Durability of immune responses to COVID-19 vaccines in HIV positive people

Simon Collins, HIV i-Base

Extended follow-up from the HIV positive substudy in 54 HIV positive men reports that six months after vaccination with Oxford/AstraZeneca ChAdOx1 vaccine, both humoral and cell mediated immunity decline. [1]

Similar declines were reported for HIV negative controls. Importantly, participants were all on suppressed ART with very high CD4 counts (median ~700 cells/mm³ (IQR: 573 to 859). Levels generally remained higher than before vaccination.

Responses to the variants of concern were detectable, but lower than wild type.

Two additional studies recently also reported on vaccines responses in people living with HIV. As with the Oxford above, both were in people with high median CD4 counts. [2, 3]

These included n=143 and  n=121 HIV positive people, respectively.

The first included just three people with CD4s <200 cells/mm³ who responded comparably to people with higher counts (but no overall correlation with CD4 counts is reported for the entire study population).

The second study included six people with CD4 counts <250 cells/mm³ and reported significantly lower immunogenicity compared to other groups.

References

1. Ogbe A el al. Durability of ChAdOx1 nCov-19 (AZD1222) vaccination in people living with HIV – responses to SARS-CoV-2, variants of concern and circulating coronaviruses. Preprint. medRxiv 2021.09.28.21264207. doi: 10.1101/2021.09.28.21264207.
   https://www.medrxiv.org/content/10.1101/2021.09.28.21264207v1
2. Levy I et al. Immunogenicity and safety of the BNT162b2 mRNA COVID-19 vaccine in people living with HIV-1. Clinical microbiology and infection. DOI: 10.1016/j.cmi.2021.07.031. (23 August 2021).
   https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(21)00423-7/fulltext 
3. Nault L et al. Covid-19 vaccine immunogenicity in people living with HIV-1. Preprint article. (13 August 2021).
   https://www.biorxiv.org/content/10.1101/2021.08.13.456258v1

Ref: Ogbe  A el al. Durability of ChAdOx1 nCov-19 (AZD1222) vaccination in people living with HIV – responses to SARS-CoV-2, variants of concern and circulating coronaviruses. Preprint. medRxiv 2021.09.28.21264207. doi: 10.1101/2021.09.28.21264207.
https://www.medrxiv.org/content/10.1101/2021.09.28.21264207v1

This report was first published on 4 October 2021.