Limited Humoral and Specific T-Cell Responses After SARS-CoV-2 Vaccination in PWH With Poor Immune Reconstitution. (6th October 2022) - Benet, Susana
Abstract: Background: We analyzed humoral and cellular immune responses induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines in people with human immunodeficiency virus (HIV; PWH) who had CD4 + T-cell counts <200/µL (HIV<200 group). Methods: This prospective cohort study included 58 PWH in the HIV<200 group, 36 with CD4 + T-cell counts >500/µL (HIV>500 group), and 33 HIV-1–negative controls (control group). Antibodies against the SARS-CoV-2 spike protein (anti-S immunoglobulin [Ig] G) and the receptor-binding domain (anti-RBD IgG) were quantified before and 4 weeks after the first and the second doses of BNT162b2 or mRNA-1273 (at week 8). Viral neutralization activity and T-cell responses were also determined. Results: At week 8, anti-S/anti-RBD IgG responses increased in all groups ( P < .001). Median (interquartile range) anti-S and anti-RBD IgG levels at week 8 were 153.6 (26.4–654.9) and 171.9 (61.8–425.8) binding antibody units (BAU)/mL, respectively, in the HIV<200 group, compared with 245.6 (145–824) and 555.8 (166.4–1751) BAU/mL in the HIV>500 group and 274.7 (193.7–680.4) and 281.6 (181–831.8) BAU/mL in controls ( P < .05). Neutralizing capacity and specific T-cell immune responses were absent or reduced in 33% of those in the HIV<200 group, compared with 3.7% in the HIV>500 group ( P < .01). Conclusions: One-third of PWH with CD4 + T-cell counts <200/µL show low anti-S/anti-RBD IgG levels, reduced in vitro neutralization activity against SARS-CoV-2, and no vaccine-induced T cells after receiving coronavirus disease 2019 mRNA vaccines. Abstract : One third of HIV-1-infected individuals with CD4+ T-cell counts ≤200 cells/mm 3 show low anti-S/anti-RBD IgG levels, reduced in vitro neutralization activity against SARS-CoV-2 and no vaccine-induced T-cells 4 weeks after a second dose of COVID-19 mRNA vaccines.