People living with HIV who are receiving suppressive antiretroviral therapy mount strong humoral responses to two and three doses of COVID-19 vaccine

Title

People living with HIV who are receiving suppressive antiretroviral therapy mount strong humoral responses to two and three doses of COVID-19 vaccine

Presenter

Hope R. Lapointe

Authors

H.R. Lapointe * (1), F. Mwimanzi (2), P.K. Cheung (1,2), Y. Sang (2), F. Yaseen (3), S. Speckmaier (1), N. Moran-Garcia (1), R. Kalikawe (2), L. Young (4), G. Umviligihozo (2), F.H. Omondi (1,2), M.C. Duncan (1,2), S. Datwani (2), O. Agafitei (2), S. Ennis (2), K. Ng (2), H. Ali (5), B. Ganase (6), H. Sudderuddin (1,7), J. Toy (1), P. Sereda (1), L. Burns (8), C.T. Costiniuk (9), C. Cooper (10,11), A.H. Anis (12,13,14), V. Leung (4,15), D. Holmes (8,15), M.L. DeMarco (8,15), J. Simons (8,15), M. Hedgcock (16), N. Prystajecky (15,17), R. Pantophlet (2,3), C. Lowe (4,15), M.G. Romney (4,15), R. Barrios (1,12), S. Guillemi (1,7,18), C.J. Brumme (1,7), J.S.G. Montaner (1,7), M. Hull (1,7), M. Niikura (2), M. Harris (1,18), M.A. Brockman (1,2,3), Z.L. Brumme (1,2)

Institutions

(1) BC Centre for Excellence in HIV/AIDS, Vancouver, Canada, (2) Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada, (3) Simon Fraser University, Department of Molecular Biology and Biochemistry, Burnaby, Canada, (4) St. Paul''s Hospital, Division of Medical Microbiology and Virology, Vancouver, Canada, (5) St. Paul''s Hospital, John Ruedy Clinic, Vancouver, Canada, (6) St. Paul''s Hospital, AIDS Research Program, Vancouver, Canada, (7) University of British Columbia, Department of Medicine, Vancouver, Canada, (8) Providence Health Care, Department of Pathology and Laboratory Medicine, Vancouver, Canada, (9) The Research Institute of the McGill University Health Centre, Division of Infectious Diseases and Chronic Viral Illness Service, Montreal, Canada, (10) University of Ottawa, Department of Medicine, Ottawa, Canada, (11) Ottawa Hospital Research Institute, Ottawa, Canada, (12) University of British Columbia, School of Population and Public Health, Vancouver, Canada, (13) University of British Columbia, CIHR Canadian HIV Trials Network, Vancouver, Canada, (14) Centre for Health Evaluation and Outcome Sciences, Vancouver, Canada, (15) University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, Canada, (16) Spectrum Health, Vancouver, Canada, (17) British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, Canada, (18) University of British Columbia, Department of Family Practice, Faculty of Medicine, Vancouver, Canada

BACKGROUND: Immune responses to COVID-19 vaccines, particularly to third doses, remain incompletely characterized in people living with HIV (PLWH).
METHODS: We are monitoring immune responses to COVID-19 vaccination in a cohort of 99 adult PLWH and 152 controls, aged 22-88 years, in British Columbia, Canada. All PLWH were receiving suppressive ART, with median CD4+ T-cell counts of 715 (Q1-Q3 545-943) cells/mm³at cohort entry. In samples collected one month after the second and third COVID-19 vaccine doses, we quantified serum antibodies against the SARS-CoV-2 spike protein receptor-binding domain (RBD) using the Roche Elecsys anti-SARS-CoV-2 assay, and measured viral neutralization activity in plasma against the original (USA-WA1/2020) and Omicron (BA.1) SARS-CoV-2 strains.
RESULTS: We previously reported that, at one month following the second COVID-19 vaccine dose, and after adjustment for sociodemographic, health, and vaccine-related variables, HIV infection was not associated with a difference in either anti-RBD antibody concentration nor live virus neutralization activity compared to responses observed in controls. In PLWH, there was no significant correlation between the most recent (or nadir) CD4+ T-cell count and vaccine responses after two doses. Rather, at this timepoint, older age, a higher burden of chronic health conditions, and having received two ChAdOx1 doses (as opposed to mRNA or heterologous regimens) were associated with lower responses. One month following the third dose, anti-RBD serum antibodies increased by 0.4 log₁₀higher on average, and viral neutralization by four-fold higher on average, than values observed one month after the second dose, in both PLWH and controls (Wilcoxon paired test p<0.0001 for all within-group comparisons between time-points). Importantly, there was no significant difference between PLWH and controls in terms of the magnitudes of post-3rd-dose responses. In a subset of 24 participants assessed to date, the ability to neutralize Omicron after three doses was on average 8-fold lower than the pandemic founder strain (p<0.0001).
CONCLUSIONS: In PLWH with well-controlled viral loads on therapy and CD4+ T-cell counts in a healthy range, humoral responses to two and three COVID-19 vaccine doses are comparable to individuals without HIV. Third COVID-19 vaccine doses induce responses capable of neutralizing Omicron to some extent.

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