延长 COVID-19 疫苗接种间隔时间可提高 HIV 感染者的血清转化率。

Extending the dosing interval of COVID-19 vaccination leads to higher rates of seroconversion in people living with HIV.

机构信息

Department of Infection, Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Institute of Hepatology and Epidemiology, Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Front Immunol. 2023 Mar 2;14:1152695. doi: 10.3389/fimmu.2023.1152695. eCollection 2023.

INTRODUCTION

Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is an effective way of protecting individuals from severe coronavirus disease 2019 (COVID-19). However, immune responses to vaccination vary considerably. This study dynamically assessed the neutralizing antibody (NAb) responses to the third dose of the inactivated COVID-19 vaccine administered to people living with human immunodeficiency virus (HIV; PLWH) with different inoculation intervals.

METHODS

A total of 171 participants were recruited: 63 PLWH were placed in cohort 1 (with 3-month interval between the second and third doses), while 95 PLWH were placed in cohort 2 (with 5-month interval between the second and third doses); 13 individuals were enrolled as healthy controls (HCs). And risk factors associated with seroconversion failure after vaccination were identified via Cox regression analysis.

RESULTS

At 6 months after the third vaccination, PLWH in cohort 2 had higher NAb levels (GMC: 64.59 vs 21.99, P < 0.0001) and seroconversion rate (68.42% vs 19.05%, P < 0.0001). A weaker neutralizing activity against the SARSCoV-2 Delta variant was observed (GMT: 3.38 and 3.63, P < 0.01) relative to the wildtype strain (GMT: 13.68 and 14.83) in both cohorts. None of the participants (including HCs or PLWH) could mount a NAb response against Omicron BA.5.2. In the risk model, independent risk factors for NAb seroconversion failure were the vaccination interval (hazed ration [HR]: 0.316, P < 0.001) and lymphocyte counts (HR: 0.409, P < 0.001). Additionally, PLWH who exhibited NAb seroconversion after vaccination had fewer initial COVID-19 symptoms when infected with Omicron.

DISCUSSION

This study demonstrated that the third vaccination elicited better NAb responses in PLWH, when a longer interval was used between vaccinations. Since post-vaccination seroconversion reduced the number of symptoms induced by Omicron, efforts to protect PLWH with risk factors for NAb seroconversion failure may be needed during future Omicron surges.

CLINICAL TRIAL REGISTRATION

https://beta.clinicaltrials.gov/study/NCT05075070, identifier NCT05075070.

简介

接种严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染疫苗是保护个体免受 2019 年冠状病毒病（COVID-19）严重感染的有效方法。然而，疫苗接种后的免疫反应差异很大。本研究动态评估了不同接种间隔的灭活 COVID-19 疫苗对人类免疫缺陷病毒（HIV）感染者（PLWH）的第三剂接种后的中和抗体（NAb）反应。

方法

共招募了 171 名参与者：63 名 PLWH 被分为队列 1（第二剂和第三剂之间间隔 3 个月），95 名 PLWH 被分为队列 2（第二剂和第三剂之间间隔 5 个月）；13 名个体被纳入健康对照组（HCs）。并通过 Cox 回归分析确定与接种后血清转换失败相关的危险因素。

结果

在第三剂接种后 6 个月时，队列 2 的 PLWH 具有更高的 NAb 水平（GMC：64.59 比 21.99，P < 0.0001）和血清转化率（68.42% 比 19.05%，P < 0.0001）。与野生型株（GMT：13.68 和 14.83）相比，两组均观察到针对 SARSCoV-2 Delta 变体的中和活性较弱（GMT：3.38 和 3.63，P < 0.01）。两组参与者（包括 HCs 或 PLWH）均无法对 Omicron BA.5.2 产生 NAb 反应。在风险模型中，NAb 血清转化率失败的独立危险因素是接种间隔（HR：0.316，P < 0.001）和淋巴细胞计数（HR：0.409，P < 0.001）。此外，接种疫苗后 NAb 血清转化率阳性的 PLWH 在感染奥密克戎时，最初的 COVID-19 症状较少。