Humoral and Cellular Immune Response Elicited by mRNA Vaccination Against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in People Living With Human Immunodeficiency Virus Receiving Antiretroviral Therapy Based on Current CD4 T-Lymphocyte Count
Andrea Antinori, Stefania Cicalini, Silvia Meschi, Veronica Bordoni, Patrizia Lorenzini, Alessandra Vergori, Simone Lanini, Lidya De Pascale, Giulia Matusali, Davide Mariotti, Alessandro Cozzi Lepri, Paola Gallì, Carmela Pinnetti, Roberta Gagliardini, Valentina Mazzotta, Ilaria Mastrorosa, Susanna Grisetti, Francesca Colavita, Eleonora Cimini, Elisabetta Grilli, Rita Bellagamba, Daniele Lapa, Alessandra Sacchi, Alessandra Marani, Carlo Cerini, Caterina Candela, Marisa Fusto, Vincenzo Puro, Concetta Castilletti, Chiara Agrati, Enrico Girardi, Francesco Vaia, for the HIV-VAC Study Group, Chiara Agrati, Alessandra Amendola, Andrea Antinori, Francesco Baldini, Rita Bellagamba, Aurora Bettini, Licia Bordi, Veronica Bordoni, Marta Camici, Caterina Candela, Rita Casetti, Concetta Castilletti, Carlo Cerini, Stefania Cicalini, Francesca Colavita, Sarah Costantini, Flavia Cristofanelli, Alessandro Cozzi Lepri, Claudia D’Alessio, Alessia De Angelis, Federico De Zottis, Lydia de Pascale, Massimo Francalancia, Marisa Fusto, Roberta Gagliardini, Paola Gallì, Enrico Girardi, Giulia Gramigna, Germana Grassi, Elisabetta Grilli, Susanna Grisetti, Denise Iafrate, Simone Lanini, Daniele Lapa, Patrizia Lorenzini, Alessandra Marani, Erminia Masone, Ilaria Mastrorosa, Davide Mariotti, Stefano Marongiu, Giulia Matusali, Valentina Mazzotta, Silvia Meschi, Annalisa Mondi, Stefania Notari, Sandrine Ottou, Jessica Paulicelli Luca Pellegrino, Carmela Pinnetti, Maria Maddalena Plazzi, Adriano Possi, Vincenzo Puro, Alessandra Sacchi, Eleonora Tartaglia, Francesco Vaia, Alessandra Vergori
Abstract
BACKGROUND: Data on SARS-CoV-2 vaccine immunogenicity in PLWH are currently limited. Aim of the study was to investigate immunogenicity according to current CD4 T-cell count. METHODS: PLWH on ART attending a SARS-CoV-2 vaccination program, were included in a prospective immunogenicity evaluation after receiving BNT162b2 or mRNA-1273. Participants were stratified by current CD4 T-cell count (poor CD4 recovery, PCDR: <200/mm3; intermediate CD4 recovery, ICDR: 200-500/mm3; high CD4 recovery, HCDR: >500/mm3). RBD-binding IgG, SARS-CoV-2 neutralizing antibodies (nAbs) and IFN-γ release were measured. As control group, HIV-negative healthcare workers (HCWs) were used. FINDINGS: Among 166 PLWH, after 1 month from the booster dose, detectable RBD-binding IgG were elicited in 86.7% of PCDR, 100% of ICDR, 98.7% of HCDR, and a neutralizing titre ≥1:10 elicited in 70.0%, 88.2%, and 93.1%, respectively. Compared to HCDR, all immune response parameters were significantly lower in PCDR. After adjusting for confounders, current CD4 T-cell <200/mm3 significantly predicted a poor magnitude of anti-RDB, nAbs and IFN-γ response. As compared with HCWs, PCDR elicited a consistently reduced immunogenicity for all parameters, ICDR only a reduced RBD-binding antibody response, whereas HCDR elicited a comparable immune response for all parameters. CONCLUSION: Humoral and cell-mediated immune response against SARS-CoV-2 were elicited in most of PLWH, albeit significantly poorer in those with CD4 T-cell <200/mm3 versus those with >500 cell/mm3 and HIV-negative controls. A lower RBD-binding antibody response than HCWs was also observed in PLWH with CD4 T-cell 200-500/mm3, whereas immune response elicited in PLWH with a CD4 T-cell >500/mm3 was comparable to HIV-negative population.