Fundació Lluita contra les Infeccions, Infectious Diseases Department, Hospital Universitari Germans Trias I Pujol, Badalona, Spain.
IrsiCaixa AIDS Research Institute, Hospital Germans Trias I Pujol, Badalona, Spain.
J Infect Dis. 2022 Nov 28;226(11):1913-1923. doi: 10.1093/infdis/jiac406.
We analyzed humoral and cellular immune responses induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines in people with human immunodeficiency virus (HIV; PWH) who had CD4+ T-cell counts <200/µL (HIV<200 group).
This prospective cohort study included 58 PWH in the HIV<200 group, 36 with CD4+ T-cell counts >500/µL (HIV>500 group), and 33 HIV-1-negative controls (control group). Antibodies against the SARS-CoV-2 spike protein (anti-S immunoglobulin [Ig] G) and the receptor-binding domain (anti-RBD IgG) were quantified before and 4 weeks after the first and the second doses of BNT162b2 or mRNA-1273 (at week 8). Viral neutralization activity and T-cell responses were also determined.
At week 8, anti-S/anti-RBD IgG responses increased in all groups (P < .001). Median (interquartile range) anti-S and anti-RBD IgG levels at week 8 were 153.6 (26.4-654.9) and 171.9 (61.8-425.8) binding antibody units (BAU)/mL, respectively, in the HIV<200 group, compared with 245.6 (145-824) and 555.8 (166.4-1751) BAU/mL in the HIV>500 group and 274.7 (193.7-680.4) and 281.6 (181-831.8) BAU/mL in controls (P < .05). Neutralizing capacity and specific T-cell immune responses were absent or reduced in 33% of those in the HIV<200 group, compared with 3.7% in the HIV>500 group (P < .01).
One-third of PWH with CD4+ T-cell counts <200/µL show low anti-S/anti-RBD IgG levels, reduced in vitro neutralization activity against SARS-CoV-2, and no vaccine-induced T cells after receiving coronavirus disease 2019 mRNA vaccines.
我们分析了严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 信使 RNA (mRNA) 疫苗在 CD4+T 细胞计数<200/µL（HIV<200 组）的人类免疫缺陷病毒 (HIV) 感染者中诱导的体液和细胞免疫应答。
这是一项前瞻性队列研究，纳入了 58 名 HIV<200 组的 HIV 感染者、36 名 CD4+T 细胞计数>500/µL（HIV>500 组）的 HIV 感染者和 33 名 HIV-1 阴性对照者（对照组）。在接种 BNT162b2 或 mRNA-1273 后的第 1 剂和第 2 剂后 4 周，定量检测针对 SARS-CoV-2 刺突蛋白（抗-S 免疫球蛋白[Ig]G）和受体结合域（抗-RBD IgG）的抗体。还测定了病毒中和活性和 T 细胞应答。
在第 8 周时，所有组的抗-S/抗-RBD IgG 应答均增加（P<0.001）。HIV<200 组第 8 周时的中位（四分位间距）抗-S 和抗-RBD IgG 水平分别为 153.6（26.4-654.9）和 171.9（61.8-425.8）结合抗体单位（BAU）/mL，与 HIV>500 组的 245.6（145-824）和 555.8（166.4-1751）BAU/mL以及对照组的 274.7（193.7-680.4）和 281.6（181-831.8）BAU/mL相比（P<0.05）。在 HIV<200 组中，有 33%的人没有中和能力或中和能力降低，也没有针对 SARS-CoV-2 的特异性 T 细胞免疫应答，而 HIV>500 组中只有 3.7%（P<0.01）。
接受新冠肺炎 2019 mRNA 疫苗后，三分之一的 CD4+T 细胞计数<200/µL 的 HIV 感染者表现出低水平的抗-S/抗-RBD IgG，对 SARS-CoV-2 的体外中和活性降低，并且没有疫苗诱导的 T 细胞。
