This is a summary, written by members of the CITF Secretariat, of:
Costiniuk CT, Singer J, Lee T, Langlois MA, Arnold C, Galipeau Y, Needham J, Kulic I, Jenabian MA, Burchell AN, Shamji H, Chambers C, Walmsley S, Ostrowski M, Kovacs C, Tan DHS, Harris M, Hull M, Brumme ZL, Lapointe HR, Brockman MA, Margolese S, Mandarino E, Samarani S, Vulesevic B, Lebouché B, Angel JB, Routy JP, Cooper CL, Anis AH; COVAXHIV Study Group. COVID-19 vaccine immunogenicity in people with HIV. AIDS. 2023 Jan 1;37(1):F1-F10. doi: 10.1097/QAD.0000000000003429. Epub 2022 Nov 18. PMID: 36476452; PMCID: PMC9794000.
The results and/or conclusions contained in the research do not necessarily reflect the views of all CITF members.
A CITF-funded study, published in AIDS and led by Drs. Cecilia Costiniuk (McGill University) and Aslam Anis (University of British Columbia, found that vaccine-induced antibodies to SARS-CoV-2 were elicited in over 90% of people living with HIV (PLWS). Of those, most (92%), maintained those antibodies for six months following a second dose, although this percentage is less than it was for HIV-negative controls. One month after a third dose, 100% of PLWH had detectable receptor binding domain and spike levels. The results demonstrate the importance of keeping up with booster doses for PLWH.
- The proportion of participants achieving comparable anti-RBD levels were similar between PLWH and people without HIV at each time point – three months post dose two, six months post dose two, and one month post dose three. Anti-S IgG levels were similar between the two groups three months post dose two and one month after a third dose.
- 92% of PLWH maintained vaccine-induced anti-S IgG immunity six months post dose two, compared with 99% of HIV-negative controls (odds ratio: 0.14).
- Neither age, ability to produce antibodies against SARS-CoV-2, comorbidities, sex, vaccine type, or timing between doses were associated with reduced IgG response.
294 PLWH and 267 HIV-negative controls were included in the final analysis. The median ages were 54 and 42, respectively. Males accounted for 77% of the PLWH group vs. 26% of controls. The median duration of HIV infection was 17 years, and approximately 20% had a history of an AIDS-defining illness. Nearly all were on antiretroviral therapy (ART) (97.6%).
Common comorbidities included obesity (21% in PLWH vs. 14% among the controls), dyslipidemia (15% vs. 8%), and hypertension (14% vs. 9%). By the time the data analysis was conducted in June 2022, 54 individuals had received a second dose, and 214 had received a third dose. Pfizer and Moderna were the most commonly administered vaccines (94% in PLWH and 99% in controls).
Overall, adult PLWH with well-controlled HIV on ART mount antibody responses following second and third mRNA vaccine doses, similar to HIV-negative individuals. Diminishing proportions of PLWH with detectable antibody levels argue for timely serial booster dosing to maintain seroprotection.