Immune responses to natural COVID-19 infection in HIV positive people

Simon Collins, HIV i-Base

This review in Nature Communications earlier this month is important for reporting that both magnitude and duration of vaccine responses in HIV positive people are related to both CD4 counts and CD4:CD8 ratio in people living with HIV.

The implications of a reduced immune response to ART is therefore related to the individual management of vaccines against COVID-19.

This study was based on cross-sectional data collected between July and November 2020 comparing different branches of adaptive immunity in 47 HIV positive (24 confirmed SARS and 23 likely) compared to 35 HIV negative health workers.

The results report that despite effective ART, incomplete immune reconstitution can reduce T-cell responses to SARS-CoV-2, especially with a low/inverted CD4:CD8 ratio.

The researchers suggest that “CD4:CD8 ratio should be considered as a readily accessible biomarker for assessing individual risks in people living with HIV, a proportion of whom may require tailored vaccine strategies to achieve long-term protective immunity”.


Alrubayyi A et al. Characterization of humoral and SARS-CoV-2 specific T cell responses in people living with HIV. Nature Communications, vol 12: article 5839. DOI:10.1038/s41467-021-26137-7. (05 October 2021).

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