Antinori Andrea, Cicalini Stefania, Meschi Silvia, Bordoni Veronica, Lorenzini Patrizia, Vergori Alessandra, Lanini Simone, De Pascale Lidya, Matusali Giulia, Mariotti Davide, Cozzi Lepri Alessandro, Gallì Paola, Pinnetti Carmela, Gagliardini Roberta, Mazzotta Valentina, Mastrorosa Ilaria, Grisetti Susanna, Colavita Francesca, Cimini Eleonora, Grilli Elisabetta, Bellagamba Rita, Lapa Daniele, Sacchi Alessandra, Marani Alessandra, Cerini Carlo, Candela Caterina, Fusto Marisa, Puro Vincenzo, Castilletti Concetta, Agrati Chiara, Girardi Enrico, Vaia Francesco
Clinical Department, HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani Istituto di Ricovero e Cura a Carattere Scientifico, Roma, Italy.
Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Roma, Italy.
Clin Infect Dis. 2022 Aug 24;75(1):e552-e563. doi: 10.1093/cid/ciac238.
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.
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.
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.
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.
目前关于艾滋病毒感染者中新型冠状病毒2型疫苗免疫原性的数据有限。本研究的目的是根据当前的CD4 T细胞计数调查免疫原性。
参加新型冠状病毒2型疫苗接种计划的接受抗逆转录病毒治疗的艾滋病毒感染者在接种BNT162b2或mRNA-1273后纳入前瞻性免疫原性评估。参与者按当前CD4 T细胞计数分层（CD4恢复差，PCDR：<200/mm³；CD4恢复中等，ICDR：200 - 500/mm³；CD4恢复良好，HCDR：>500/mm³）。检测RBD结合IgG、新型冠状病毒2型中和抗体（nAbs）和IFN-γ释放。作为对照组，使用了HIV阴性医护人员（HCW）。
在166名艾滋病毒感染者中，加强剂量后1个月，PCDR组中86.7%、ICDR组中100%、HCDR组中98.7%可检测到RBD结合IgG，中和滴度≥1:10的分别为70.0%、88.2%和93.1%。与HCDR组相比，PCDR组的所有免疫反应参数均显著较低。在调整混杂因素后，当前CD4 T细胞<200/mm³显著预测抗RDB、nAbs和IFN-γ反应的强度较差。与医护人员相比，PCDR组所有参数的免疫原性持续降低，ICDR组仅RBD结合抗体反应降低，而HCDR组所有参数的免疫反应相当。
大多数艾滋病毒感染者对新型冠状病毒2型产生了体液和细胞介导的免疫反应，尽管CD4 T细胞<200/mm³的感染者与CD4 T细胞>500/mm³的感染者及HIV阴性对照组相比明显较差。CD4 T细胞为200 - 500/mm³的艾滋病毒感染者中也观察到RBD结合抗体反应低于医护人员，而CD4 T细胞>500/mm³的艾滋病毒感染者引发的免疫反应与HIV阴性人群相当。
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