Polvere Jacopo, Fabbiani Massimiliano, Pastore Gabiria, Rancan Ilaria, Rossetti Barbara, Durante Miriam, Zirpoli Sara, Morelli Enrico, Pettini Elena, Lucchesi Simone, Fiorino Fabio, Tumbarello Mario, Ciabattini Annalisa, Montagnani Francesca, Medaglini Donata
Laboratory of Molecular Microbiology and Biotechnology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
Department of Medical Sciences, Infectious and Tropical Diseases Unit, University Hospital of Siena, Siena, Italy.
Commun Med (Lond). 2023 Jan 30;3(1):13. doi: 10.1038/s43856-023-00245-5.
Limited longitudinal data are available on immune response to mRNA SARS-CoV-2 vaccination in people living with HIV (PLWHIV); therefore, new evidence on induction and persistence of spike-specific antibodies and B cells is needed.
In this pilot study we investigated the spike-specific humoral and B cell responses up to six months after vaccination with two doses of mRNA vaccines in 84 PLWHIV under antiretroviral therapy compared to 79 healthy controls (HCs).
Spike-specific IgG persisted six months in PLWHIV with no significant differences compared to HCs, even though a significantly lower IgG response was observed in patients with CD4 T cells < 350/mmc. The frequency of subjects with antibodies capable of inhibiting ACE2/RBD binding was comparable between PLWHIV and HCs a month after the second vaccine dose, then a higher drop was observed in PLWHIV. A comparable percentage of spike-specific memory B cells was observed at month six in PLWHIV and HCs. However, PLWHIV showed a higher frequency of spike-specific IgD CD27 double-negative memory B cells and a significantly lower rate of IgD CD27 Ig-switched memory B cells compared to HCs, suggesting a reduced functionality of the antigen-specific memory B population.
The mRNA vaccination against SARS-CoV-2 elicits humoral and B cell responses quantitatively similar between PLWHIV and HCs, but there are important differences in terms of antibody functionality and phenotypes of memory B cells, reinforcing the notion that tailored vaccination policies should be considered for these patients.
关于HIV感染者（PLWHIV）对SARS-CoV-2 mRNA疫苗免疫反应的纵向数据有限；因此，需要有关刺突特异性抗体和B细胞诱导及持久性的新证据。
在这项前瞻性研究中，我们调查了84名接受抗逆转录病毒治疗的PLWHIV与79名健康对照者（HCs）接种两剂mRNA疫苗后长达六个月的刺突特异性体液和B细胞反应。
刺突特异性IgG在PLWHIV中持续了六个月，与HCs相比无显著差异，尽管CD4 T细胞<350/mmc的患者中观察到IgG反应明显较低。在第二次接种疫苗后一个月，PLWHIV和HCs中能够抑制ACE2/RBD结合的抗体受试者频率相当，随后在PLWHIV中观察到更高的下降率。在第6个月时，PLWHIV和HCs中观察到的刺突特异性记忆B细胞百分比相当。然而，与HCs相比，PLWHIV中刺突特异性IgD CD27双阴性记忆B细胞的频率更高，而IgD CD27 Ig转换记忆B细胞的比例显著更低，这表明抗原特异性记忆B细胞群体的功能有所降低。
针对SARS-CoV-2的mRNA疫苗在PLWHIV和HCs中引发的体液和B细胞反应在数量上相似，但在抗体功能和记忆B细胞表型方面存在重要差异，这进一步强化了应为这些患者考虑量身定制的疫苗接种策略这一观点。
