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Corma-Gómez A, Fernández-Fuertes M, Viñuela L, Domínguez C, Santos M, Fuentes-López A, Rojas A, Fernández-Pérez N, Martín-Carmona J, Serrano-Conde E, Real LM, Mendoza J, Macías J, Pineda JA, García F. Reduced neutralizing antibody response to SARS-CoV-2 vaccine booster dose in people living with HIV with severe immunosuppression. J Med Virol 2023; 95:e28602. [PMID: 36880164 DOI: 10.1002/jmv.28602] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/02/2023] [Accepted: 02/17/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVE To assess the immunogenicity of SARS-CoV-2 vaccines among PLWH with severe immunosuppression, after a booster dose. METHODS Case-control study nested in a prospective cohort of PLWH. All patients with CD4 cell count <200 cells/mm3 who had received additional dose of mRNA COVID-19 vaccine, after a standard immunization scheme were included. CONTROL GROUP patients age- and sex-matched, with CD4 ≥200 cells/mm3, in the ratio of 2:1. Antibody response to a booster dose (anti-S levels 33.8 ≥BAU/mL) and neutralizing activity against SARS-CoV-2 B.1, B.1.617.2, and Omicron BA.1, BA.2 and BA.5 strains were assessed after the booster shot. RESULTS 54 PLWH were included, 18 with CD4 counts <200 cells/mm3 . 51 (94%) showed response to a booster dose. Response was less frequent in PLWH with CD4 <200 cells/mm3 than in those with CD4 counts ≥200 cells/mm3 [15 (83%) vs. 36 (100%), p=0.033]. In the multivariate analysis, CD4 counts ≥200 cells/mm3 [IRR=18.1 (CI 95% 16.8-19.5), p<0.001] was associated with a higher probability of showing antibody response. Neutralization activity against SARS-CoV-2 B.1, B.1.617, BA.1 and BA.2 strains was significantly inferior among individuals with CD4 counts <200 cells/mm3 . CONCLUSIONS Among PLWH with CD4 counts<200 cells/mm3 , the immune response elicited by mRNA additional vaccine dose is reduced. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Anaïs Corma-Gómez
- Unit of Infectious Diseases and Microbiology. Hospital Universitario Virgen de Valme, Sevilla, Spain.,Instituto de Biomedicina de Sevilla (IBiS).,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC
| | - Marta Fernández-Fuertes
- Unit of Infectious Diseases and Microbiology. Hospital Universitario Virgen de Valme, Sevilla, Spain.,Instituto de Biomedicina de Sevilla (IBiS).,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC
| | - Laura Viñuela
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC.,Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain.,Instituto de Investigacion Biosanitaria Ibs.Granada, Granada, Spain
| | - Carmen Domínguez
- Unit of Infectious Diseases and Microbiology. Hospital Universitario Virgen de Valme, Sevilla, Spain
| | - Martos Santos
- Unit of Infectious Diseases and Microbiology. Hospital Universitario Virgen de Valme, Sevilla, Spain.,Instituto de Biomedicina de Sevilla (IBiS).,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC
| | - Ana Fuentes-López
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC.,Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain.,Instituto de Investigacion Biosanitaria Ibs.Granada, Granada, Spain
| | | | - Nieves Fernández-Pérez
- Unit of Infectious Diseases and Microbiology. Hospital Universitario Virgen de Valme, Sevilla, Spain
| | - Jessica Martín-Carmona
- Unit of Infectious Diseases and Microbiology. Hospital Universitario Virgen de Valme, Sevilla, Spain.,Instituto de Biomedicina de Sevilla (IBiS).,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC
| | - Esther Serrano-Conde
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC.,Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain.,Instituto de Investigacion Biosanitaria Ibs.Granada, Granada, Spain
| | - Luis M Real
- Department of Surgery, Biochemistry and Immunology, School of Medicine, University of Málaga, Spain
| | | | - Juan Macías
- Unit of Infectious Diseases and Microbiology. Hospital Universitario Virgen de Valme, Sevilla, Spain.,Instituto de Biomedicina de Sevilla (IBiS).,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC.,Medicine Department, University of Sevilla, Spain
| | - Juan A Pineda
- Unit of Infectious Diseases and Microbiology. Hospital Universitario Virgen de Valme, Sevilla, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC.,Medicine Department, University of Sevilla, Spain
| | - Federico García
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC.,Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain.,Instituto de Investigacion Biosanitaria Ibs.Granada, Granada, Spain
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Delgado-Fernández M, García-Gemar GM, Fuentes-López A, Muñoz-Pérez MI, Oyonarte-Gómez S, Ruíz-García I, Martín-Carmona J, Sanz-Cánovas J, Castaño-Carracedo MÁ, Reguera-Iglesias JM, Ruíz-Mesa JD. Treatment of COVID-19 with convalescent plasma in patients with humoral immunodeficiency - Three consecutive cases and review of the literature. Enferm Infecc Microbiol Clin (Engl Ed) 2022; 40:507-516. [PMID: 36336380 PMCID: PMC9631336 DOI: 10.1016/j.eimce.2021.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/20/2021] [Indexed: 06/16/2023]
Abstract
Patients lacking humoral response have been suggested to develop a less severe COVID-19, but there are some reports with a prolonged, relapsing or deadly course. From April 2020, there is growing evidence on the benefits of COVID-19 convalescent plasma (CCP) for patients with humoral immunodeficiency. Most of them had a congenital primary immunodeficiency or were on treatment with anti CD20 antibodies. We report on three patients treated in our hospital and review thirty-one more cases described in the literature. All patients but three resolved clinical picture with CCP. A dose from 200 to 800ml was enough in most cases. Antibody levels after transfusion were negative or low, suggesting consumption of them in SARS-CoV-2 neutralization. These patients have a protracted clinical course shortened after CCP. CCP could be helpful for patients with humoral immunodeficiency. It avoid relapses and chronification. CCP should be transfused as early as possible in patients with COVID-19 and humoral immunodeficiency.
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Affiliation(s)
| | | | - Ana Fuentes-López
- Microbiology Department, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | | | - Salvador Oyonarte-Gómez
- Director of "Red andaluza de Medicina transfusional, tejidos y células" del Sistema Sanitario Público de Andalucía, Spain
| | | | | | - Jaime Sanz-Cánovas
- Internal Medicine Department, Hospital Regional Universitario de Málaga, Spain
| | | | | | - Juan Diego Ruíz-Mesa
- Infectious Diseases Department, Hospital Regional Universitario de Málaga, Spain
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Delgado-Fernández M, García-Gemar GM, Fuentes-López A, Muñoz-Pérez MI, Oyonarte-Gómez S, Ruíz-García I, Martín-Carmona J, Sanz-Cánovas J, Castaño-Carracedo MÁ, Reguera-Iglesias JM, Ruíz-Mesa JD. Treatment of COVID-19 with convalescent plasma in patients with humoral immunodeficiency - Three consecutive cases and review of the literature. Enferm Infecc Microbiol Clin 2021; 40:S0213-005X(21)00035-5. [PMID: 33741148 PMCID: PMC7877207 DOI: 10.1016/j.eimc.2021.01.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 12/31/2022]
Abstract
Patients lacking humoral response have been suggested to develop a less severe COVID-19, but there are some reports with a prolonged, relapsing or deadly course. From April 2020, there is growing evidence on the benefits of COVID-19 convalescent plasma (CCP) for patients with humoral immunodeficiency. Most of them had a congenital primary immunodeficiency or were on treatment with anti CD20 antibodies. We report on three patients treated in our hospital and review thirty-one more cases described in the literature. All patients but three resolved clinical picture with CCP. A dose from 200 to 800ml was enough in most cases. Antibody levels after transfusion were negative or low, suggesting consumption of them in SARS-CoV-2 neutralization. These patients have a protracted clinical course shortened after CCP. CCP could be helpful for patients with humoral immunodeficiency. It avoid relapses and chronification. CCP should be transfused as early as possible in patients with COVID-19 and humoral immunodeficiency.
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Affiliation(s)
| | | | - Ana Fuentes-López
- Microbiology Department, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | | | - Salvador Oyonarte-Gómez
- Director of "Red andaluza de Medicina transfusional, tejidos y células" del Sistema Sanitario Público de Andalucía, Spain
| | | | | | - Jaime Sanz-Cánovas
- Internal Medicine Department, Hospital Regional Universitario de Málaga, Spain
| | | | | | - Juan Diego Ruíz-Mesa
- Infectious Diseases Department, Hospital Regional Universitario de Málaga, Spain
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