{"id":43201,"date":"2022-07-01T07:23:39","date_gmt":"2022-07-01T07:23:39","guid":{"rendered":"https:\/\/i-base.info\/htb\/?p=43201"},"modified":"2022-07-01T08:34:49","modified_gmt":"2022-07-01T08:34:49","slug":"similar-covid-19-vaccination-responses-in-hiv-positive-people-on-art-and-with-good-cd4-counts-compared-to-hiv-negative-controls","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/43201","title":{"rendered":"Similar COVID-19 vaccination responses in HIV positive people on ART and with good CD4 counts compared to HIV negative controls"},"content":{"rendered":"

Kirk Taylor, HIV i-Base<\/strong><\/p>\n

<\/span>A small Canadian cohort reported similar vaccine responses irrespective of HIV status although people living with HIV in the study were on ART with CD4 counts generally above 200 cells\/mm3<\/sup>. [1]<\/strong><\/p>\n

The participants living with HIV (n=99) were aged 54 (IQR: 40 to 61), male (88%) and ethnicity was White (69%), Black (5%) or Asian (10%). Recent CD4 counts were 715 cells\/mm3<\/sup> (IQR: 545 to 943) at entry, whilst CD4 nadir was 280 cells\/mm3<\/sup> (IQR: 123 to 490). Viral load was <50 copies\/mL on ART.<\/p>\n

Control participants (n=152) were aged 47 (IQR: 35 to 70), male (33%) and ethnicity was White (51%), Black (0.7%) or Asian (38%).<\/p>\n

Antibody responses were comparable and booster vaccines equally effective for both groups. Although protection against the omicron variant was reduced compared to wild-type virus. Greatest antibody responses were in people that received mRNA boosters.<\/p>\n

Lower antibody responses were associated with being older, having co-morbidities and receiving two doses of adenoviral-based vaccines.<\/p>\n

However CD4 counts correlate with vaccine response and nearly all participants were >200 cells\/mm3<\/sup> which generates greater antibody responses.<\/p>\n

The present study did not detect differences in post-vaccination antibody levels between groups, but it is unclear whether people with HIV that received mRNA vaccines received higher doses, as recommended.<\/p>\n

comment<\/h3>\n

As with many other similar studies, only one or two of the people living with HIV had CD4 counts <200 cells\/mm3<\/sup> which has been linked to reduced antibody responses but neither the paper nor the editorial commented on this.<\/strong><\/p>\n

The authors did not discuss this limitation of the study although an commentary questioned whether immune responses would be lower with unsuppressed viral load and CD4 counts <200 cells\/mm3<\/sup>. [2] <\/strong><\/p>\n

Although most people on ART have CD4 counts >200 cells\/mm3<\/sup>, late diagnoses is still common, often at CD4 counts where vaccine protection should not be assumed.<\/strong><\/p>\n

Recent studies report lower incidence of breakthrough COVID cases for people with higher CD4 counts, and a greater chance of severe symptoms for those with CD4 counts <350. [3, 4]<\/strong><\/p>\n

References<\/p>\n

    \n
  1. Lapointe HR et al. People with HIV receiving suppressive antiretroviral therapy show typical antibody therapy durability after dual COVID-19 vaccination, and strong third dose responses. J. Inf. Dis. DOI:10.1093\/infdis\/jiac229 (07 June 2022).
    \nhttps:\/\/academic.oup.com\/jid\/advance-article\/doi\/10.1093\/infdis\/jiac229\/6603521<\/a><\/li>\n
  2. Jacobsen JM. Immune responses to SARS-CoV-2 vaccination in people with HIV: A tale of two pandemics. J. Inf. Dis. DOI:\u00a010.1093\/infdis\/jiac231 (07 June 2022).
    \n    https:\/\/academic.oup.com\/jid\/advance-article\/doi\/10.1093\/infdis\/jiac231\/6603522<\/a><\/li>\n
  3. Coburn SB et al. Analysis of postvaccination breakthrough COVID-19 infections among adults with HIV in the United States. JAMA.\u00a0DOI:10.1001\/jamanetworkopen.2022.15934 (07 June 2022).
    \n    https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2793102<\/a><\/li>\n
  4. Lang R et al. Analysis of severe illness after post-vaccination COVID-19 breakthroguh among adults with and without HIV in the United States. medRxiv. DOI:\u00a010.1101\/2022.04.15.22273913. (16 April 2022).
    \n    https:\/\/www.medrxiv.org\/content\/10.1101\/2022.04.15.22273913v1<\/a><\/li>\n<\/ol>\n

    This report was first published on 26 June 2022.<\/em><\/p>\n\n","protected":false},"excerpt":{"rendered":"

    Kirk Taylor, HIV i-Base A small Canadian cohort reported similar vaccine responses irrespective of HIV status although people living with HIV in the study were on ART with CD4 counts generally above 200 cells\/mm3. [1] The participants living with HIV …<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[31,282,292,278],"tags":[],"class_list":["post-43201","post","type-post","status-publish","format-standard","hentry","category-opportunistic-infections-coinfections-and-complications","category-covid-19-hiv-and-covid-19-coinfection","category-covid-19-vaccine","category-covid-19"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/43201","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=43201"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/43201\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=43201"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=43201"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=43201"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}