Immunological changes after COVID-19 vaccination in an HIV-positive patient

Gong, Changlin; Song, Xiaojing; Li, Xiaoxia; Lu, Lianfeng; Li, Taisheng

doi:10.1016/j.ijid.2021.08.039

Cited by 16 publications

(13 citation statements)

References 20 publications

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“…However, other studies have shown contrasting results indicating that this group can also elicit an antibody response after being vaccinated with a SARS-CoV-2 mRNA vaccine [ 10–12 ]. In addition, a case of viral activation and CD4 + T cell loss after receiving an inactivated COVID-19 vaccine in a treatment-naïve HIV-positive patient was reported by a recent study [ 13 ]. Therefore, the safety and immunogenicity of inactivated vaccines in PLWH are still unclear.…”

Section: Introductionmentioning

confidence: 99%

Safety and immunogenicity of inactivated SARS-CoV-2 vaccines in people living with HIV

Cao

et al. 2022

Emerging Microbes & Infections

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It is important to know the safety and efficacy of vaccination in immunocompromised people living with HIV (PLWH), but currently, there is limited data on the inactivated SARS-CoV-2 vaccines’ safety and immune responses in PLWH. In this prospective observational study, 139 PLWH and 120 healthy controls were enrolled and monitored for 21–105 days after a two-dose vaccination. The safety, anti-receptor binding domain IgG (anti-RBD-IgG) and anti-spike-IgG responses, and RBD-specific memory B cell (MBC) responses were evaluated. The overall adverse events within seven days were reported in 12.9% (18/139) of PLWH and 13.3% (16/120) of healthy controls. No serious adverse events occurred in both groups. Overall, the seroprevalence of anti-RBD-IgG in PLWH was significantly decreased (87.1% vs. 99.2%; p <0.001). The geometric mean end-point titer (GMT) of anti-RBD-IgG in PLWH was also reduced, especially in patients with CD4 counts <200 cells/µL, regardless of age, gender, or HIV viral load. GMTs of anti-RBD-IgG in both PLWH and healthy controls declined gradually over time. Similar results were also observed in the anti-spike-IgG response. The frequency of RBD-specific MBCs in PLWH decreased ( p <0.05), and then remained stable over time. Lastly, through multivariate analysis, we found the factors that predicted a less robust response to inactivated vaccines in PLWH were a low CD4 count and long time interval after vaccination. In conclusion, inactivated vaccines are well-tolerated in PLWH but with low immunogenicity. Therefore, SARS-CoV-2 vaccines and booster doses should be given priority in PLWH, especially in patients with low CD4 counts. Trial registration: .

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Section: Introductionmentioning

confidence: 99%

Safety and immunogenicity of inactivated SARS-CoV-2 vaccines in people living with HIV

Cao

et al. 2022

Emerging Microbes & Infections

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“…8 The clinical course of people living with HIV/AIDS (PLWHA) with COVID-19 is not well studied, but the World Health Organization has reported high occurrences of severe disease and mortality. [9][10][11] Many vaccine preparations for this group of people are on trial. 12 The WHO recommended only COVID-19 vaccines (AstraZeneca/Oxford, Johnson & Johnson, Moderna, Pfizer, Sinopharm, and Sinovac) are safe for people living with HIV.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Intention to Receive COVID-19 Vaccine Among HIV Positive Patients Attending ART Clinic in Southwest Ethiopia

Mesfin¹,

Argaw²,

Tenaw³

2021

PPA

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Introduction:By the end of 2021, Ethiopia plans to vaccinate 20% of the population. The prioritized group includes people older than 65 years, health care workers, teachers, soldiers, and people living with comorbid diseases, including HIV/AIDS. However, due to a lack of intention and other reasons, only less than one percent of the population has taken COVID-19 vaccine. Therefore, this study aimed to assess the determinant factors of intention to receive the COVID-19 vaccine among HIV-positive patients attending ART clinics in southern Ethiopia. Methods: A facility-based cross-sectional study was conducted among 398 HIV-positive patients from March 1 to April 28, 2021. Data were collected using a structured questionnaire by three midwives. We entered the data into Epi InfoTM 3.5.1. Binary logistic regression was used to identify independently associated variables in bivariate and multivariate analyses using SPSS version 20. Results: Currently, the intention to take COVID-19 vaccine among HIV-positive patients was 33.7%. The probability of PLWHA to take COVID-19 vaccine was two (AOR = 2 (1.08-3.44)) times higher among those who have been diagnosed with chronic diseases (exclude HIV) with those with not been diagnosed. PLWHA who were male in sex were five (AOR = 5 (2.96-8.68)) times more likely to take COVID-19 vaccine than female. The study also indicated that the odds of intention to take the COVID-19 vaccine were 4.1 times (AOR = 4.1 (2.33-7.31)) times higher among those participants who had good knowledge of COVID-19 practice compared with those who had poor knowledge. Conclusion:The overall intention to receive the COVID-19 vaccine among PLWHA is low. Therefore, there is a need to improve the intention to receive the COVID-19 vaccine among HIV-positive patients to achieve the 2021 goal of Ethiopia for 20% of the population vaccination. Patients with chronic illness, knowledge of the COVID-19 vaccine, and sex were factors associated with the intention to receive COVID-19 vaccine.

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“…In other words, the presumptive cerebral toxoplasmosis found in both patients was an AIDS-defining illness regardless of CD4+ count. Based on the previously reported case, we speculate that possible activation of HIV infection after inactivated COVID-19 vaccine injection led to increased CD4+ T cells destruction, which in turn caused progressive clinical deteriorations in the reported cases [ 21 ]. However, it should be taken into account that this speculation is based on only a single case report of a treatment-naïve HIV-positive patient and the findings cannot be generalized to other patients with HIV.…”

Section: Discussionmentioning

confidence: 93%

“…To date, there is no clear understanding of adverse events following COVID-19 vaccination in PLWHA with previously unknown HIV status. The closest study we found to our current report was a case report in a treatment-naïve HIV-positive patient who experienced deterioration of HIV infection after receiving the first dose of an inactivated COVID-19 vaccine [ 21 ]. This report suggested the possibility of activated HIV infection that directly increased the rate of CD4+ T cells destruction, thus causing serial depletion of CD4+ T cells.…”

Section: Discussionmentioning

confidence: 99%

“…This report suggested the possibility of activated HIV infection that directly increased the rate of CD4+ T cells destruction, thus causing serial depletion of CD4+ T cells. This report also suggested that ART initiation in the case of treatment-naïve PLWHA could be beneficial to preserve immune function, prevent secondary HIV transmission, and prevent complications of health conditions or procedures, including vaccines [ 21 ]. In addition, infection with HIV-1 and SARS-CoV-2 causes marked CD4+ T cell lymphopenia by the mechanisms of direct CD4+ T cells attacks, immune activation, and CD4+ T cell redistributions [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Progressive Worsening of Neurological Manifestations in HIV-Associated Opportunistic Central Nervous System (CNS) Infection Patients After COVID-19 Vaccinations: A Possible Co-Incidence Causality

et al. 2022

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Immunological changes after COVID-19 vaccination in an HIV-positive patient

Cited by 16 publications

References 20 publications

Safety and immunogenicity of inactivated SARS-CoV-2 vaccines in people living with HIV

Safety and immunogenicity of inactivated SARS-CoV-2 vaccines in people living with HIV

Factors Associated with Intention to Receive COVID-19 Vaccine Among HIV Positive Patients Attending ART Clinic in Southwest Ethiopia

Progressive Worsening of Neurological Manifestations in HIV-Associated Opportunistic Central Nervous System (CNS) Infection Patients After COVID-19 Vaccinations: A Possible Co-Incidence Causality

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