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Immunogenicity to COVID-19 mRNA vaccine third dose in people living with HIV.

ABSTRACT: In order to investigate safety and immunogenicity of SARS-CoV-2 vaccine third dose in people living with HIV (PLWH), we analyze anti-RBD, microneutralization assay and IFN-γ production in 216 PLWH on ART with advanced disease (CD4 count <200 cell/mm³ and/or previous AIDS) receiving the third dose of a mRNA vaccine (BNT162b2 or mRNA-1273) after a median of 142 days from the second dose. Median age is 54 years, median CD4 nadir 45 cell/mm³ (20-122), 93% HIV-RNA < 50 c/mL. In 68% of PLWH at least one side-effect, generally mild, is recorded. Humoral response after the third dose was strong and higher than that achieved with the second dose (>2 log₂ difference), especially when a heterologous combination with mRNA-1273 as third shot is used. In contrast, cell-mediated immunity remain stable. Our data support usefulness of third dose in PLWH currently receiving suppressive ART who presented with severe immune dysregulation.

SUBMITTER: Vergori A

PROVIDER: S-EPMC9395398 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Immunogenicity to COVID-19 mRNA vaccine third dose in people living with HIV.

Vergori Alessandra A Cozzi Lepri Alessandro A Cicalini Stefania S Matusali Giulia G Bordoni Veronica V Lanini Simone S Meschi Silvia S Iannazzo Roberta R Mazzotta Valentina V Colavita Francesca F Mastrorosa Ilaria I Cimini Eleonora E Mariotti Davide D De Pascale Lydia L Marani Alessandra A Gallì Paola P Garbuglia AnnaRosa A Castilletti Concetta C Puro Vincenzo V Agrati Chiara C Girardi Enrico E Vaia Francesco F Antinori Andrea A

Nature communications 20220822 1

In order to investigate safety and immunogenicity of SARS-CoV-2 vaccine third dose in people living with HIV (PLWH), we analyze anti-RBD, microneutralization assay and IFN-γ production in 216 PLWH on ART with advanced disease (CD4 count <200 cell/mm<sup>3</sup> and/or previous AIDS) receiving the third dose of a mRNA vaccine (BNT162b2 or mRNA-1273) after a median of 142 days from the second dose. Median age is 54 years, median CD4 nadir 45 cell/mm<sup>3</sup> (20-122), 93% HIV-RNA < 50 c/mL. In ...[more]

PMID: 35995780

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Project description:Background and aimsCirrhosis is associated with immune dysregulation and hypo-responsiveness to several vaccines including against COVID-19. Our aim was to study the association of the receipt of three doses of either the Pfizer BNT162b2 mRNA or Moderna mRNA-1273 vaccines in patients with cirrhosis, compared to a propensity-matched control group of patients at similar risk of infection who received two doses.MethodsThis was a retrospective cohort study of patients with cirrhosis who received two or three doses of a COVID-19 mRNA vaccine at the Veterans Health Administration. Participants who received three doses of the vaccine (n=13,041) were propensity matched with 13,041 controls who received two doses, and studied between July 18, 2021 and February 11, 2022, when B.1.617.2 (Delta) and B.1.1.529 (Omicron) were the predominant variants. Outcomes were aggregated as all cases with COVID-19, symptomatic COVD-19, with at least moderate COVID-19, or severe or critical COVID-19.ResultsReceipt of the third dose of a COVID-19 mRNA vaccine was associated with an 80.7% reduction COVID-19 (95% CI 39.2-89.1, p<0.001), 80.4% reduction in symptomatic COVID-19, 80% reduction in moderate/ severe or critical COVID-19, (95% CI 34.5-87.6%, p=0.005), 100% reduction in severe or critical COVID-19 (95% CI 99.2-100.0, p=0.01), and a 100% reduction in COVID-19-related death (95% CI 99.8-100.0, p=0.007). The magnitude of reduction in COVID-19 was greater with the third dose of BNT 162b2 than mRNA-1273 and among participants with compensated than decompensated cirrhosis.ConclusionsAdministration of a third dose of a COVID-19 mRNA vaccine was associated with a more significant reduction in COVID-19 in cirrhosis than reported in the general population, suggesting that the third dose can overcome vaccine hyporesponsiveness in this population.Lay summaryCirrhosis is associated with decreased responsiveness to several vaccines, including against COVID-19. In this study of 26,082 participants with cirrhosis during the delta and omicron surge, receipt of the third dose of the vaccine was associated with 80% reduction in COVID-19, 100% reduction in severe/critical COVID-19, and 100% reduction in COVID-19-related death. The findings support the third dose of mRNA vaccine among patients with cirrhosis.

Dataset Information

Immunogenicity to COVID-19 mRNA vaccine third dose in people living with HIV.

Publications

Immunogenicity to COVID-19 mRNA vaccine third dose in people living with HIV.

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