Zhou Qian, Liu Yihuang, Zeng Furong, Meng Yu, Liu Hong, Deng Guangtong
Hunan Key Laboratory of Skin Cancer and Psoriasis, Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha 410008, China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China.
Vaccines (Basel). 2023 Apr 4;11(4):789. doi: 10.3390/vaccines11040789.
To evaluate the potential factors for predicting seroconversion due to the coronavirus disease 2019 (COVID-19) vaccine in people living with HIV (PLWH).
We searched the PubMed, Embase and Cochrane databases for eligible studies published from inception to 13th September 2022 on the predictors of serologic response to the COVID-19 vaccine among PLWH. This meta-analysis was registered with PROSPERO (CRD42022359603).
A total of 23 studies comprising 4428 PLWH were included in the meta-analysis. Pooled data demonstrated that seroconversion was about 4.6 times in patients with high CD4 T-cell counts (odds ratio (OR) = 4.64, 95% CI 2.63 to 8.19) compared with those with low CD4 T-cell counts. Seroconversion was about 17.5 times in patients receiving mRNA COVID-19 vaccines (OR = 17.48, 95% CI 6.16 to 49.55) compared with those receiving other types of COVID-19 vaccines. There were no differences in seroconversion among patients with different ages, gender, HIV viral load, comorbidities, days after complete vaccination, and mRNA type. Subgroup analyses further validated our findings about the predictive value of CD4 T-cell counts for seroconversion due to COVID-19 vaccines in PLWH (OR range, 2.30 to 9.59).
The CD4 T-cell counts were associated with seroconversion in COVID-19 vaccinated PLWH. Precautions should be emphasized in these patients with low CD4 T-cell counts, even after a complete course of vaccination.
评估预测人类免疫缺陷病毒（HIV）感染者（PLWH）接种2019冠状病毒病（COVID-19）疫苗后血清阳转的潜在因素。
我们检索了PubMed、Embase和Cochrane数据库，以查找从数据库建立至2022年9月13日发表的关于PLWH中COVID-19疫苗血清学反应预测因素的符合条件的研究。该荟萃分析已在国际前瞻性系统评价注册库（PROSPERO）注册（注册号：CRD42022359603）。
荟萃分析共纳入23项研究，涉及4428例PLWH。汇总数据表明，CD4 T细胞计数高的患者血清阳转率约为CD4 T细胞计数低的患者的4.6倍（比值比（OR）=4.64，95%置信区间[CI]为2.63至8.19）。与接种其他类型COVID-19疫苗的患者相比，接种mRNA COVID-19疫苗的患者血清阳转率约为17.5倍（OR = 17.48，95% CI为6.16至49.55）。不同年龄、性别、HIV病毒载量、合并症、完成疫苗接种后天数以及mRNA类型的患者之间血清阳转率无差异。亚组分析进一步验证了我们关于PLWH中CD4 T细胞计数对COVID-19疫苗血清阳转预测价值的研究结果（OR范围为2.30至9.59）。
CD4 T细胞计数与接种COVID-19疫苗的PLWH的血清阳转有关。即使在完成全程疫苗接种后，也应重视这些CD4 T细胞计数低的患者。
