Farhadian Negin, Sharifi Sara, Taghadosi Mahdi, Farhadian Maryam, Vaziri Siavash
Nano Drug Delivery Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Students Research Committee, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Rev Med Virol. 2023 Jul;33(4):e2451. doi: 10.1002/rmv.2451. Epub 2023 Apr 18.
People living with HIV (PLWH) are susceptible to severe COVID-19 infection and hence this fragile population has prioritised vaccination. This systematic review and meta-analysis aimed to assess the humoral immune response after receiving two doses schedule of COVID-19 mRNA vaccinations in this high-risk population. A systematic electronic search on the PubMed database and manual searches were performed for relevant articles until 30 Sep 2022. Two outcomes of interest were seroconversion rates and anti-spike receptor binding domain (anti-S-RBD) antibody titres at the median time of 14-35 days following two-dose vaccination among PLWH. Nineteen cohorts and one cross-sectional study were eligible for inclusion in this study. The pooled estimate of seroconversion rate after receiving two doses of mRNA vaccination schedule were 98.4% and 75.2% among PLWH with CD4>500 cells/mm and CD4<200 cells/mm , respectively. Compared with controls, PLWH with CD4>500 cells/mm had a 51% likelihood of having positive anti-Spike-RBD immunoglobulin G (IgG) (OR: 0.509, 95% CI: 0.228, 1.133, p = 0.098) post-vaccination and this value was only 1.4% (OR: 0.014, 95% CI: 0.002, 0.078, p = 0.000) for PLWH with CD4<200 cells/mm . There was no significant difference in titres of antibodies on 14-35 days post-vaccination between PLWH with CD4>500 cells/mm and healthy controls (p = 0.06). The pooled median of anti-S-RBD IgG values were 1461.93 binding antibody units (BAU)/ml and 457.41 BAU/ml in PLWH with CD4>500 cells/mm and CD4<200 cells/mm , respectively. According to these findings, vaccination with both Pfizer-BioNTech and Moderna vaccines induced a robust humoral response in ART-treated HIV patients with preserved CD cell count. A diminished humoral immune response to vaccination against COVID-19 in PLWH with unrestored CD4 count implied the need of specific vaccination schemes.
人类免疫缺陷病毒感染者(PLWH)易感染重症2019冠状病毒病(COVID-19),因此这一脆弱人群将疫苗接种列为优先事项。本系统评价和荟萃分析旨在评估这一高危人群接种两剂次COVID-19信使核糖核酸(mRNA)疫苗后的体液免疫反应。在PubMed数据库上进行了系统的电子检索,并人工检索了相关文章,检索截至2022年9月30日。两个感兴趣的结果是PLWH在两剂疫苗接种后14至35天中位时间的血清转化率和抗刺突受体结合域(抗S-RBD)抗体滴度。19个队列研究和1项横断面研究符合纳入本研究的条件。在CD4>500个细胞/mm³和CD4<200个细胞/mm³的PLWH中,接种两剂mRNA疫苗后的血清转化率合并估计值分别为98.4%和75.2%。与对照组相比,CD4>500个细胞/mm³的PLWH接种疫苗后抗刺突-RBD免疫球蛋白G(IgG)呈阳性的可能性为51%(比值比:0.509,95%置信区间:0.228,1.133,p = 0.098),而对于CD4<200个细胞/mm³的PLWH,这一数值仅为1.4%(比值比:0.014,95%置信区间:0.002,0.078,p = 0.000)。CD4>500个细胞/mm³的PLWH与健康对照组在接种疫苗后14至35天的抗体滴度无显著差异(p = 0.06)。在CD4>500个细胞/mm³和CD4<200个细胞/mm³的PLWH中,抗S-RBD IgG值的合并中位数分别为1461.93结合抗体单位(BAU)/ml和457.41 BAU/ml。根据这些发现,辉瑞-生物科技公司和莫德纳公司的疫苗接种均在接受抗逆转录病毒治疗且CD细胞计数保留的HIV患者中诱导了强烈的体液免疫反应。CD4计数未恢复的PLWH对COVID-19疫苗接种的体液免疫反应减弱,这意味着需要特定的疫苗接种方案。