Department of Infectious Diseases, CIBERINFEC (Centro de Investigacion en Red en Enfermedades Infecciosas, Biomedical Research Center Network in Infectious Diseases).
Laboratory of Immunovirology, Hospital Universitario Ramón y Cajal, Madrid, Spain.
AIDS. 2023 May 1;37(6):877-882. doi: 10.1097/QAD.0000000000003504. Epub 2023 Feb 7.
We evaluated T-cell immune responses against SARS-CoV-2 variants of concern (VOC) after vaccination in people with HIV (PWH), and their impact on the incidence of disease.
A prospective cohort study. Peripheral blood mononuclear cells (PBMCs) were collected a median of 53 days after second dose of mRNA vaccine. Humoral response and T cell responses against the spike (S) glycoprotein of wild-type SARS-CoV-2 (ancestral Wuhan variant) and mutated S-protein regions found in the Delta and Omicron variants were assessed by flow cytometry analysis.
In 142 PWH without preceding SARS-CoV-2 infection, bivariate correlations showed a close association between T-cell responses to the different variants. However, despite at least 70% of PWH having a cellular immune response to any variant, CD4 + and CD8 + T cell responses against VOC were lower in frequency and magnitude (-3% and -20% for Delta, -33% and -28% for Omicron variant) compared with that observed against the Wuhan strain. A higher magnitude of SARS-CoV-2 spike-specific CD8 + T cell responses against all the variants was observed in those PWH with greater immune reconstitution. Notably, 27 symptomatic breakthrough infections (19%) in the setting of Delta and Omicron transmission were observed during follow-up, associated with a significant lower humoral and T-cell response to ancestral strain and VOC. On the contrary, only one PWH with COVID-19 (4%) required hospitalization.
A blunted T-cell response against Delta and Omicron variant is observed in PWH who received two doses of mRNA vaccine. This lower immune response is associated with breakthrough SARS-CoV-2 infections.
我们评估了 HIV 感染者（PWH）接种疫苗后针对 SARS-CoV-2 关注变异株（VOC）的 T 细胞免疫反应及其对疾病发生率的影响。
前瞻性队列研究。在 mRNA 疫苗接种后中位数 53 天采集外周血单核细胞（PBMC）。通过流式细胞术分析评估针对野生型 SARS-CoV-2（原始武汉株）和 Delta 和奥密克戎变异株中发现的突变 S 蛋白区域的 Spike（S）糖蛋白的体液反应和 T 细胞反应。
在 142 名未感染过 SARS-CoV-2 的 PWH 中，双变量相关性表明 T 细胞对不同变异株的反应密切相关。然而，尽管至少有 70%的 PWH 对任何变异株均有细胞免疫反应，但针对 VOC 的 CD4+和 CD8+T 细胞反应的频率和幅度均较低（与武汉株相比，Delta 变异株分别降低 3%和 20%，Omicron 变异株分别降低 33%和 28%）。在免疫重建较好的 PWH 中，针对所有变异株的 SARS-CoV-2 刺突特异性 CD8+T 细胞反应幅度更大。值得注意的是，在 Delta 和 Omicron 传播期间，观察到 27 例（19%）有症状的突破性感染，这与针对原始株和 VOC 的体液和 T 细胞反应显著降低有关。相反，仅有 1 例 COVID-19（4%）的 PWH 需要住院治疗。
在接受两剂 mRNA 疫苗接种的 PWH 中观察到针对 Delta 和 Omicron 变异株的 T 细胞反应减弱。这种较低的免疫反应与突破性 SARS-CoV-2 感染有关。
