Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China.
Department of infection, The Second Hospital of Huhhot, Huhhot, China.
Front Immunol. 2023 Mar 13;14:1129651. doi: 10.3389/fimmu.2023.1129651. eCollection 2023.
People living with HIV (PLWH) are more vulnerable to SARS-CoV-2. However, evidence on the immunogenicity of coronavirus disease 2019 (COVID-19) vaccines in this population is insufficient. The objective of this study is to assess the immunogenicity and safety of the two-dose schedule of Sinovac CoronaVac for 6 months postvaccination in PLWH.
We conducted a multicenter prospective cohort study among PLWH and HIV-negative adults in China. Participants who received two doses of CoronaVac prior to the recruitment were allocated into two groups and followed up for 6 months. The neutralizing antibodies (nAbs), immunoglobulin G against the receptor-binding domain of the spike protein (S-IgG), and gamma-interferon (IFN-γ) were measured to assess the associations among CoronaVac immunogenicity and related factors. Adverse reactions were collected to evaluate the safety profile of vaccination.
A total of 203 PLWH and 100 HIV-negative individuals were enrolled. A small portion of participants reported mild or moderate adverse reactions without serious adverse events. Median nAbs level in PLWH (31.96 IU/mL, IQR: 12.34-76.40) was lower than that in the control group (46.52 IU/mL, IQR: 29.08-77.30) at the 2-4 weeks postvaccination (=0.002), and the same trend was presented for median S-IgG titer (37.09 vs. 60.02 IU/ml) (both 0.05). The nAbs seroconversion rate in the PLWH group was also lower than in the control group (75.86% vs. 89.00%). After then, the immune responses reduced over time in term of only 23.04% of PLWH and 36.00% of HIV-negative individuals had a positive seroconversion for nAbs at 6-month. The multivariable generalized estimating equation analysis showed that PLWH with CD4+T count≥350 cells/µL presented higher immune response than PLWH with CD4+T count <350 cells/µL in terms of antibody seroconversion and titers. The immunogenicity did not differ in participants with low or high HIV viral load. The S-antigen specific IFN-γ immunity was generally stable and had a slow attenuation in both two groups for 6 months postvaccination.
The Sinovac CoronaVac was generally safe and immunogenic in PLWH, but the immunity response was inferior and the antibodies vanished faster compared to HIV-negative individuals. This study suggested a shorter than 6-month interval of prime-boost vaccination for PLWH to ensure a better protection.
感染 HIV 的人（PLWH）更容易感染 SARS-CoV-2。然而，目前有关该人群中 2019 年冠状病毒病（COVID-19）疫苗免疫原性的证据不足。本研究的目的是评估科兴新冠疫苗在接种后 6 个月内对 PLWH 的两剂方案的免疫原性和安全性。
我们在中国开展了一项多中心前瞻性队列研究，纳入 PLWH 和 HIV 阴性成年人。在招募前接受了两剂科兴新冠疫苗的参与者被分为两组，并随访 6 个月。测量中和抗体（nAbs）、针对刺突蛋白受体结合域的免疫球蛋白 G（S-IgG）和γ-干扰素（IFN-γ），以评估科兴新冠疫苗免疫原性与相关因素之间的关系。收集不良反应以评估接种的安全性。
共纳入 203 名 PLWH 和 100 名 HIV 阴性个体。一小部分参与者报告了轻度或中度不良反应，没有严重不良事件。接种后 2-4 周，PLWH 组的中位数 nAbs 水平（31.96 IU/ml，IQR：12.34-76.40）低于对照组（46.52 IU/ml，IQR：29.08-77.30）（均 P=0.002），中位数 S-IgG 滴度（37.09 与 60.02 IU/ml）也呈现相同趋势（均 P=0.05）。PLWH 组的 nAbs 血清转化率也低于对照组（75.86% vs. 89.00%）。之后，仅 23.04%的 PLWH 和 36.00%的 HIV 阴性个体在 6 个月时 nAbs 血清转化率呈阳性，免疫应答随时间逐渐下降。多变量广义估计方程分析显示，与 CD4+T 计数<350 个/µL 的 PLWH 相比，CD4+T 计数≥350 个/µL 的 PLWH 在抗体血清转化率和滴度方面具有更高的免疫反应。在低或高 HIV 病毒载量的参与者中，免疫原性没有差异。S 抗原特异性 IFN-γ 免疫通常稳定，两组在接种后 6 个月内均缓慢减弱。
科兴新冠疫苗在 PLWH 中通常是安全且具有免疫原性的，但与 HIV 阴性个体相比，免疫反应较低，抗体消失更快。本研究建议 PLWH 加强针与基础免疫的间隔应短于 6 个月，以确保更好的保护效果。
Zotero 插件
