PU, Rayroux C, Berra G, Portillo V, Puntel M, Yerly S, Bugeia S, Gutknecht G, Di Marco M, Mach N, Soccal PM, Chalandon Y, Calmy A, Addeo A. SARS-CoV-2 m-RNA Vaccine Response in Immunocompromised Patients: A Monocentric Study Comparing Cancer, People Living with HIV, Hematopoietic Stem Cell Transplant Patients and Lung Transplant Recipients. Vaccines (Basel) 2023; 11:1284. [PMID: 37631852 PMCID: PMC10459936 DOI: 10.3390/vaccines11081284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/12/2023] [Accepted: 07/19/2023] [Indexed: 08/27/2023] Open
Abstract
Immunocompromised patients (ICPs) have a higher risk of developing severe forms of COVID-19 and experience a higher burden of complications and mortality than the general population. However, recent studies have suggested that the antibody response to SARS-CoV-2 mRNA vaccines could be highly variable among different ICPs. Using a collaborative, monocentric, prospective cohort study, we assessed anti-SARS-CoV-2 spike protein antibody titers following two and three doses of mRNA vaccines in four groups of ICPs (cancer [n = 232]: hematopoietic stem cell transplant [HSCT; n = 126] patients; people living with HIV [PLWH; n = 131]; and lung transplant [LT; n = 39] recipients) treated at Geneva University Hospitals; and healthy individuals (n = 49). After primo-vaccination, the highest anti-S antibody geometric mean titer (IU/mL) was observed in healthy individuals (2417 IU/mL [95% CI: 2327-2500]), the PLWH group (2024 IU/mL [95% CI:1854-2209]) and patients with cancer (840 IU/mL [95% CI: 625-1129]), whereas patients in the HSCT and LT groups had weaker antibody responses (198 IU/mL [95% CI: 108-361] and 7.3 IU/mL [95% CI: 2.5-22]). The booster dose conferred a high antibody response after 1 month in both PLWH (2500 IU/mL) and cancer patients (2386 IU/mL [95% CI: 2182-2500]), a moderate response in HSCT patients (521 IU/mL [95% CI: 306-885]) and a poor response in LT recipients (84 IU/mL [95% CI: 18-389]). Contemporary treatment with immunosuppressive drugs used in transplantation or chemotherapy was associated with a poor response to vaccination. Our findings confirmed the heterogeneity of the humoral response after mRNA vaccines among different ICPs and the need for personalized recommendations for each of these different groups.
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Affiliation(s)
- Natacha Bordry
- Department of Oncology, Geneva University Hospitals, University of Geneva and Swiss Cancer Center Leman, 1205 Geneva, Switzerland; (N.B.)
| | - Anne-Claire Mamez
- Department of Haematology, Geneva University Hospitals and Faculty of Medicine University of Geneva, 1205 Geneva, Switzerland; (A.-C.M.)
| | - Chiara Fedeli
- Department of Infectious Diseases, Geneva University Hospitals, University of Geneva, 1205 Geneva, Switzerland (A.C.)
| | - Chloé Cantero
- Department of Pneumology, Geneva University Hospitals, University of Geneva, 1205 Geneva, Switzerland
| | - Cyril Jaksic
- CRC & Division of Clinical Epidemiology, Department of Health and Community Medicine, University of Geneva and Geneva University Hospital, 1205 Geneva, Switzerland
| | - Pilar Ustero Alonso
- Department of Infectious Diseases, Geneva University Hospitals, University of Geneva, 1205 Geneva, Switzerland (A.C.)
| | - Caroline Rayroux
- Department of Pneumology, Geneva University Hospitals, University of Geneva, 1205 Geneva, Switzerland
| | - Gregory Berra
- Department of Pneumology, Geneva University Hospitals, University of Geneva, 1205 Geneva, Switzerland
| | - Vera Portillo
- Department of Infectious Diseases, Geneva University Hospitals, University of Geneva, 1205 Geneva, Switzerland (A.C.)
| | - Maeva Puntel
- Department of Infectious Diseases, Geneva University Hospitals, University of Geneva, 1205 Geneva, Switzerland (A.C.)
| | - Sabine Yerly
- Laboratory of Virology, Division of Laboratory Medicine, Geneva University Hospitals & Faculty of Medicine, 1205 Geneva, Switzerland
| | - Sébastien Bugeia
- Department of Oncology, Geneva University Hospitals, University of Geneva and Swiss Cancer Center Leman, 1205 Geneva, Switzerland; (N.B.)
| | - Garance Gutknecht
- Department of Oncology, Geneva University Hospitals, University of Geneva and Swiss Cancer Center Leman, 1205 Geneva, Switzerland; (N.B.)
| | - Mariagrazia Di Marco
- Department of Oncology, Geneva University Hospitals, University of Geneva and Swiss Cancer Center Leman, 1205 Geneva, Switzerland; (N.B.)
| | - Nicolas Mach
- Department of Oncology, Geneva University Hospitals, University of Geneva and Swiss Cancer Center Leman, 1205 Geneva, Switzerland; (N.B.)
| | - Paola Marina Soccal
- Department of Pneumology, Geneva University Hospitals, University of Geneva, 1205 Geneva, Switzerland
| | - Yves Chalandon
- Department of Haematology, Geneva University Hospitals and Faculty of Medicine University of Geneva, 1205 Geneva, Switzerland; (A.-C.M.)
| | - Alexandra Calmy
- Department of Infectious Diseases, Geneva University Hospitals, University of Geneva, 1205 Geneva, Switzerland (A.C.)
| | - Alfredo Addeo
- Department of Oncology, Geneva University Hospitals, University of Geneva and Swiss Cancer Center Leman, 1205 Geneva, Switzerland; (N.B.)
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El Moussaoui M, Desmecht S, Lambert N, Maes N, Braghini J, Marechal N, Quintana C, Briquet K, Gofflot S, Toussaint F, Hayette MP, Vermeersch P, Lutteri L, Grégoire C, Beguin Y, Rahmouni S, Moutschen M, Desmecht D, Darcis G. Cluster Analysis Identifies Distinct Patterns of T-Cell and Humoral Immune Responses Evolution Following a Third Dose of SARS-CoV-2 Vaccine in People Living with HIV. Viruses 2023; 15:1435. [PMID: 37515123 PMCID: PMC10383048 DOI: 10.3390/v15071435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/08/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Many vaccines require higher, additional doses or adjuvants to provide adequate protection for people living with HIV (PLWH). Despite their potential risk of severe coronavirus disease 2019, immunological data remain sparse, and a clear consensus for the best booster strategy is lacking. (2) Methods: Using the data obtained from our previous study assessing prospective T-cell and humoral immune responses before and after administration of a third dose of SARS-CoV-2 vaccine, we assessed the correlations between immune parameters reflecting humoral and cellular immune responses. We further aimed at identifying distinct clusters of patients with similar patterns of immune response evolution to determine how these relate to demographic and clinical factors. (3) Results: Among 80 PLWH and 51 healthcare workers (HCWs) enrolled in the study, cluster analysis identified four distinct patterns of evolution characterised by specific immune patterns and clinical factors. We observed that immune responses appeared to be less robust in cluster A, whose individuals were mostly PLWH who had never been infected with SARS-CoV-2. Cluster C, whose individuals showed a particularly drastic increase in markers of humoral immune response following the third dose of vaccine, was mainly composed of female participants who experienced SARS-CoV-2. Regarding the correlation study, although we observed a strong positive correlation between markers mirroring humoral immune response, markers of T-cell response following vaccination correlated only in a lesser extent with markers of humoral immunity. This suggests that neutralising antibody titers alone are not always a reliable reflection of the magnitude of the whole immune response. (4) Conclusions: Our findings show heterogeneity in immune responses among SARS-CoV-2 vaccinated PLWH. Specific subgroups could therefore benefit from distinct immunization strategies. Prior or breakthrough natural infection enhances the activity of vaccines and must be taken into account for informing global vaccine strategies among PLWH, even those with a viro-immunologically controlled infection.
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Affiliation(s)
- Majdouline El Moussaoui
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liège, Belgium
| | - Salomé Desmecht
- Laboratory of Animal Genomics, GIGA-Medical Genomics, GIGA-Institute, University of Liège, 4000 Liège, Belgium
| | - Nicolas Lambert
- Department of Neurology, University Hospital of Liège, 4000 Liège, Belgium
| | - Nathalie Maes
- Biostatistics and Research Method Center (B-STAT), University Hospital of Liège, 4000 Liège, Belgium
| | - Joachim Braghini
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liège, Belgium
| | - Nicole Marechal
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liège, Belgium
| | - Céline Quintana
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liège, Belgium
| | - Karine Briquet
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liège, Belgium
| | - Stéphanie Gofflot
- Department of Biothèque Hospitalo-Universitaire de Liège (BHUL), University Hospital of Liège, 4000 Liège, Belgium
| | - Françoise Toussaint
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liège, Belgium
| | - Marie-Pierre Hayette
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liège, Belgium
| | - Pieter Vermeersch
- Department of Laboratory Medicine, University Hospital of Leuven, 3000 Leuven, Belgium
| | - Laurence Lutteri
- Department of Clinical Chemistry, University Hospital of Liège, 4000 Liège, Belgium
| | - Céline Grégoire
- Department of Haematology, University Hospital of Liège, University of Liège, 4000 Liège, Belgium
| | - Yves Beguin
- Department of Biothèque Hospitalo-Universitaire de Liège (BHUL), University Hospital of Liège, 4000 Liège, Belgium
- Department of Haematology, University Hospital of Liège, University of Liège, 4000 Liège, Belgium
| | - Souad Rahmouni
- Laboratory of Animal Genomics, GIGA-Medical Genomics, GIGA-Institute, University of Liège, 4000 Liège, Belgium
| | - Michel Moutschen
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liège, Belgium
| | - Daniel Desmecht
- Department of Animal Pathology, Fundamental and Applied Research for Animals & Health, University of Liège, 4000 Liège, Belgium
| | - Gilles Darcis
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liège, Belgium
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Petrone L, Sette A, de Vries RD, Goletti D. The Importance of Measuring SARS-CoV-2-Specific T-Cell Responses in an Ongoing Pandemic. Pathogens 2023; 12:862. [PMID: 37513709 PMCID: PMC10385870 DOI: 10.3390/pathogens12070862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023] Open
Abstract
Neutralizing antibodies are considered a correlate of protection against SARS-CoV-2 infection and severe COVID-19, although they are not the only contributing factor to immunity: T-cell responses are considered important in protecting against severe COVID-19 and contributing to the success of vaccination effort. T-cell responses after vaccination largely mirror those of natural infection in magnitude and functional capacity, but not in breadth, as T-cells induced by vaccination exclusively target the surface spike glycoprotein. T-cell responses offer a long-lived line of defense and, unlike humoral responses, largely retain reactivity against the SARS-CoV-2 variants. Given the increasingly recognized role of T-cell responses in protection against severe COVID-19, the circulation of SARS-CoV-2 variants, and the potential implementation of novel vaccines, it becomes imperative to continuously monitor T-cell responses. In addition to "classical" T-cell assays requiring the isolation of peripheral blood mononuclear cells, simple whole-blood-based interferon-γ release assays have a potential role in routine T-cell response monitoring. These assays could be particularly useful for immunocompromised people and other clinically vulnerable populations, where interactions between cellular and humoral immunity are complex. As we continue to live alongside COVID-19, the importance of considering immunity as a whole, incorporating both humoral and cellular responses, is crucial.
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Affiliation(s)
- Linda Petrone
- Translational Research Unit, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, 00149 Rome, Italy;
| | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA;
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego (UCSD), La Jolla, CA 92037, USA
| | - Rory D. de Vries
- Department Viroscience, Erasmus University Medical Center, 3015CN Rotterdam, The Netherlands;
| | - Delia Goletti
- Translational Research Unit, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, 00149 Rome, Italy;
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Huang CF, Jang TY, Wu PH, Kuo MC, Yeh ML, Wang CW, Liang PC, Wei YJ, Hsu PY, Huang CI, Hsieh MY, Lin YH, Hsiao HH, Hsu CM, Huang CT, Lee CY, Chen YH, Chen TC, Lin KD, Wang SH, Wang SF, Huang JF, Dai CY, Chuang WL, Yu ML. Impact of comorbidities on the serological response to COVID-19 vaccination in a Taiwanese cohort. Virol J 2023; 20:112. [PMID: 37268999 DOI: 10.1186/s12985-023-02056-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 04/27/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND/AIMS Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is one of the best policies to control COVID-19 pandemic. The serological response to COVID-19 vaccination in Taiwanese patients with different comorbidities is elusive. METHODS Uninfected subjects who received 3 doses of mRNA vaccines (BNT162b2 [Pfizer-BioNTech, BNT] and mRNA-1273 [Moderna]), viral vector-based vaccines (ChAdOx1-S (AZD1222, AZ) or protein subunit vaccines (Medigen COVID-19 vaccine) were prospectively enrolled. The SARS-CoV-2-IgG spike antibody level was determined within three months after the 3rd dose of vaccination. The Charlson Comorbidity Index (CCI) was applied to determine the association between vaccine titers and underlying comorbidities. RESULTS A total of 824 subjects were enrolled in the current study. The proportions of CCI scores of 0-1, 2-3 and > 4 were 52.8% (n = 435), 31.3% (n = 258) and 15.9% (n = 131), respectively. The most commonly used vaccination combination was AZ-AZ-Moderna (39.2%), followed by Moderna-Moderna-Moderna (27.8%). The mean vaccination titer was 3.11 log BAU/mL after a median of 48 days after the 3rd dose. Factors associated with potentially effective neutralization capacity (IgG level ≥ 4160 AU/mL) included age ≥ 60 years (odds ratio [OR]/95% confidence interval [CI]: 0.50/0.34-0.72, P < 0.001), female sex (OR/CI: 1.85/1.30-2.63, P = 0.001), Moderna-Moderna-based vaccination (compared to AZ-AZ-based vaccination, OR/CI: 6.49/3.90-10.83, P < 0.001), BNT-BNT-based vaccination (compared to AZ-AZ-based vaccination, OR/CI: 7.91/1.82-34.3, P = 0.006) and a CCI score ≥ 4 (OR/CI: 0.53/0.34-0.82, P = 0.004). There was a decreasing trend in antibody titers with increasing CCI scores (trend P < 0.001). Linear regression analysis revealed that higher CCI scores (β: - 0.083; 95% CI: - 0.094-0.011, P = 0.014) independently correlated with low IgG spike antibody levels. CONCLUSIONS Subjects with more comorbidities had a poor serological response to 3 doses of COVID-19 vaccination.
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Affiliation(s)
- Chung-Feng Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou Road, Kaohsiung City, 807, Taiwan
- Ph.D. Program in Translational Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Academia Sinica, Taipei, Taiwan
- Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tyng-Yuan Jang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou Road, Kaohsiung City, 807, Taiwan
| | - Ping-Hsun Wu
- Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Mei-Chuan Kuo
- Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Lun Yeh
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou Road, Kaohsiung City, 807, Taiwan
- Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Wen Wang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou Road, Kaohsiung City, 807, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po-Cheng Liang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou Road, Kaohsiung City, 807, Taiwan
| | - Yu-Ju Wei
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou Road, Kaohsiung City, 807, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po-Yao Hsu
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou Road, Kaohsiung City, 807, Taiwan
| | - Ching-I Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou Road, Kaohsiung City, 807, Taiwan
- Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Yen Hsieh
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou Road, Kaohsiung City, 807, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Hung Lin
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou Road, Kaohsiung City, 807, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hui-Hua Hsiao
- Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chin-Mu Hsu
- Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chien-Tzu Huang
- Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Yuan Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Medicine, M.Sc. Program in Tropical Medicine, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yen-Hsu Chen
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Medicine, Graduate Institute of Medicine, Sepsis Research Center, Center of Tropical Medicine and Infectious Diseases, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Biological Science and Technology, College of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
- School of Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Tun-Chieh Chen
- Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | - Shuo-Hung Wang
- Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sheng-Fan Wang
- Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jee-Fu Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou Road, Kaohsiung City, 807, Taiwan
- Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Yen Dai
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou Road, Kaohsiung City, 807, Taiwan
- Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wan-Long Chuang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou Road, Kaohsiung City, 807, Taiwan
- Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Lung Yu
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou Road, Kaohsiung City, 807, Taiwan.
- Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- School of Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan.
- School of Medicine, and Doctoral Program of Clinical and Experimental Medicine, College of Medicine, Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-Sen University, Kaohsiung, Taiwan.
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
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Fusco FM, Carleo MA, Sangiovanni N, D'Abbraccio M, Tambaro O, Borrelli F, Viglietti R, Camaioni C, Bruner V, Falanga R, Pisapia R, Palmiero G, Rizzo V, Rosario P, Cuomo N, Spatarella M, Esposito V, Sangiovanni V. Does COVID-19 Vaccination with BNT162b2 Influence HIV-Related Immunological and Virological Markers? Data from 235 Persons Living with HIV at Cotugno Hospital, Naples, Italy: Immune Response After Second and Third Doses, and Influence on Immunovirological Markers. Viral Immunol 2023; 36:360-365. [PMID: 37140991 DOI: 10.1089/vim.2022.0182] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
Few data are available on the impact of COVID-19 vaccination on CD4 counts and HIV-RNA in persons living with HIV (PLWH). We present the data of 235 PLWH who were vaccinated with BNT162b2 in March 2021-February 2022 at the "Cotugno" hospital in Naples. PLWH treated at the "Cotugno" hospital, who were vaccinated at the hospital vaccination center, without prior COVID-19 and for whom immunological/virological data were available in the last 12 months and in the 6 months after vaccination were included. Antispike Ab were available for 187 and 64 PLWH after the second and third doses: PLWH with antispikes >33 binding antibodies units (BAU)/mL increased from 91% to 98%. Antinucleocapsid Ab performed in 147 and 56 patients identified 19 (13%) asymptomatic/paucisymptomatic COVID-19 infections after the second dose and an additional 15 (27%) after the third dose. Immunological/virological data were collected before vaccination (T0), after the second dose (T1), and after the third dose (T2). The absolute number of CD4 increased after the third dose (median 663, 657, and 707 at T0, T1, and T2; p < 0.000 T0 vs. T2). The proportion of patients with HIV-RNA <50 copies/mL increases significantly after the second dose (73%; 85.7%; 87.7%; p < 0.000 T0 vs. T2). The presence of COVID-19 asymptomatic/paucisymptomatic infections (demonstrated by the presence of antinucleocapsid Ab) significantly increases SARS-CoV-2 antispike Ab after second dose, but not after third dose. Asymptomatic/paucisymptomatic COVID-19 infections do not have influence on CD4 cell number and HIV-RNA level. Similarly, the presence of not-controlled HIV-RNA (HIV-RNA >50 copies/mL) does not influence antispike Ab response. According to our data, the response to SARS-CoV2 vaccination is effective in people living with HIV. Vaccination against COVID-19 appears to positively affect immunological and virological levels in people living with HIV.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Rosa Falanga
- "D. Cotugno" Hospital, AOS dei Colli, Naples, Italy
| | | | | | | | | | - Nunzia Cuomo
- "D. Cotugno" Hospital, AOS dei Colli, Naples, Italy
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Abstract
PURPOSE OF REVIEW Persons living with HIV (PLWH) may have a moderately increased risk of morbidity and mortality from COVID-19 infection, especially if viral load is not controlled and if they are immunosuppressed. Vaccination against SARS-CoV-2 is the most effective measure to prevent morbidity and mortality. However, individuals with HIV/AIDS may have less protection after vaccination. The purpose of this review is to summarize some of the recent studies focused on examining the safety, immunogenicity and effectiveness of anti-SARS-CoV-2 vaccines. RECENT FINDINGS The safety of all anti-SARS-CoV-2 vaccines among PLWH is not different from the safety of these vaccines among HIV-negative individuals and is acceptable. PLWH with viral suppression and immune reconstitution (CD4 + cell count > 350 cells/μl) may reach almost same immunogenicity such as people without HIV albeit antibody levels and neutralization may decline more rapidly than in people without HIV. PLWH with viremia or immunosuppressed, especially AIDS, have less immunogenicity. SUMMARY Full vaccination against SARS-CoV-2 is a well tolerated and efficient way to prevent mortality and morbidity from COVID-19 among PLWH and AIDS patients. It is very important to follow recommended booster vaccination for a continuous and prompt immunogenicity.
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Affiliation(s)
- Itzchak Levy
- Infectious Disease Unit, Sheba Medical Center, Tel Hashomer
- Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Galia Rahav
- Infectious Disease Unit, Sheba Medical Center, Tel Hashomer
- Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
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Santoro A, Capri A, Petrone D, Colavita F, Meschi S, Matusali G, Mizzoni K, Notari S, Agrati C, Goletti D, Pezzotti P, Puro V. SARS-CoV-2 Breakthrough Infections According to the Immune Response Elicited after mRNA Third Dose Vaccination in COVID-19-Naïve Hospital Personnel. Biomedicines 2023; 11:biomedicines11051247. [PMID: 37238918 DOI: 10.3390/biomedicines11051247] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/19/2023] [Accepted: 04/22/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Vaccine-induced SARS-CoV-2-anti-spike antibody (anti-S/RBD) titers are often used as a marker of immune protection and to anticipate the risk of breakthrough infections, although no clear cut-off is available. We describe the incidence of SARS-CoV-2 vaccine breakthrough infections in COVID-19-free personnel of our hospital, according to B- and T-cell immune response elicited one month after mRNA third dose vaccination. METHODS The study included 487 individuals for whom data on anti-S/RBD were available. Neutralizing antibody titers (nAbsT) against the ancestral Whuan SARS-CoV-2, and the BA.1 Omicron variant, and SARS-CoV-2 T-cell specific response were measured in subsets of 197 (40.5%), 159 (32.6%), and 127 (26.1%) individuals, respectively. RESULTS On a total of 92,063 days of observation, 204 participants (42%) had SARS-CoV-2 infection. No significant differences in the probability of SARS-CoV-2 infection for different levels of anti-S/RBD, nAbsT, Omicron nAbsT, or SARS-CoV-2 T cell specific response, and no protective thresholds for infection were found. CONCLUSIONS Routine testing for vaccine-induced humoral immune response to SARS-CoV-2 is not recommended if measured as parameters of 'protective immunity' from SARS-CoV-2 after vaccination. Whether these findings apply to new Omicron-specific bivalent vaccines is going to be evaluated.
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Affiliation(s)
- Annapaola Santoro
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
- Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Andrea Capri
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
| | - Daniele Petrone
- Department of Infectious Diseases, National Institute of Health (ISS), 00161 Rome, Italy
| | - Francesca Colavita
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
| | - Silvia Meschi
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
| | - Giulia Matusali
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
| | - Klizia Mizzoni
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
| | - Stefania Notari
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
| | - Chiara Agrati
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
- Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Delia Goletti
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, National Institute of Health (ISS), 00161 Rome, Italy
| | - Vincenzo Puro
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
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Lu T, Chen Z, Cao Y, Ao L, Li Z, Gu X, Ren X, Wang Y, Zhang G, Xiang D, Chen M, Cai D, Hu P, Zhang D, Peng M, Shi X, Ren H. Dynamic immunogenicity after primary and booster inactivated SARS-CoV-2 vaccination in people living with HIV: A longitudinal observational study. J Med Virol 2023; 95:e28730. [PMID: 37185852 DOI: 10.1002/jmv.28730] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/17/2023] [Accepted: 04/04/2023] [Indexed: 05/17/2023]
Abstract
People living with HIV (PLWH) have poor outcomes from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); vaccination reduces the associated mortality. The humoral immune response dynamics after booster inactivated vaccinations in PLWH remain unclear. In this longitudinal observational study, 100 PLWH after primary inactivated SARS-CoV-2 vaccination were consecutively recruited and followed up. After booster vaccination (BV), neutralizing antibodies (NAbs) were detected at 1 month from all the PLWH, and the titer increased sixfold compared to that associated with the primary vaccination (PV), similar to that in healthy controls after BV. The NAbs titer declined over time after BV, but remained higher at 6 months than after PV. The NAbs response was elevated after BV with CD4 count <200 cells/μL, it was the poorest among the different CD4 cell count subgroups. Similar results were observed for anti-RBD-IgG responses. Moreover, RBD-specific MBCs were significantly elevated after BV in PLWH. No serious AEs were observed after BV in PLWH. In conclusion, booster inactivated SARS-CoV-2 vaccination is well tolerated and can elicit robust and durable humoral responses in PLWH. PLWH may benefit from a third dose of the inactivated vaccine.
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Affiliation(s)
- Ting Lu
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- The People's Hospital of Tongliang District, Chongqing, China
| | - Zhiwei Chen
- Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yu Cao
- The People's Hospital of Tongliang District, Chongqing, China
| | - Ling Ao
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zisheng Li
- The People's Hospital of Tongliang District, Chongqing, China
| | - Xiaoyi Gu
- The People's Hospital of Tongliang District, Chongqing, China
| | - Xingqian Ren
- The People's Hospital of Tongliang District, Chongqing, China
| | - Yixuan Wang
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Gaoli Zhang
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dejuan Xiang
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Min Chen
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dachuan Cai
- Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Peng Hu
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dazhi Zhang
- Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mingli Peng
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaofeng Shi
- Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hong Ren
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Antibody response durability following three-dose coronavirus disease 2019 vaccination in people with HIV receiving suppressive antiretroviral therapy. AIDS 2023; 37:709-721. [PMID: 36545783 PMCID: PMC9994797 DOI: 10.1097/qad.0000000000003469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Limited data exist regarding longer term antibody responses following three-dose coronavirus disease 2019 (COVID-19) vaccination, and the impact of a first SARS-CoV-2 infection during this time, in people with HIV (PWH) receiving suppressive antiretroviral therapy (ART). We quantified wild-type-specific, Omicron BA.1-specific and Omicron BA.5-specific responses up to 6 months post-third dose in 64 PWH and 117 controls who remained COVID-19-naive or experienced their first SARS-CoV-2 infection during this time. DESIGN Longitudinal observational cohort. METHODS We quantified wild-type-specific and Omicron-specific anti-Spike receptor-binding domain IgG concentrations, ACE2 displacement activities and live virus neutralization at 1, 3 and 6 months post-third vaccine dose. RESULTS Third doses boosted all antibody measures above two-dose levels, but BA.1-specific responses remained significantly lower than wild-type-specific ones, with BA.5-specific responses lower still. Serum IgG concentrations declined at similar rates in COVID-19-naive PWH and controls post-third dose (median wild-type-specific and BA.1-specific half-lives were between 66 and 74 days for both groups). Antibody function also declined significantly yet comparably between groups: 6 months post-third dose, BA.1-specific neutralization was undetectable in more than 80% of COVID-19 naive PWH and more than 90% of controls. Breakthrough SARS-CoV-2 infection boosted antibody concentrations and function significantly above vaccine-induced levels in both PWH and controls, though BA.5-specific neutralization remained significantly poorer than BA.1 even post-breakthrough. CONCLUSION Following three-dose COVID-19 vaccination, antibody response durability in PWH receiving ART is comparable with controls. PWH also mounted strong responses to breakthrough infection. Due to temporal response declines, however, COVID-19-naive individuals, regardless of HIV status, would benefit from a fourth dose within 6 months of their third.
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Augello M, Bono V, Rovito R, Tincati C, Marchetti G. Immunologic Interplay Between HIV/AIDS and COVID-19: Adding Fuel to the Flames? Curr HIV/AIDS Rep 2023; 20:51-75. [PMID: 36680700 PMCID: PMC9860243 DOI: 10.1007/s11904-023-00647-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2022] [Indexed: 01/22/2023]
Abstract
PURPOSE OF REVIEW HIV/AIDS and COVID-19 have been the major pandemics overwhelming our times. Given the enduring immune disfunction featuring people living with HIV (PLWH) despite combination antiretroviral therapy (cART), concerns for higher incidence and severity of SARS-CoV-2 infection as well as for suboptimal responses to the newly developed vaccines in this population arose early during the pandemics. Herein, we discuss the complex interplay between HIV and SARS-CoV-2, with a special focus on the immune responses to SARS-CoV-2 natural infection and vaccination in PLWH. RECENT FINDINGS Overall, current literature shows that COVID-19 severity and outcomes may be worse and immune responses to infection or vaccination lower in PLWH with poor CD4 + T-cell counts and/or uncontrolled HIV viremia. Data regarding the risk of post-acute sequelae of SARS-CoV-2 infection (PASC) among PLWH are extremely scarce, yet they seem to suggest a higher incidence of such condition. Scarce immunovirological control appears to be the major driver of weak immune responses to SARS-CoV-2 infection/vaccination and worse COVID-19 outcomes in PLWH. Therefore, such individuals should be prioritized for vaccination and should receive additional vaccine doses. Furthermore, given the potentially higher risk of developing long-term sequelae, PLWH who experienced COVID-19 should be ensured a more careful and prolonged follow-up.
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Affiliation(s)
- Matteo Augello
- Clinic of Infectious Diseases and Tropical Medicine, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo E Carlo, University of Milan, Via A. Di Rudinì, 8, 20142, Milan, Italy
| | - Valeria Bono
- Clinic of Infectious Diseases and Tropical Medicine, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo E Carlo, University of Milan, Via A. Di Rudinì, 8, 20142, Milan, Italy
| | - Roberta Rovito
- Clinic of Infectious Diseases and Tropical Medicine, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo E Carlo, University of Milan, Via A. Di Rudinì, 8, 20142, Milan, Italy
| | - Camilla Tincati
- Clinic of Infectious Diseases and Tropical Medicine, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo E Carlo, University of Milan, Via A. Di Rudinì, 8, 20142, Milan, Italy
| | - Giulia Marchetti
- Clinic of Infectious Diseases and Tropical Medicine, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo E Carlo, University of Milan, Via A. Di Rudinì, 8, 20142, Milan, Italy.
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SARS-CoV-2 live virus neutralization after four COVID-19 vaccine doses in people with HIV receiving suppressive antiretroviral therapy. AIDS 2023; 37:F11-F18. [PMID: 36789806 PMCID: PMC9994812 DOI: 10.1097/qad.0000000000003519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVE Limited data exist regarding the immune benefits of fourth COVID-19 vaccine doses in people with HIV (PWH) receiving antiretroviral therapy (ART), particularly now that most have experienced a SARS-CoV-2 infection. We quantified wild-type, Omicron-BA.5 and Omicron-BQ.1-specific neutralization up to 1 month post-fourth COVID-19 vaccine dose in 63 (19 SARS-CoV-2-naive and 44 SARS-CoV-2-experienced) PWH. DESIGN A longitudinal observational cohort. METHODS Quantification of wild-type-, Omicron-BA.5, and Omicron-BQ.1-specific neutralization using live virus assays. RESULTS Participants received monovalent (44%) and bivalent (56%) mRNA fourth doses. In COVID-19-naive PWH, fourth doses enhanced wild-type and Omicron-BA.5-specific neutralization modestly above three-dose levels ( P = 0.1). In COVID-19-experienced PWH, fourth doses enhanced wild-type specific neutralization modestly ( P = 0.1) and BA.5-specific neutralization substantially ( P = 0.002). Consistent with humoral benefits of 'hybrid' immunity, COVID-19-experienced PWH exhibited the highest neutralization post-fourth dose, wherein those with Omicron-era infections displayed higher wild-type specific ( P = 0.04) but similar BA.5 and BQ.1-specific neutralization than those with pre-Omicron-era infections. Nevertheless, BA.5-specific neutralization was significantly below wild-type in everyone regardless of COVID-19 experience, with BQ.1-specific neutralization lower still (both P < 0.0001). In multivariable analyses, fourth dose valency did not affect neutralization magnitude. Rather, an mRNA-1273 fourth dose (versus a BNT162b2 one) was the strongest correlate of wild-type specific neutralization, while prior COVID-19, regardless of pandemic era, was the strongest correlate of BA.5 and BQ.1-specific neutralization post-fourth dose. CONCLUSION Fourth COVID-19 vaccine doses, irrespective of valency, benefit PWH regardless of prior SARS-CoV-2 infection. Results support recommendations that all adults receive a fourth COVID-19 vaccine dose within 6 months of their third dose (or their most recent SARS-CoV-2 infection).
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