ABSTRACT
Background. We evaluated the immune response to COVID-19 vaccines in several specific populations at high risk of severe COVID-19. Methods. Participants from the French national multi-center prospective cohort studyANRS0001S COV-POPART were included (11 specific subpopulations: and 2 control groups (18-64 years and over 65 years)). In this preliminary analysis patients and controls who had received at least two vaccine doses have been included. Percentages (95% confidence intervals (CI)) of participants with anti-Spike SARS-CoV-2 IgG antibodies (ELISA) and specific neutralizing antibodies (in vitro neutralization assay) were evaluated at one month after the second dose of COVID-19 vaccine. Results. 3703 were included: 2650 participants from specific subpopulations (171 solid cancers, 160 SOT, 100 HCT, 91 chronic renal failures, 141 systemic autoimmune diseases, 157 autoimmune inflammatory rheumatic diseases, 361 multiple sclerosis (MS) or neuromyelitis optica spectrum disorders, 61 hypogammaglobulinemia, 401 diabetic, 739 obeses non-diabetic and 476 HIV) and 1053 controls (893: 18- 64 years and 160 over 65 years). Median age was 51.7 years [InterQuartile range: 40.8 - 60.9] and 50.7% were male. Most of the participants received BNT162b2 vaccine (86.4%). In the control group, 100% (95%CI: 99.6;100.0) of those aged 18-64 and 99.4% (96.6;100.0) of those over 65 years developed anti-Spike IgG antibodies. PLWHIV, cancer and diabetic patients had high rate of responders after two doses with 98.3% (97.2;99.1), 93.0% (88.1;96.3) and 92.0% (88.9;94.5), respectively. The lowest percentage of responders was found in patients with SOT (13.8% (8.8;20.1), HSCT (34.0% (24.8;44.2) and hypogammaglobulinemia (52.5% 39.3;65.4). In both control groups, the frequency of neutralizing antibodies was similar to the anti-Spike IgG antibody response. In the immunodeficient populations, neutralizing antibodies responders tended to be less frequent than anti-Spike antibodies responders. Similar trends than for IgG antibody were identified (Figure 1). Anti-Spike and Neutralizing antibody (Ab) responses (95% CI) one month after the second dose of COVID-19 vaccine in specific and control populations. Conclusion. Lower COVID-19 vaccine humoral response was observed in specific populations than in controls, especially in patients with hypogammaglobulinemia, HSCT and SOT. (Figure Presented).
ABSTRACT
Background: High effectiveness of COVID-19 vaccines was demonstrated. In people living with HIV (PLWHIV), immunogenicity and efficacy of COVID-19 vaccines might be lower. We evaluated the humoral immune response to COVID-19 vaccines in PLWHIV compared to controls without specific comorbidities. Methods: PLWHIV and controls from the French national multi-center prospective COVID 19 vaccine cohort study ANRS0001S COV-PopART were included. Participants with pre-vaccination positive SARS CoV-2 antibodies, history of SARS CoV-2 infection, or positive SARS CoV-2 anti-nucleocapsid (NCP) antibodies were excluded. Percentage (95% confidence interval (CI)) of responders, geometric means (95% CI) of anti-Spike SARS-CoV-2 IgG antibodies (ELISA) and specific neutralizing antibodies (in vitro neutralization assay) were estimated one month after the second vaccine dose. Serological tests (ELISA Euroimmun) with tests limits and seroneutralization for the original SARS-CoV-2 strain were performed centrally. Results: Among the 6089 participants included, 2625 were PLWHIV or controls;1212 had serological measures available one month after their second dose and 1133 had negative anti-NCP antibodies: 591 PLWHIV and 542 controls. PLWHIV were older than controls: 56.5 years, (51.2-62.2) vs 52.1 years (42.1-62.6) and more frequently male (78.7% vs 52.1%). All PLWHIV were under antiretroviral therapy, 76% had an undetectable viral load and 70.6% had CD4 counts above 500 cells/mm3. Participants had primarily received BNT162b2 (92.4% in PLWHIV vs 88.2% in controls). Proportions of participants who developed anti-Spike IgG (98.5% [97.1;99.3] vs 100.0% [99.3;100.0], p<0.01) and neutralizing antibodies (96.8% [95.0;98.1] vs 99.8 [99.0;100.0], p<0.01) were significantly lower in PLWHIV compared to controls. Of the nine non-responding PLWHIV, all were in CDC stage C, two had detectable HIV viral load and seven had CD4 cell counts below 200/mm3. PLWHIV had similar levels of anti-Spike antibodies (1149.0 [1066.6;1237.8] vs 1299.3 [1208.7;1396.6] BAU/mL, p=0.27) but lower seroneutralization titers (156.8 [141.9;173.2] vs 279.8 [256.1;305.6] IU/mL, p<0.01) than controls (figure). Conclusion: PLWHIV under ARV treatment had high response rates one month after two doses of COVID-19 vaccination. Nonetheless, seroneutralization titers were lower, and non-responders in PLWHIV had a more advanced disease stage. Longer follow-up is needed to gain a better insight into the humoral response after COVID-19 vaccination in PLWHIV.
ABSTRACT
Introduction L'efficacité de la vaccination Covid-19 est diminuée chez les personnes immunodéprimées. La réponse en anticorps anti-Spike est hétérogène dans ces populations mais la plupart des études publiées sont de taille limitée sans groupe contrôle. Matériels et méthodes COV-POPART est une cohorte nationale prospective multicentrique ayant inclus, entre le 25 mars et le 31 décembre 2021, des participants adultes dans 11 populations particulières (cancer solide, transplantés organe solide (TOS), greffés cellules souches hématopoïétiques (GCSH), insuffisants rénaux chroniques (IRC), maladies auto-immunes et systémiques (MAIS), rhumatismes inflammatoires chroniques (RIC), Sclérose En Plaques et maladies du spectre de la neuromyélite optique (SEP), hypogammaglobulinémie, diabète (1 et 2), obésité sans diabète, Personnes Vivant avec le VIH-1 (PVVIH)) et 2 groupes contrôles (18-74 ans et > 74 ans) indemnes des affections suscitées. Les participants ayant à l'inclusion des anticorps anti-nucléocapside (NCP) positifs ont été exclus. La proportion de participants avec des anticorps IgG anti-Spike (ELISA Euroimmun) (=répondeurs) et des anticorps neutralisants spécifiques (test de neutralisation in vitro sur la souche originale) a été évaluée de manière standardisée et centralisée un mois après la deuxième dose de vaccin. Résultats Parmi les 6612 participants de la cohorte, 3301 avaient des résultats disponibles au 17/02/2022 et 3127 des anticorps anti-NCP négatifs : 2271 participants de populations particulières (156 cancers solides, 135 TOS, 47 GCSH, 81 IRC, 124 MAI, 129 RIC, 321 SEP, 50 hypogammaglobulinémies, 320 diabétiques, 623 obèses non diabétiques et 777 VIH) et 856 contrôles (831 : 18-74 ans et 25 : >74 ans). La majorité des participants (86,7%) a reçu deux doses de BNT162b2. Dans le groupe contrôle, 99,9% (IC95% 99,3 ;100,0) des personnes âgées de 18 à 74 ans et 96,0% (79.6 ;99,9) des personnes âgées de plus de 75 ans ont développé des anticorps IgG anti-Spike. Chez les patients obèses et les PVVIH, les pourcentages de répondeurs étaient de 88,9 % (86,2 ;91,3) et 97.3 % (95,9 ;98,3). Les pourcentages de répondeurs étaient plus faibles chez les SEP (73,8 % [68,7 ;78,6]), GCSH (61,7 % [46,4 ;75,5]) ou TOS (31,1 % [23,4 ;39,6]). La fréquence des anticorps neutralisants était similaire à celle des anticorps anti-Spike dans les groupes contrôles. Les obèses et PVVIH (85,8 % [82,8 ;88,5] et 95,6 % [93,9 ;96,9]) présentaient plus fréquemment des anticorps neutralisants contrairement aux participants SEP, GSCH et TOS (69,8 % [64,4 ;74,8], 57,4 % [42,2 ;71,7] et 27,4 % [20,1 ;35,7]). Conclusion Les résultats préliminaires de la cohorte COV-POPART montrent, à 1 mois de la fin du schéma vaccinal standard de primo-vaccination Covid-19, une réponse humorale hétérogène dans les populations particulières. Cette réponse est plus faible chez les patients atteints de SEP, GSCH ou TOS. Aucun lien d'intérêt