HUMORAL IMMUNE RESPONSE after COVID-19 VACCINATION in PEOPLE LIVING with HIV

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.