This is a summary, written by members of the CITF Secretariat, of:
Lapointe HR, Mwimanzi F, Cheung PK, Sang Y, Yaseen F, Umviligihozo G, Kalikawe R, Speckmaier S, Moran-Garcia N, Datwani S, Duncan MC, Agafitei O, Ennis S, Young L, Ali H, Ganase B, Omondi FH, Dong W, Toy J, Sereda P, Burns L, Costiniuk CT, Cooper C, Anis A, Leung V, Holmes DT, DeMarco ML, Simons J, Hedgcock M, Prystajecky N, Lowe CF, Pantophlet R, Romney MG, Barrios R, Guillemi S, Brumme CJ, Montaner JSG, Hull M, Harris M, Niikura M, Brockman MA, Brumme ZL.
People with HIV receiving suppressive antiretroviral therapy show typical antibody durability after dual COVID-19 vaccination, and strong third dose responses. medRxiv. 2022.03.22.22272793; doi: https://doi.org/10.1101/2022.03.22.22272793.
The results and/or conclusions contained in the research do not necessarily reflect the views of all CITF members.
In a pre-print, not yet peer reviewed, Drs. Zabrina Brumme and Mark Brockman from Simon Fraser University and the BC Centre for Excellence in HIV/AIDS, and members of the Canadian HIV Trials Network, led by Dr. Aslam Anis from the University of British Columbia, demonstrated that responses to COVID-19 vaccines in people living with HIV (PLWH) are similar to those in controls without HIV. Following both the second and the third dose of COVID-19 vaccine, PLWH also exhibited similar antibody and neutralization responses against the Omicron variant compared to controls without HIV, though anti-Omicron responses were not as strong as those against the original SARS-CoV-2 strain. The study was funded by the CITF.
The study examined the longevity of antibody and virus neutralization responses against SARS-CoV-2 up to six months after two COVID-19 vaccine doses in people living with HIV (PLWH) with suppressed viral loads on antiretroviral therapy (ART)Antiretroviral therapy is the combination of several antiretroviral medicines used to slow the rate at which HIV makes copies of itself (multiplies) in the body.. The team also measured the magnitude of these responses at one month after a third (booster) dose.
- After two doses of COVID-19 vaccine, anti-RBD antibody responses were of similar magnitude and durability in PLWH and controls without HIV. Weaker antibody responses after two doses were generally associated with a higher number of chronic conditions, older age and immunization with two doses of AstraZeneca ChAdOx vaccine, regardless of HIV status.
- A longer interval between first and second vaccine doses was associated with higher antibody concentrations immediately after the second dose, but this impact diminished over time.
- Third vaccine doses boosted antibody responses in both groups above what had been the peak response after the second dose. Prior COVID-19 infection and third doses of the Moderna mRNA vaccine were associated with higher virus neutralization activity.
With respect to the Omicron variant:
- Third vaccine doses boosted anti-Omicron responses in both PLWH and control groups above what was seen after a second dose.
- Third doses of Moderna mRNA-1273 were associated with a more robust antibody response.
- Males had a slightly lower antibody response following a third dose.
- Neutralizing activity against Omicron was 4- to 8-fold lower than against wild-type SARS-CoV-2 in both groups after two and three doses.
The 99 PLWH (who were taking ART and had suppressed plasma HIV loads) and 152 control (predominantly healthcare workers) participants were broadly similar in age. They had similar numbers of chronic health conditions, but the PLWH group included a greater proportion of white men. At study entry, 8% of PLWH and 10% of controls had prior infections of SARS-CoV-2. An additional 31 participants (18 PLWH and 13 control) experienced post-vaccination SARS-CoV-2 infections, 26 of which occurred during the Omicron wave. The interval between the first and the second dose was longer among the controls (89 days) when compared to PLWH (58 days). 80% PLWH and 88% controls received the third dose of the mRNA vaccine, on average 6.3 months after their second dose.
This study is important because PLWH may be at increased risk of severe COVID-19 due to immunosuppression, higher rates of comorbidities, and/or negative social determinants of health.