Dataset Information

SARS-CoV-2 live virus neutralization after four COVID-19 vaccine doses in people with HIV receiving suppressive ART.

ABSTRACT:

Objective

Limited data exist regarding the immune benefits of fourth COVID-19 vaccine doses in people with HIV (PWH) receiving ART, particularly now that most have experienced a SARS-CoV-2 infection. We quantified wild-type (WT)-, Omicron-BA.5- and Omicron-BQ.1-specific neutralization up to one month postfourth COVID-19 vaccine dose in 63 (19 SARS-CoV-2-naive and 44 SARS-CoV-2-experienced) PWH.

Design

Longitudinal observational cohort.

Methods

Quantification of wild-type (WT)-, Omicron-BA.5- and Omicron-BQ.1-specific neutralization using live virus assays.

Results

Participants received monovalent (44%) and bivalent (56%) mRNA fourth doses. In COVID-19-naive PWH, fourth doses enhanced WT- and Omicron-BA.5-specific neutralization modestly above three-dose levels (P = 0.1). In COVID-19-experienced PWH, fourth doses enhanced WT-specific neutralization modestly (P = 0.1) and BA.5-specific neutralization substantially (P = 0.002). Consistent with humoral benefits of 'hybrid' immunity, COVID-19-experienced PWH exhibited the highest neutralization postfourth dose, where those with Omicron-era infections displayed higher WT-specific (P = 0.04) but similar BA.5- and BQ.1-specific neutralization than those with pre-Omicron-era infections. Nevertheless, BA.5-specific neutralization was significantly below WT in everyone regardless of COVID-19 experience, with BQ.1-specific neutralization lower still (both P < 0.0001). In multivariable analyses, fourth dose valency did not affect neutralization magnitude. Rather, an mRNA-1273 fourth dose (versus a BNT162b2 one) was the strongest correlate of WT-specific neutralization, while prior COVID-19, regardless of pandemic era, was the strongest correlate of BA.5 and BQ.1-specific neutralization postfourth dose.

Conclusions

Fourth COVID-19 vaccine doses, irrespective of valency, benefit PWH regardless of prior SARS-CoV-2 infection. Results support recommendations that all adults receive a fourth COVID-19 vaccine dose within 6 months of their third (or their most recent SARS-CoV-2 infection).

SUBMITTER: Cheung PK

PROVIDER: S-EPMC9994812 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

SARS-CoV-2 live virus neutralization after four COVID-19 vaccine doses in people with HIV receiving suppressive antiretroviral therapy.

Cheung Peter K PK Lapointe Hope R HR Sang Yurou Y Ennis Siobhan S Mwimanzi Francis F Speckmaier Sarah S Barad Evan E Dong Winnie W Liang Richard R Simons Janet J Lowe Christopher F CF Romney Marc G MG Brumme Chanson J CJ Niikura Masahiro M Brockman Mark A MA Brumme Zabrina L ZL

AIDS (London, England) 20230214 5

<h4>Objective</h4>Limited data exist regarding the immune benefits of fourth COVID-19 vaccine doses in people with HIV (PWH) receiving antiretroviral therapy (ART), particularly now that most have experienced a SARS-CoV-2 infection. We quantified wild-type, Omicron-BA.5 and Omicron-BQ.1-specific neutralization up to 1 month post-fourth COVID-19 vaccine dose in 63 (19 SARS-CoV-2-naive and 44 SARS-CoV-2-experienced) PWH.<h4>Design</h4>A longitudinal observational cohort.<h4>Methods</h4>Quantificat ...[more]

PMID: 36789806

Similar Datasets

Project description:BackgroundLimited 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.DesignLongitudinal observational cohort.MethodsWe 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.ResultsThird 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.ConclusionFollowing 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.