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. 2024 Jun 16;12(6):663.
doi: 10.3390/vaccines12060663.

SARS-CoV-2 Humoral and Cellular Immune Responses in People Living with HIV

Simona Ruta  1   2 , Corneliu Petru Popescu  1   3 , Lilia Matei  2 , Camelia Grancea  2 , Adrian Marius Paun  3 , Cristiana Oprea  1   3 , Camelia Sultana  1   2
Affiliations

SARS-CoV-2 Humoral and Cellular Immune Responses in People Living with HIV

Simona Ruta et al. Vaccines (Basel). .

Abstract

Immunosuppressed individuals, such as people living with HIV (PLWH), remain vulnerable to severe COVID-19. We analyzed the persistence of specific SARS-CoV-2 humoral and cellular immune responses in a retrospective, cross-sectional study in PLWH on antiretroviral therapy. Among 104 participants, 70.2% had anti-S IgG antibodies, and 55.8% had significant neutralizing activity against the Omicron variant in a surrogate virus neutralization test. Only 38.5% were vaccinated (8.76 ± 4.1 months prior), all displaying anti-S IgG, 75% with neutralizing antibodies and anti-S IgA. Overall, 29.8% of PLWH had no SARS-CoV-2 serologic markers; they displayed significantly lower CD4 counts and higher HIV viral load. Severe immunosuppression (present in 12.5% of participants) was linked to lower levels of detectable anti-S IgG (p = 0.0003), anti-S IgA (p < 0.0001) and lack of neutralizing activity against the Omicron variant (p < 0.0001). T-cell responses were present in 86.7% of tested participants, even in those lacking serological markers. In PLWH without severe immunosuppression, neutralizing antibodies and T-cell responses persisted for up to 9 months post-infection or vaccination. Advanced immunosuppression led to diminished humoral immune responses but retained specific cellular immunity.

Keywords: COVID-19; SARS-CoV-2; cellular; humoral immune response; immunosuppression; vaccination.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Patients’ distribution by SARS-CoV-2 serologic status and vaccination/infection history. The classification was based on the presence or absence of SARS-CoV-2 serological markers and self-declared vaccine history.
Figure 2
Figure 2
Antibody responses according to SARS-CoV-2 infection/vaccination status. V = SARS-CoV-2 vaccinated; I = SARS-CoV-2 infected; V + I = SARS-CoV-2 vaccinated and infected (with hybrid immunity).
Figure 3
Figure 3
Correlation between anti-S IgG and CD4/CD8 (3A) and between anti-S IgA and CD4/CD8 (3B).
Figure 4
Figure 4
SARS-CoV-2-specific T-cell responses in HIV-positive subjects. (A). Number of IFN-γ SFU per 106 PBMCs by CD4 counts following stimulation with recombinant SARS-CoV-2 BA.4/BA.5 S1 protein. (B). Correlation between CD4/CD8 ratio in individuals infected with HIV with their total SARS-CoV-2 responses. The non-parametric Spearman test was used for correlation analysis.
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