Effectiveness and evolution of anti-SARS-CoV-2 spike protein titers after three doses of COVID-19 vaccination in people with HIV

Wang-Da Liu ¹, Meng-Shuan Lin ², Hsin-Yun Sun ³

¹Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan.
²Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan.
³Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
⁴School of Medicine, National Tsing Hua University, Hsinchu, Taiwan.
⁵Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Center of Infection Control, National Taiwan University Hospital, Taipei, Taiwan.
⁶Center of Infection Control, National Taiwan University Hospital, Taipei, Taiwan.
⁷Department of Nursing, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
⁸Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan.
⁹Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; School of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
¹⁰Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
¹¹Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan; Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan.

⁰Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan.

Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi +

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March 1, 2024

View abstract on PubMed

Summary

Third vaccine doses against SARS-CoV-2 showed similar effectiveness in people with HIV (PWH). The 100-μg mRNA-1273 booster generated a stronger antibody response compared to other options.

Area Of Science

Immunology
Infectious Diseases
Public Health

Background

Limited data exists on real-world vaccine effectiveness of third SARS-CoV-2 vaccine doses in people with HIV (PWH).
Understanding immune response and protection in this population is crucial for public health strategies.

Purpose Of The Study

To investigate the real-world vaccine effectiveness of the third dose of COVID-19 vaccines in people with HIV (PWH).
To compare the immunogenicity and effectiveness of BNT162b2 and mRNA-1273 (50-μg and 100-μg) third doses in PWH.

Main Methods

A cohort of 1427 people with HIV (PWH) received a third dose of either BNT162b2 or mRNA-1273 (50- or 100-μg).
Participants were followed for 180 days, monitoring SARS-CoV-2 infection, seroconversion, and antibody titers (anti-spike IgG).
Factors influencing antibody response, including CD4 count and HIV RNA levels, were analyzed.

Main Results

No significant difference in SARS-CoV-2 infection rates was observed between vaccine groups (246.1 to 280.8 per 1000 person-months).
Higher anti-spike IgG titers (>1047 BAU/mL) were associated with higher CD4 counts, lower HIV RNA levels, and prior mRNA vaccination.
The 100-μg mRNA-1273 dose showed a trend towards higher antibody response compared to 50-μg mRNA-1273 and BNT162b2.

Conclusions

Third doses of COVID-19 vaccines provide similar real-world effectiveness against SARS-CoV-2 infection in people with HIV (PWH).
The 100-μg mRNA-1273 vaccine may elicit a superior antibody response in PWH compared to other third-dose options.
Maintaining high antibody titers is influenced by immune status, including CD4 count and viral load.

Keywords:

BNT162b2 vaccine Booster vaccination Humoral immunity Immunogenicity Serologic response mRNA-1273 vaccine