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Observational Study
. 2024 Jul 1;38(8):1120-1130.
doi: 10.1097/QAD.0000000000003841. Epub 2024 Jan 22.

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

Maggie C Duncan  1   2 , F Harrison Omondi  1   2 , Natalie N Kinloch  1   2 , Hope R Lapointe  1 , Sarah Speckmaier  1 , Nadia Moran-Garcia  1 , Tanya Lawson  3 , Mari L DeMarco  4   5 , Janet Simons  4   5 , Daniel T Holmes  4   5 , Christopher F Lowe  3   4   5 , Nic Bacani  1 , Paul Sereda  1 , Rolando Barrios  1   6 , Marianne Harris  1   7 , Marc G Romney  3   4   5 , Julio S G Montaner  1   8 , Chanson J Brumme  1   8 , Mark A Brockman  1   2   9 , Zabrina L Brumme  1   2
Affiliations
Observational Study

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

Maggie C Duncan et al. AIDS. .

Abstract

Objective: The immunogenic nature of coronavirus disease 2019 (COVID-19) mRNA vaccines led to some initial concern that these could stimulate the HIV reservoir. We analyzed changes in plasma HIV loads (pVL) and reservoir size following COVID-19 mRNA vaccination in 62 people with HIV (PWH) receiving antiretroviral therapy (ART), and analyzed province-wide trends in pVL before and after the mass vaccination campaign.

Design: Longitudinal observational cohort and province-wide analysis.

Methods: Sixty-two participants were sampled prevaccination, and one month after their first and second COVID-19 immunizations. Vaccine-induced anti-SARS-CoV-2-Spike antibodies in serum were measured using the Roche Elecsys Anti-S assay. HIV reservoirs were quantified using the intact proviral DNA assay; pVL were measured using the cobas 6800 (lower limit of quantification: 20 copies/ml). The province-wide analysis included all 290 401 pVL performed in British Columbia, Canada between 2012 and 2022.

Results: Prevaccination, the median intact reservoir size was 77 [interquartile range (IQR): 20-204] HIV copies/million CD4 + T-cells, compared to 74 (IQR: 27-212) and 65 (IQR: 22-174) postfirst and -second dose, respectively (all comparisons P > 0.07). Prevaccination, 82% of participants had pVL <20 copies/ml (max: 110 copies/ml), compared to 79% postfirst dose (max: 183 copies/ml) and 85% postsecond dose (max: 79 copies/ml) ( P > 0.4). There was no evidence that the magnitude of the vaccine-elicited anti-SARS-CoV-2-Spike immune response influenced pVL nor changes in reservoir size ( P > 0.6). We found no evidence linking the COVID-19 mass vaccination campaign to population-level increases in detectable pVL frequency among all PWH in the province, nor among those who maintained pVL suppression on ART.

Conclusion: We found no evidence that COVID-19 mRNA vaccines induced changes in HIV reservoir size nor plasma viremia.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Plasma HIV loads following one- and two-dose COVID-19 vaccination.
Fig. 2
Fig. 2
Measures of intact reservoir size, and total, 5’-defective, 3’-defective proviral burdens after one- and two-dose COVID-19 vaccination.
Fig. 3
Fig. 3
Relationship between reservoir size, plasma viral load and COVID-19 vaccine immune response magnitude.
Fig. 4
Fig. 4
Population-level analysis of pVL test results in BC.
See this image and copyright information in PMC

Update of

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