Infectious Diseases and Clinic Microbiology Unit. Biomedicine Institute of Seville/Virgen del Rocío University Hospital/Consejo Superior de Investigaciones Científicas/University of Seville, Seville, Spain.
Pharmacy Service, Virgen del Rocío University Hospital, Seville, ;Spain.
Front Immunol. 2023 Mar 15;14:1129753. doi: 10.3389/fimmu.2023.1129753. eCollection 2023.
Data on SARS-CoV-2 mRNA vaccine immunogenicity in people living with human immunodeficiency virus (PLWH) and discordant immune response (DIR) are currently limited. Therefore, we compare the immunogenicity of these vaccines in DIR and immunological responders (IR).
A prospective cohort that enrolled 89 participants. Finally, 22 IR and 24 DIR were analyzed before vaccination (T), one (T) and six months (T) after receiving BNT162b2 or mRNA-1273 vaccine. Additionally, 10 IR and 16 DIR were evaluated after a third dose (T). Anti-S-RBD IgG, neutralizing antibodies (nAb), neutralization activity, and specific memory B cells were quantified. Furthermore, specific CD4 and CD8 responses were determined by intracellular cytokine staining and polyfunctionality indexes (Pindex).
At T, all participants developed anti-S-RBD. 100% IR developed nAb compared to 83.3% DIR. Spike-specific B cells were detected in all IR and 21/24 DIR. Memory CD4 T cells responded in 5/9 IR and 7/9 DIR, mainly based on the expression of IFN-γ and TNF-α, with a higher Pindex in DIR. Memory CD8 T cells responded in only four participants in each group. At T, anti-S-RBD and nAb titers were higher in DIR than in IR. In both groups, there was an increase in specific B memory cells, higher in DIR. Six IR and five DIR maintained a specific memory CD4 response. Memory CD8 response was preserved in IR but was lost in DIR. In a multivariate linear regression analysis, receiving mRNA-1273 instead of BNT162b2 played a prominent role in the results.
Our data suggest that PLWH with DIR can mount an immune response similar to those with higher CD4, provided they receive the mRNA-1273 vaccine instead of others less immunogenic.
目前，关于 SARS-CoV-2 mRNA 疫苗在人类免疫缺陷病毒（PLWH）感染者中的免疫原性和免疫反应不一致（DIR）的数据有限。因此，我们比较了这些疫苗在 DIR 和免疫反应者（IR）中的免疫原性。
这是一项前瞻性队列研究，共纳入了 89 名参与者。最终，在接种疫苗前（T）、接种后 1 个月（T）和 6 个月（T）分析了 22 名 IR 和 24 名 DIR，在接受 BNT162b2 或 mRNA-1273 疫苗后，还评估了 10 名 IR 和 16 名 DIR。定量检测了抗 S-RBD IgG、中和抗体（nAb）、中和活性和特异性记忆 B 细胞。此外，通过细胞内细胞因子染色和多功能性指数（Pindex）测定了特异性 CD4 和 CD8 反应。
在 T 时，所有参与者均产生了抗 S-RBD。100%的 IR 产生了 nAb，而 DIR 为 83.3%。所有 IR 和 24 名 DIR 中均检测到 Spike 特异性 B 细胞。5/9 IR 和 7/9 DIR 中检测到记忆 CD4 T 细胞反应，主要基于 IFN-γ和 TNF-α的表达，且 DIR 的 Pindex 更高。两组中仅各有 4 名参与者的记忆 CD8 T 细胞有反应。在 T 时，DIR 的抗 S-RBD 和 nAb 滴度高于 IR。在两组中，特异性 B 记忆细胞均增加，且 DIR 中增加更多。6 名 IR 和 5 名 DIR 保持了特异性记忆 CD4 反应。IR 中的记忆 CD8 反应得到保留，但 DIR 中却丢失了。在多元线性回归分析中，接受 mRNA-1273 而非 BNT162b2 疫苗在结果中起主要作用。
我们的数据表明，与那些 CD4 较高的患者相比，具有 DIR 的 PLWH 可以产生类似的免疫反应，只要他们接种的是 mRNA-1273 疫苗，而非其他免疫原性较低的疫苗。
