This is a summary, written by members of the CITF Secretariat, of:

Lapointe HR, Mwimanzi F, Cheung PK, Sang Y, Yaseen F, Umviligihozo G, Kalikawe R, Speckmaier S, Moran-Garcia N, Datwani S, Duncan MC, Agafitei O, Ennis S, Young L, Ali H, Ganase B, Omondi FH, Dong W, Toy J, Sereda P, Burns L, Costiniuk CT, Cooper C, Anis A, Leung V, Holmes DT, DeMarco ML, Simons J, Hedgcock M, Prystajecky N, Lowe CF, Pantophlet R, Romney MG, Barrios R, Guillemi S, Brumme CJ, Montaner JSG, Hull M, Harris M, Niikura M, Brockman MA, Brumme ZL. People with HIV receiving suppressive antiretroviral therapy show typical antibody durability after dual COVID-19 vaccination, and strong third dose responses.  The Journal of Infectious Diseases, 2022; jiac229, https://doi.org/10.1093/infdis/jiac229.

The results and/or conclusions contained in the research do not necessarily reflect the views of all CITF members.

In a paper now published in the Journal of Infectious Diseases, Drs. Zabrina Brumme and Mark Brockman from Simon Fraser University and the BC Centre for Excellence in HIV/AIDS, and members of the Canadian HIV Trials Network, led by Dr. Aslam Anis from the University of British Columbia, demonstrate that responses to COVID-19 vaccines in people living with HIV (PLWH) are similar to those without HIV. Following both the second and the third dose of COVID-19 vaccine, PLWH also exhibited similar total antibody and neutralizing antibody responses against the Omicron variant compared to controls without HIV. In both groups, however, anti-Omicron responses were not as strong as those against the original SARS-CoV-2 strain.

The study examined the ability to measure of anti-COVID antibodies and virus neutralization responses against SARS-CoV-2 up to six months after two COVID-19 vaccine doses in PLWH well controlled on antiretroviral therapy. The team also measured the magnitude of these responses one month after a third dose.

Key findings:

  • After two doses of vaccine, antibody responses against the receptor binding domain were of similar magnitude and durability in PLWH and people without HIV.
    • Weaker antibody responses after two doses were generally associated with a higher number of chronic conditions, older age, and immunization with two doses of AstraZeneca’s Vaxzeria vaccine, regardless of HIV status.
  • In both groups, a longer interval between the first and second vaccine dose was associated with higher antibody concentrations immediately after the second dose, but this impact diminished over time.
  • Third doses boosted antibody responses in both groups above what had been the peak response after the second dose.
  • Prior SARS-CoV-2 infection and having received Moderna’s Spikevax vaccine as a third dose were associated with higher virus neutralization.

With respect to the Omicron variant:

  • Third doses boosted anti-Omicron responses in both PLWH and control groups above what was seen after a second dose.
  • Third doses of Moderna were associated with a more robust antibody response compared to Pfizer-BioNTech’s Comirnaty vaccine.
  • Males had a slightly lower antibody response following a third dose compared to females.
  • Neutralizing activity against Omicron was 4- to 8-fold lower than against the original SARS-CoV-2 strain in both groups after two and three doses.

The 99 PLWH (who were taking ART and had suppressed plasma HIV loads) and 152 controls (predominantly healthcare workers) participants were broadly similar in age. They had similar numbers of chronic health conditions, but the PLWH group included a greater proportion of white men. At study entry, 8% of PLWH and 10% of controls had prior infections of SARS-CoV-2. An additional 31 participants (18 PLWH and 13 controls) experienced post-vaccination SARS-CoV-2 infections, 26 of which occurred during the Omicron wave. The interval between the first and the second dose was longer among the controls (89 days) when compared to PLWH (58 days). 80% of PLWH and 88% of controls received the third dose of the mRNA vaccine, on average 6.3 months after their second dose.

This study is important because PLWH may be at increased risk of severe COVID-19 due to immunosuppression, higher rates of comorbidities, and/or negative social determinants of health.