Antibody neutralization capacity after COVID-19 vaccination in people with HIV (CIHR Canadian HIV trials network 328)

Abstract

Objectives: Many vaccines require higher/additional doses or adjuvants to provide adequate protection for people living with HIV (PLWH). Here, we compare COVID-19 vaccine-induced antibody neutralization capacity in PLWH vs. HIV-negative individuals following two vaccine doses. Design: In Canadian prospective observational cohorts, inlcuding a multi-centre study of PLWH receiving ≥2 COVID-19 vaccinations (mRNA or ChAdOx1-S), and a parallel study of HIV-negative controls (Stop the Spread Ottawa Cohort), we measured vaccine-induced neutralization capacity 3 months post-dose 2 (± 1 month). Methods: COVID-19 neutralization efficiency was measured by calculating the half maximal inhibitory dilution(ID50) using a high-throughput protein based neutralization assay for Ancestral(Wuhan), Delta and Omicron (BA.1) spike variants. Univariable and multivariable quantile regression were used to compareCOVID-19-specific antibody neutralization capacity by HIV status. Results: Neutralization assays were performed on 256 PLWH and 256 controls based on specimen availability at the timepoint of interest, having received 2 vaccines and known date of vaccination. There was a significant interaction between HIV status and previous COVID-19 infection status in median ID50. There were no differences in median ID50 for HIV+ vs HIV-negative persons without past COVID-19 infection.For participants with past COVID-19 infection, median ICD50 was significantly higher in controls than in PLWH for Ancestral SARS-CoV-2 and Omicron variants, with a trend for the Delta variant in the same direction. Conclusion: Vaccine-induced SARS-CoV-2 neutralization capacity was similar between PLWH vs HIV-negative persons without past COVID-19 infection, demonstrating favourable humoral-mediated immunogenicity. Both HIV+ and HIV-negative persons demonstrated hybrid immunity. Funding: Public Health Agency of Canada, through the Vaccine Surveillance Reference group, the COVID-19 Immunity Task Force (2122-HQ-000075) and the CTN. Production of COVID-19 reagents was financially supported by National Research Council of Canada (NRC) Pandemic Response Challenge Program. Trial registration: clinicaltrials.gov NCT04894448

Effects of COVID-19 mRNA vaccination on HIV viremia and reservoir size

“…In conclusion, we found no evidence that COVID-19 mRNA vaccines induced changes in HIV reservoir size nor plasma viremia in PWH receiving suppressive ART. Taken together with similar findings from other studies [ 33 – 35 , 37 ], we conclude that there is now a strong body of evidence indicating COVID-19 immunization is safe and effective in PWH [ 4 – 12 ]. This should provide additional reassurance to PWH and their care providers regarding the safety of COVID-19 mRNA vaccines.…”

“…Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is particularly important for people with HIV (PWH) who are at a higher risk of severe coronavirus disease 2019 (COVID- 19) outcomes [1][2][3]. Reassuringly, a large body of evidence now confirms that PWH receiving suppressive antiretroviral therapy (ART) generally mount robust immune responses to these vaccines [4][5][6][7][8][9][10][11][12]. Initially however, COVID-19 vaccine confidence was typically lower among PWH compared to the general population [13,14], with possible effects of vaccination on viral rebound cited among the concerns [15,16].…”

Effects of COVID-19 mRNA vaccination on HIV viremia and reservoir size

“…Taken together with similar findings from other studies [27][28][29]31], we conclude that there is now a strong body of evidence indicating COVID-19 immunization is safe and effective in PWH [4][5][6][7][8][9][10][11][12]. This should provide additional reassurance to PWH and their care providers regarding the safety of COVID-19 mRNA vaccines.…”

“…The mass rollout of safe and effective SARS-CoV-2 mRNA vaccines was critical in combatting the COVID-19 pandemic. As people with HIV (PWH) are at a higher risk of severe COVID-19 outcomes [1][2][3], it was particularly important for this group to be vaccinated, and a large body of evidence now reassuringly confirms that PWH receiving suppressive antiretroviral therapy (ART) generally mount robust immune responses to COVID-19 vaccination [4][5][6][7][8][9][10][11][12]. Initially however, COVID-19 vaccine confidence was typically lower among PWH compared to the general population [13,14], with possible effects of vaccination on viral rebound cited among the concerns [15,16].…”

Correlates of Breakthrough SARS-CoV-2 Infections in People with HIV: Results from the CIHR CTN 328 Study

“…The CTN 328 protocol was previously published [28] and later amended to accommodate third and fourth doses/boosters. Enrolment occurred from April to June 2021 in Vancouver and from June 2021 to January 2022 for the remaining sites [29,30]. The participants attended visits prior to and following the vaccine dosing for phlebotomy and questionnaire completion [29,30].…”