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. 2023 Apr 1;37(5):709-721.
doi: 10.1097/QAD.0000000000003469. Epub 2022 Dec 22.

Antibody response durability following three-dose coronavirus disease 2019 vaccination in people with HIV receiving suppressive antiretroviral therapy

Hope R Lapointe  1 , Francis Mwimanzi  2 , Peter K Cheung  1   2 , Yurou Sang  2 , Fatima Yaseen  3 , Sarah Speckmaier  1 , Evan Barad  1   2 , Nadia Moran-Garcia  1 , Sneha Datwani  2 , Maggie C Duncan  1   2 , Rebecca Kalikawe  2 , Siobhan Ennis  2 , Landon Young  4 , Bruce Ganase  5 , F Harrison Omondi  1   2 , Gisele Umviligihozo  2 , Winnie Dong  1 , Junine Toy  1 , Paul Sereda  1 , Laura Burns  6 , Cecilia T Costiniuk  7 , Curtis Cooper  8   9 , Aslam H Anis  10   11   12 , Victor Leung  4   6   13 , Daniel Holmes  6   13 , Mari L DeMarco  6   13 , Janet Simons  6   13 , Malcolm Hedgcock  14 , Natalie Prystajecky  13   15 , Christopher F Lowe  4   6   13 , Marc G Romney  4   6   13 , Rolando Barrios  1   10 , Silvia Guillemi  1   16 , Chanson J Brumme  1   17 , Julio S G Montaner  1   17 , Mark Hull  1   17 , Marianne Harris  1   16 , Masahiro Niikura  2 , Mark A Brockman  1   2   3 , Zabrina L Brumme  1   2
Affiliations

Antibody response durability following three-dose coronavirus disease 2019 vaccination in people with HIV receiving suppressive antiretroviral therapy

Hope R Lapointe et al. AIDS. .

Abstract

Background: Limited data exist regarding longer term antibody responses following three-dose coronavirus disease 2019 (COVID-19) vaccination, and the impact of a first SARS-CoV-2 infection during this time, in people with HIV (PWH) receiving suppressive antiretroviral therapy (ART). We quantified wild-type-specific, Omicron BA.1-specific and Omicron BA.5-specific responses up to 6 months post-third dose in 64 PWH and 117 controls who remained COVID-19-naive or experienced their first SARS-CoV-2 infection during this time.

Design: Longitudinal observational cohort.

Methods: We quantified wild-type-specific and Omicron-specific anti-Spike receptor-binding domain IgG concentrations, ACE2 displacement activities and live virus neutralization at 1, 3 and 6 months post-third vaccine dose.

Results: Third doses boosted all antibody measures above two-dose levels, but BA.1-specific responses remained significantly lower than wild-type-specific ones, with BA.5-specific responses lower still. Serum IgG concentrations declined at similar rates in COVID-19-naive PWH and controls post-third dose (median wild-type-specific and BA.1-specific half-lives were between 66 and 74 days for both groups). Antibody function also declined significantly yet comparably between groups: 6 months post-third dose, BA.1-specific neutralization was undetectable in more than 80% of COVID-19 naive PWH and more than 90% of controls. Breakthrough SARS-CoV-2 infection boosted antibody concentrations and function significantly above vaccine-induced levels in both PWH and controls, though BA.5-specific neutralization remained significantly poorer than BA.1 even post-breakthrough.

Conclusion: Following three-dose COVID-19 vaccination, antibody response durability in PWH receiving ART is comparable with controls. PWH also mounted strong responses to breakthrough infection. Due to temporal response declines, however, COVID-19-naive individuals, regardless of HIV status, would benefit from a fourth dose within 6 months of their third.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Fig. 1
Fig. 1
Wild-type-specific and Omicron BA.1-specific anti-RBD IgG concentrations following three-dose coronavirus disease 2019 vaccination.
Fig. 2
Fig. 2
Wild-type-specific and Omicron BA.1-specific ACE2 displacement function following three-dose COVID-19 vaccination.
Fig. 3
Fig. 3
Wild-type-specific and Omicron BA.1-specific live virus neutralization activity following three-dose coronavirus disease 2019 vaccination.
Fig. 4
Fig. 4
Wild-type-specific, Omicron BA.1-specific and Omicron BA.5-specific live virus neutralization activity before and after breakthrough infection.
See this image and copyright information in PMC

Comment in

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