Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Québec, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, Quebec, Canada.
Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Québec, Canada.
Vaccine. 2022 Jun 9;40(26):3633-3637. doi: 10.1016/j.vaccine.2022.04.090. Epub 2022 May 5.
COVID-19 vaccine efficacy has been evaluated in large clinical trials and in real-world situation. Although they have proven to be very effective in the general population, little is known about their efficacy in immunocompromised patients. HIV-infected individuals' response to vaccine may vary according to the type of vaccine and their level of immunosuppression. We evaluated immunogenicity of an mRNA anti-SARS CoV-2 vaccine in HIV-positive individuals.
HIV-positive individuals (n = 121) were recruited from HIV clinics in Montreal and stratified according to their CD4 counts. A control group of 20 health care workers naïve to SARS CoV-2 was used. The participants' Anti-RBD IgG responses were measured by ELISA at baseline and 3-4 weeks after receiving the first dose of an mRNA vaccine).
Eleven of 121 participants had anti-COVID-19 antibodies at baseline, and a further 4 had incomplete data for the analysis. Mean anti-RBD IgG responses were similar between the HIV negative control group (n = 20) and the combined HIV+ group (n = 106) (p = 0.72). However, these responses were significantly lower in the group with <250 CD4 cells/mm. (p < 0.0001). Increasing age was independently associated with decreased immunogenicity.
HIV-positive individuals with CD4 counts over 250 cells/mm have an anti-RBD IgG response similar to the general population. However, HIV-positive individuals with the lowest CD4 counts (<250 cells/mm) have a weaker response. These data would support the hypothesis that a booster dose might be needed in this subgroup of HIV-positive individuals, depending on their response to the second dose.
COVID-19 疫苗的疗效已在大型临床试验和真实环境中得到评估。尽管它们在普通人群中被证明非常有效，但对于免疫功能低下患者的疗效知之甚少。HIV 感染者对疫苗的反应可能因疫苗类型和免疫抑制程度而异。我们评估了 mRNA 抗 SARS-CoV-2 疫苗在 HIV 阳性个体中的免疫原性。
从蒙特利尔的 HIV 诊所招募了 121 名 HIV 阳性个体，并根据他们的 CD4 计数进行分层。使用 20 名对 SARS-CoV-2 无反应的健康护理工作者作为对照组。在接受第一剂 mRNA 疫苗后 3-4 周，通过 ELISA 测量参与者的抗 RBD IgG 反应。
在 121 名参与者中有 11 名在基线时有抗 COVID-19 抗体，另有 4 名参与者的分析数据不完整。HIV 阴性对照组（n=20）和合并的 HIV+组（n=106）之间的平均抗 RBD IgG 反应相似（p=0.72）。然而，在 CD4 细胞<250/mm 的组中，这些反应显著较低（p<0.0001）。年龄的增加与免疫原性降低独立相关。
CD4 计数>250 个细胞/mm 的 HIV 阳性个体具有与普通人群相似的抗 RBD IgG 反应。然而，CD4 计数最低（<250 个细胞/mm）的 HIV 阳性个体反应较弱。这些数据支持以下假设，即根据第二剂的反应，这组 HIV 阳性个体可能需要加强剂量。
