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. 2022 Nov 28;226(11):1913-1923.
doi: 10.1093/infdis/jiac406.

Limited Humoral and Specific T-Cell Responses After SARS-CoV-2 Vaccination in PWH With Poor Immune Reconstitution

Susana Benet  1 , Oscar Blanch-Lombarte  2 , Erola Ainsua-Enrich  2 , Núria Pedreño-Lopez  2 , Jordana Muñoz-Basagoiti  2 , Dàlia Raïch-Regué  2 , Daniel Perez-Zsolt  2 , Ruth Peña  2 , Esther Jiménez  2 , María Luisa Rodríguez de la Concepción  2 , Carlos Ávila  2 , Samandhy Cedeño  2 , Tuixent Escribà  2 , Luis Romero-Martín  2 , Yovaninna Alarcón-Soto  1 , Gabriel Felipe Rodriguez-Lozano  2 , Cristina Miranda  1 , Sandra González  1 , Lucía Bailón  1   3 , Julià Blanco  2   4   5   6 , Marta Massanella  2   6 , Christian Brander  2   5   6   7 , Bonaventura Clotet  1   2   4   5 , Roger Paredes  1   2   4   5   6 , María Esteve  8   3 , Nuria Izquierdo-Useros  2   4   6 , Jorge Carrillo  2   4   6 , Julia G Prado  2   4   6 , José Moltó  1   6 , Beatriz Mothe  1   2   5   6
Affiliations

Limited Humoral and Specific T-Cell Responses After SARS-CoV-2 Vaccination in PWH With Poor Immune Reconstitution

Susana Benet et al. J Infect Dis. .

Abstract

Background: We analyzed humoral and cellular immune responses induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines in people with human immunodeficiency virus (HIV; PWH) who had CD4+ T-cell counts <200/µL (HIV<200 group).

Methods: This prospective cohort study included 58 PWH in the HIV<200 group, 36 with CD4+ T-cell counts >500/µL (HIV>500 group), and 33 HIV-1-negative controls (control group). Antibodies against the SARS-CoV-2 spike protein (anti-S immunoglobulin [Ig] G) and the receptor-binding domain (anti-RBD IgG) were quantified before and 4 weeks after the first and the second doses of BNT162b2 or mRNA-1273 (at week 8). Viral neutralization activity and T-cell responses were also determined.

Results: At week 8, anti-S/anti-RBD IgG responses increased in all groups (P < .001). Median (interquartile range) anti-S and anti-RBD IgG levels at week 8 were 153.6 (26.4-654.9) and 171.9 (61.8-425.8) binding antibody units (BAU)/mL, respectively, in the HIV<200 group, compared with 245.6 (145-824) and 555.8 (166.4-1751) BAU/mL in the HIV>500 group and 274.7 (193.7-680.4) and 281.6 (181-831.8) BAU/mL in controls (P < .05). Neutralizing capacity and specific T-cell immune responses were absent or reduced in 33% of those in the HIV<200 group, compared with 3.7% in the HIV>500 group (P < .01).

Conclusions: One-third of PWH with CD4+ T-cell counts <200/µL show low anti-S/anti-RBD IgG levels, reduced in vitro neutralization activity against SARS-CoV-2, and no vaccine-induced T cells after receiving coronavirus disease 2019 mRNA vaccines.

Keywords: SARS-CoV-2 vaccine; anti-RBD IgG; anti-S IgG; neutralizing antibodies; people with HIV.

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Conflict of interest statement

Potential conflicts of interest. Unrelated to the submitted work, RP reports institutional grants from GileaD, MSD, VIIV, GSK, THERATECHNOLOGIES, LILLY. Unrelated to the submitted work, N.I-U. reports institutional grants from HIPRA, Pharma Mar, Grifols, Amassence and Palobiofarma. Unrelated to the submitted work, BM reports institutional grants from Janssen and Aelix Therapeutics. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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