COVID-19 Vaccination in People Living with HIV (PLWH) in China: A Cross Sectional Study of Vaccine Hesitancy, Safety, and Immunogenicity

Liu, Ying; Han, Junyan; Li, Xin; Chen, Danying; Zhao, Xiongyan; Qiu, Yaruo; Zhang, Leidan; Xiao, Jing; Li, Bei; Zhao, Hongxin

doi:10.3390/vaccines9121458

Cited by 61 publications

(68 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Contrary to the findings of Liu, 22 who reported that PLWH have spike receptor binding domain-protein specific IgG (S-RBD-IgG) antibody titers comparable to those of healthy controls following inactivated COVID-19 vaccination, our study revealed a poor immune response in PLWH compared with HDs. This discrepancy may be due to differences in detection indicators.…”

Section: Discussioncontrasting

confidence: 99%

“… 21 Further analysis revealed a markedly lower antibody level in patients with CD4 + T-cell counts ≤350 cells per μL, consistent with the finding that CD4 + T-cell count is positively correlated with neutralizing antibody responses to inactivated SARS-CoV-2. 22 , 23 Therefore, a booster dose or dose adjustment might be needed in HIV-infected individuals, especially those with lower CD4 + T-cell counts.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Safety and Immunogenicity of Inactivated COVID-19 Vaccines Among People Living with HIV in China

Han¹,

Yu²,

Han³

et al. 2022

IDR

Self Cite

View full text Add to dashboard Cite

Purpose Vaccination reduces the incidence of severe COVID-19 and death and effectively limits viral spread. Concerns have been raised about COVID-19 vaccine responses in the large population of HIV-infected patients. This study aims to explore the safety and immunogenicity of the inactivated COVID-19 vaccine in people living with HIV (PLWH). Patients and Methods All participants in this study already had their second dose of an inactivated COVID-19 vaccine at least 14 days earlier, without a history of SARS-CoV-2 infection. The primary safety outcomes were the incidence of adverse reactions and changes in CD4 + T-cell counts. SARS-CoV-2 IgG and neutralizing antibody responses to the D614G variant and delta variant were measured for immune response assessment. Results Forty-seven HIV-infected patients and 18 healthy donors (HDs) were enrolled in this study. Adverse reactions were mild or self-limiting and were reported in 19.1% of HIV-infected patients. Most PLWH developed antibody responses against the inactivated COVID-19 vaccine. The longitudinal analysis of antibody responses in PLWH (median interval between detection and complete vaccination, 59 days) showed that antibodies were maintained for at least three months, though their titers were reduced. However, the antibody-positive rates in PLWH were significantly lower than those in HDs. Additionally, compared to HDs (Geomean titers (GMT) of 165 for D614G and GMT of 72 for delta), the neutralizing antibody titers against the two variants in PLWH (GMT of 43 for D614G and GMT 13 for delta) were decreased significantly (p = 0.018 and p < 0.001, respectively). HIV-infected patients with CD4 + T-cell counts ≤350 cells/μL appeared to exhibit a poor antibody response to inactivated vaccination. Conclusion Inactivated COVID-19 vaccines appear to be efficacious in PLWH. However, antibody responses in HIV-infected patients are inferior to those in healthy individuals, especially PLWH with lower CD4 + T-cell counts.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Safety and Immunogenicity of Inactivated COVID-19 Vaccines Among People Living with HIV in China

Han¹,

Yu²,

Han³

et al. 2022

IDR

Self Cite

View full text Add to dashboard Cite

show abstract

“…Our results on the humoral immune response are in agreement with other reports that reported on immunogenicity and safety of COVID-19 vaccines 55, 56, 57 . In contrast, similar antibody responses were reported in a PLWH cohort that received an inactivated SARS-CoV-2 vaccine 58 .…”

Section: Discussionsupporting

confidence: 73%

Impact of SARS-CoV-2 vaccination on systemic immune responses in people living with HIV

Bessen

Plaza-Sirvent

Bhat

et al. 2022

Preprint

View full text Add to dashboard Cite

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) and an ongoing global pandemic. Despite the development of vaccines, which protect healthy people from severe and life-threatening COVID-19, the immunological responses of people with secondary immunodeficiencies to SARS-CoV-2 mRNA vaccines are currently not well understood. Human Immunodeficiency Virus (HIV), causing acquired immunodeficiency syndrome (AIDS), targets CD4+ T helper (Th) cells that orchestrate the immune response. Anti-retroviral therapy suppresses HIV burden and restores Th cell numbers. Here, we investigated the humoral and cellular immune responses elicited by the BTN162b2 vaccine in a cohort of people living with HIV (PLWH), who receive anti-retroviral therapy. While antibody responses in PLWH increased progressively after the first and second vaccination compared to baseline, they were reduced compared to HIV negative study participants (controls). CD8+ T cells exhibited a general activated phenotype and increased effector and effector memory compartments. In contrast, CD4+ Th cell responses exhibited a vaccination-dependent increase and were comparable between PLWH and controls. In line with their reduced humoral response, the correlation between neutralizing antibodies and the CD4+ T cell response was decreased in PLWH compared to healthy controls. Interestingly, CD4+ T cell activation negatively correlated with the CD4 to CD8 ratio, indicating that low CD4 T cell numbers do not necessarily interfere with cellular immune responses. Taken together, our data demonstrate that COVID-19 mRNA vaccination in PLWH results in potent cellular immune responses, but the reduced antibody responses suggest that booster vaccination might be required for preventing disease.

show abstract

“…Our study contributes to the limited literature on vaccine hesitancy among the nationwide sample of PWH living in the U.S., revealing most participants having some levels of hesitancy concerning COVID-19 vaccination. Previously reported vaccine hesitancy rates range from 22% to 42.4% among the adult American population [ 5 , 6 , 7 , 31 ] and 27.5% to 38.4% among PWH across various settings [ 32 , 33 , 34 ]. It is troubling that the vaccine hesitancy among PWH in our sample fell on the higher side of these ranges, as the pandemic adversely impacts HIV care with increasing loss to follow-up or disengagement [ 8 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

“…These included concerns about the efficacy, safety, and side effects of the vaccine. Although COVID-19 vaccine hesitancy among PWH across the globe is still advancing, multiple studies have already highlighted similar findings across various settings [ 32 , 33 , 34 ]. This finding becomes especially relevant in the context of the reported mistrust in COVID-19 or COVID-19 vaccine information sources, which has also been correlated with vaccine hesitancy [ 8 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Vaccine Hesitancy and Associated Factors among People with HIV in the United States: Findings from a National Survey

et al. 2022

View full text Add to dashboard Cite

Introduction: Scaling up vaccination against COVID-19 is central to controlling the COVID-19 epidemic in the United States. Several vaccines are now approved for the prevention of COVID-19, but public concerns over safety and efficacy have heightened distrust and vaccine hesitancy. This is particularly concerning among people with HIV (PWH) who may be vulnerable to more severe COVID-19 disease. Here, we aimed to identify and understand COVID-19 vaccine hesitancy in a sample of PWH in the U.S. Methods: We conducted a cross-sectional online survey among PWH in the U.S. between 6 December 2020 and 8 January 2021. Measures included demographics, participants’ HIV and health-related attributes, COVID-19 history and experiences, COVID-19 vaccine-related concerns, and standardized measures of attitudes towards COVID-19 vaccines. Multivariate linear regression was used to identify factors associated with vaccine hesitancy in this sample. Results: Among the 1030 respondents, most were male (89.7%), White (66.0%), and identified as gay or lesbian (84.5%). Participants’ mean time living with HIV was 17.0 years (standard deviation (SD) = 11.1). The mean score for vaccine hesitancy was 1.5 (SD = 0.5; range: 1–5); 935 participants (90.8%) had a score greater than 1.0, indicating most participants had some degree of vaccine hesitancy. The final multivariate linear regression showed that greater vaccine hesitancy was associated with being Black (b = 0.149, p = 0.005), single (b = 0.070, p = 0.018), politically conservative (b = 0.157, p = 0.010), “anti-vaxxer” (b = 1.791, p < 0.001), concern about side effects (b = 0.226, p < 0.001), concern about safety (b = 0.260, p < 0.001), and being worried that the vaccine will not be effective (b = 0.169, p = 0.008) and they were being experimented on (b = 0.287, p < 0.001). Participants who were male White (b = −0.093, p = 0.008) and university graduates (b = −0.093, p < 0.001) and had a CD4 count of 200 cells/mm3 (b = −0.082, p = 0.048) and a liberal political orientation (b = −0.131, p < 0.001) were associated with lower vaccine hesitancy. Conclusions: Our findings provide important insights regarding COVID-19 vaccine hesitancy among PWH. Further efforts are required to understand how various social, political, and psychological factors contribute to COVID-19 vaccine hesitancy among key populations.

show abstract

COVID-19 Vaccination in People Living with HIV (PLWH) in China: A Cross Sectional Study of Vaccine Hesitancy, Safety, and Immunogenicity

Cited by 61 publications

References 36 publications

Safety and Immunogenicity of Inactivated COVID-19 Vaccines Among People Living with HIV in China

Safety and Immunogenicity of Inactivated COVID-19 Vaccines Among People Living with HIV in China

Impact of SARS-CoV-2 vaccination on systemic immune responses in people living with HIV

COVID-19 Vaccine Hesitancy and Associated Factors among People with HIV in the United States: Findings from a National Survey

Contact Info

Product

Resources

About