People living with HIV have shown a favorable immune response to mRNA-based COVID-19 booster shots, according to a recent study. The research aimed to evaluate immune responses in HIV-positive individuals after receiving a third dose of mRNA-based COVID-19 vaccine.
The study, a retrospective cohort study, included people living with HIV who received booster vaccinations with either BNT-162b2 or mRNA-1273 from October 2021 to January 2022. The participants’ immune responses were assessed through various indicators, including anti-spike receptor-binding domain (RBD) immunoglobulin G (IgG), virus neutralizing activity (VNA) titers, and T-cell response.
Out of 84 HIV-positive individuals who received an mRNA-based booster vaccination, 76 were eligible for analysis. These participants were on effective antiretroviral therapy (ART) and had a median CD4 cell count of 670 cells/μL. Following the booster vaccination, the median anti-spike RBD IgG increased by 705.2 binding antibody units per milliliter (BAU/mL), and the median VNA titers increased by 1000 inhibitory dilution (ID) at the follow-up assessment, which occurred around 13 weeks later.
To determine the factors influencing serological immune responses, multivariate regression models were used. The analysis showed that the time since the second vaccination was a predictor of stronger serological responses, indicating that longer intervals between doses may lead to higher immune responses. Other factors, including CD4 cell count, choice of mRNA vaccine, and concomitant influenza vaccination, did not show a significant association with immune response.
The study also assessed T-cell responses using an interferon-gamma-release-assay (IGRA). Among the participants, 45 individuals had a reactive baseline IGRA, with only two losing reactivity during follow-up. Of the 31 individuals with a non-reactive baseline IGRA, 17 converted to reactive, and seven remained unchanged after the booster vaccination.
Overall, people living with HIV and CD4 cell counts of at least 500 cells/μL showed positive immune responses to mRNA-based COVID-19 booster vaccination. The study also highlighted the importance of preventing COVID-19 in individuals living with HIV, who may be at an increased risk of morbidity and mortality.
While earlier studies have demonstrated the efficacy and safety of two-dose mRNA-based immunization in HIV-positive individuals with favorable CD4 cell counts, this study focused specifically on booster vaccinations and the influencing factors. Previous studies have compared immune responses between HIV-positive individuals and healthcare workers, showing comparable serological responses in those with higher CD4 cell counts. However, individuals with lower CD4 cell counts exhibited lower serological responses.
The findings of this study contribute to the growing body of evidence on the effectiveness of mRNA-based COVID-19 vaccines in people living with HIV. It is crucial to ensure that this vulnerable population receives appropriate preventive strategies, and booster vaccinations have shown promising results in strengthening immune responses. Further research is needed to explore immune responses in HIV-positive individuals with lower CD4 cell counts and to assess the long-term effectiveness of booster vaccinations in this population.
In conclusion, mRNA-based COVID-19 booster shots have elicited favorable immune responses in people living with HIV. The study highlights the significance of booster vaccinations and emphasizes the need to protect individuals living with HIV from COVID-19. By understanding the factors influencing immune responses, healthcare providers can tailor vaccination strategies to optimize protection in this vulnerable population.
