Background Little is known about vaccine efficacy and sustainability among people with HIV (PWH). We estimated humoral and cellular immune responses post-vaccination with BNT162b2 mRNA COVID-19 vaccine among PWH in Tel-Aviv medical center. Methods The vaccine humoral response was evaluated by measuring IgG titers of anti-spike receptor-binding domain antibodies (anti-RBD IgG). Cellular response was assessed by stimulating donor peripheral blood mononuclear cells with pooled complete S-peptide mix. Results 136 PWH who completed 2 doses of the SARS-CoV-2 vaccine were tested for anti-RBD IgG and compared with 61 vaccinated healthcare workers (HCW). The antibody titers were similar between the groups (median of 118 BAU/ml for PWH and 101.4 BAU/ml for HCW, p=0.231), although the mean time from 2 nd vaccine was 4.5 months in PWH and 6.7 months in HCW (P<0.0001). Longer time from 2 nd vaccine dose was associated with decreased antibody level, as were CD4 counts of <300 cells/µL compared with higher CD4 counts (25.1 BAU/ml vs. 119.3 BAU/ml, respectively, p=0.047). There was no difference in cellular immune response between vaccinated PWH, convalescent unvaccinated PWH and vaccinated HCW. Conclusions The humoral immune response of PWH was comparable to those of HCW after BNT162b2 mRNA vaccination. Cellular immune response did not differ between vaccinated PWH, convalescent PWH and vaccinated HCW. PWH with CD4 count of < 300 cells/µL (n=9) had lower antibody titers compared with patients with counts of >300 cells/µL (n=127).

Background: Infectious diseases are a major threat to healthcare workers and patients alike. Standard precautions (SPs) are a pivotal element in controlling their spread. However, worldwide reported compliance with SP guidelines is suboptimal among workers and students in the healthcare field.

Objective To compare the measured bone conduction threshold at 3 kHz with the calculated threshold in newly diagnosed sudden sensorineural hearing loss. Methods A retrospective chart review was conducted of pure tone audiograms in confirmed sudden sensorineural hearing loss cases. Results Of 157 patients with sudden sensorineural hearing loss, 144 had idiopathic hearing loss, 8 had vestibular schwannoma and 5 had Ménière's disease. The r value for the correlation between the two methods of 3 kHz assessment for all patients was 0.887 (p < 0.001). The mean difference between the measured and calculated 3 kHz thresholds was 0.76 ± 7.96 dB, 0.4 ± 8.08 dB and 1.5 ± 1.8 dB in the sudden sensorineural hearing loss, idiopathic and Ménière's disease groups, respectively. The mean difference between the measured and calculated 3 kHz thresholds was significantly greater in the vestibular schwannoma group (6.86 ± 4.38 dB) than in the idiopathic group (p = 0.013). Conclusion The 3 kHz frequency may encompass important audiometric information. A discrepancy between the measured and calculated bone conduction 3 kHz thresholds raises suspicion of an underlying vestibular schwannoma as an aetiology for sudden sensorineural hearing loss, and these thresholds should therefore be measured independently and routinely.

Background Recent studies had shown good serological and cellular immune responses after vaccination with 2 doses of mRNA SARS-CoV2 vaccine among people living with HIV (PLWH). Data regarding the response after three vaccine doses are missing. Materials and Methods We followed a group of PLWH who received three doses of the mRNA BNT162b2 vaccine and for whom data of humoral immune response after two vaccine doses were available. Patients provided a blood sample 4-6 months after the booster dose. The aim of the study was to measure the serologic and cellular response after the 3rd dose and to evaluate factors associated with the vaccine response. Results Fifty patients have provided a serum sample for serologic evaluation after the booster. The anti-RBD IgG titers were higher after the booster with a median delta of 3240 AU/ml. Median CD4 count was 660 cells/ml (515-958) and had no influence on the antibody level. Factors that were associated with lower delta included higher CD8 count (p = 0.018) and longer time between the 3rd dose and the blood test (p = 0.011). Higher anti-RBD IgG titer after the 2nd vaccine (p = 0.03), as well as a longer interval between 2nd and 3rd doses (p = 0.031) were associated with higher delta. There was no increase in the median number of activated INFγ+ and TNFα+ CD4 cells after the booster (n = 8). Conclusions The anti-RBD IgG level after 3 doses of mRNA BNT162b2 vaccine was higher when compared to the level after 2 doses, suggesting additional value of the booster. Cellular response did not further increase after a booster.

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