Antinori, Andrea; Cicalini, Stefania; Meschi, Silvia; Bordoni, Veronica; Lorenzini, Patrizia; Vergori, Alessandra; Lanini, Simone; ... HIV-VAC Study Group, .; + view all Antinori, Andrea; Cicalini, Stefania; Meschi, Silvia; Bordoni, Veronica; Lorenzini, Patrizia; Vergori, Alessandra; Lanini, Simone; De Pascale, Lidya; Matusali, Giulia; Mariotti, Davide; Cozzi Lepri, Alessandro; Gallì, Paola; Pinnetti, Carmela; Gagliardini, Roberta; Mazzotta, Valentina; Mastrorosa, Ilaria; Grisetti, Susanna; Colavita, Francesca; Cimini, Eleonora; Grilli, Elisabetta; Bellagamba, Rita; Lapa, Daniele; Sacchi, Alessandra; Marani, Alessandra; Cerini, Carlo; Candela, Caterina; Fusto, Marisa; Puro, Vincenzo; Castilletti, Concetta; Agrati, Chiara; Girardi, Enrico; Vaia, Francesco; HIV-VAC Study Group, .; - view fewer (2022) Humoral and cellular immune response elicited by mRNA vaccination against SARS-CoV-2 in people living with HIV (PLWH) receiving antiretroviral therapy (ART) according with current CD4 T-lymphocyte count. Clinical Infectious Diseases 10.1093/cid/ciac238. (In press).

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Abstract

BACKGROUND: Data on SARS-CoV-2 vaccine immunogenicity in PLWH are currently limited. Aim of the study was to investigate immunogenicity according to current CD4 T-cell count. METHODS: PLWH on ART attending a SARS-CoV-2 vaccination program, were included in a prospective immunogenicity evaluation after receiving BNT162b2 or mRNA-1273. Participants were stratified by current CD4 T-cell count (poor CD4 recovery, PCDR: <200/mm^{3}; intermediate CD4 recovery, ICDR: 200-500/mm^{3} high CD4 recovery, HCDR: >500/mm^{3}). RBD-binding IgG, SARS-CoV-2 neutralizing antibodies (nAbs) and IFN-γ release were measured. As control group, HIV-negative healthcare workers (HCWs) were used. FINDINGS: Among 166 PLWH after 1 month from the second dose, detectable RBD-binding IgG were elicited in 86.7% of PCDR, 100% of ICDR, 98.7% of HCDR, and a neutralizing titre ≥1:10 elicited in 70.0%, 88.2% and 93.1%, respectively. Compared to HCDR, all immune response parameters were significantly lower in PCDR. After adjusting for confounders, current CD4 T-cell <200/mm^{3} significantly predicted a poor magnitude of anti-RDB, nAbs and IFN-γ response. As compared with HCWs, PCDR elicited a consistently reduced immunogenicity for all parameters, ICDR only a reduced RBD-binding antibody response, whereas HCDR elicited a comparable immune response for all parameters. CONCLUSION: Humoral and cell-mediated immune response against SARS-CoV-2 were elicited in most of PLWH, albeit significantly poorer in those with CD4 T-cell <200/mm^{3} versus those with >500 cell/mm^{3} and HIV-negative controls. A decreased RBD-binding antibody response than HCWs was also observed in PLWH with CD4 T-cell 200-500/mm^{3}, whereas immune response elicited in PLWH with a CD4 T-cell >500/mm^{}3 was comparable to HIV-negative population.

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