Corma-Gomez, Anais , Fernandez-Fuertes, Marta , Garcia, Estefania , Fuentes-Lopez, Ana , Gomez-Ayerbe, Cristina , Rivero-Juarez, Antonio , INFANTE DOMINGUEZ, CARMEN, Santos, Marta , Vinuela, Laura , Palacios, Rosario , Real, Luis M. , Rivero, Antonio , Macias, Juan , Pineda, Juan A. , Garcia, Federico
No
Clin. Microbiol. Infect.
Article
Científica
1
1
14.2
3.587
01/11/2022
8,83028E+11
Objectives: The aim of this study was to assess the immunogenicity of SARS-CoV-2 available vaccines among people living with HIV (PLWH) after a complete vaccination scheme, and determine predictors of seroconversion. Methods: This multicentre prospective cohort study included 420 PLWH who had received a standard immunization, either with mRNA or adenoviral-vectored COVID-19 vaccines. Antibody response was evaluated within 1 to 2 months after the last dose of the vaccine with a quantitative determination of antitrimeric spike protein-specific IgG antibodies and IgG neutralizing antibodies. Results: Overall, 384 of 420 PLWH (91%) showed antibody response to vaccination. Seroconversion was observed in 308 of 326 individuals with cluster of differentiation 4 (CD4) counts >= 350 cells/mm(3) (95%), 55 of 61 PLWH with 200 to 349 cells/mm3 (90%), and 21 of 33 PLWH with CD4 counts < 200 cells/mm3 (64%; p < 0.001). The median log10 IgG neutralization levels were 2.4 IU/mL (Q1-Q3, 1.0-3.1) among PLWH with CD4 counts < 200 cells/mm(3), 3.1 IU/mL (Q1-Q3, 2.8-3.4) for the 200 to 349 cells/mm3 group, and 3.1 IU/mL (Q1-Q3, 2.7-3.4) for PLWH with CD4 counts >= 350 cells/mm(3) (p = 0.016). In the multivariate analysis, CD4 counts >= 350 cells/mm(3) (OR: 7.10; 95% CI, 1.91-26.46; p = 0.004) and receiving mRNA-vectored COVID-19 vaccines (OR: 8.19; 95% CI, 3.24-20.70; p <= 0.001) were independently associated with a higher probability of response to vaccination. Discussion: HIV-related immunosuppression impairs the antibody response to SARS-CoV-2 vaccines. Specific vaccination schemes should be urgently tailored in this setting, particularly in patients with CD4 cell counts < 200 cells/mL. Adenoviral-vectored vaccines should be avoided in PLWH whenever possible.(c) 2022 Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases.
CD4 T-cell counts; Humoral response; People living with HIV; SARS-CoV-2; Vaccine