People With Human Immunodeficiency Virus Receiving Suppressive Antiretroviral Therapy Show Typical Antibody Durability After Dual Coronavirus Disease 2019 Vaccination and Strong Third Dose Responses
Hope R. Lapointe, Francis Mwimanzi, Peter K. Cheung, Yurou Sang, Fatima Yaseen, Gisele Umviligihozo, Rebecca Kalikawe, Sarah Speckmaier, Nadia Moran-Garcia, Sneha Datwani, Maggie C. Duncan, Olga Agafitei, Siobhan Ennis, Landon Young, Hesham Ali, Bruce Ganase, F. Harrison Omondi, Winnie Dong, Junine Toy, Paul Sereda, Laura Burns, Cecilia T. Costiniuk, Curtis Cooper, Aslam H. Anis, Victor C. M. Leung, Daniel T. Holmes, Mari L. DeMarco, Janet Simons, Malcolm Hedgcock, Natalie Prystajecky, Christopher F. Lowe, Ralph Pantophlet, Marc G. Romney, Rolando Barrios, Silvia Guillemi, Chanson J. Brumme, Julio Montaner, Mark Hull, Marianne Harris, Masahiro Niikura, Mark A. Brockman, Zabrina L. Brumme
Abstract
BACKGROUND: Longer-term humoral responses to 2-dose coronavirus disease 2019 (COVID-19) vaccines remain incompletely characterized in people living with human immunodeficiency virus (HIV) (PLWH), as do initial responses to a third dose. METHODS: We measured antibodies against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein receptor-binding domain, angiotensin-converting enzyme 2 (ACE2) displacement, and viral neutralization against wild-type and Omicron strains up to 6 months after 2-dose vaccination, and 1 month after the third dose, in 99 PLWH receiving suppressive antiretroviral therapy and 152 controls. RESULTS: Although humoral responses naturally decline after 2-dose vaccination, we found no evidence of lower antibody concentrations or faster rates of antibody decline in PLWH compared with controls after accounting for sociodemographic, health, and vaccine-related factors. We also found no evidence of poorer viral neutralization in PLWH after 2 doses, nor evidence that a low nadir CD4+ T-cell count compromised responses. Post-third-dose humoral responses substantially exceeded post-second-dose levels, though Omicron-specific responses were consistently weaker than responses against wild-type virus. Nevertheless, post-third-dose responses in PLWH were comparable to or higher than controls. An mRNA-1273 third dose was the strongest consistent correlate of higher post-third-dose responses. CONCLUSION: PLWH receiving suppressive antiretroviral therapy mount strong antibody responses after 2- and 3-dose COVID-19 vaccination. Results underscore the immune benefits of third doses in light of Omicron.