Faculty of Health, Aarhus University, Aarhus C, Region Midtjylland, Denmark.
Ecoscience Department, Aarhus University, Aarhus C, Denmark.
HIV Med. 2024 Jan;25(1):16-37. doi: 10.1111/hiv.13537. Epub 2023 Sep 21.
Previous publications on the immunogenicity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in people living with HIV (PLWH) have reported inconsistent results. Additionally, a meta-analysis investigating the immunogenicity in PLWH after the third SARS-CoV-2 vaccine dose is lacking. In this article we aim to provide a systematic review and a meta-analysis studying the immunogenicity of SARS-CoV-2 vaccines in PLWH and to identify potential drivers for antibody response in PLWH.
We used three databases (PubMed, Embase and Web of Science) to conduct our review. Studies with information on numbers of PLWH producing immunoglobulin G (IgG) antibodies or neutralizing antibodies were included.
The meta-analysis included 59 studies and illustrated a pooled serological response of 87.09% in the 10 343 PLWH after they received a SARS-CoV-2 vaccine. High CD4 T-cell counts and low viral load indicated that the study populations had HIV that was well treated, despite varying in location. The pooled effect increased to 91.62% for 8053 PLWH when excluding studies that used inactivated vaccines (BBIBP-CorV and CoronaVac). For the third vaccine dose, the pooled effect was 92.35% for 1974 PLWH. Additionally, weighted linear regression models demonstrated weak relationships between CD4 T-cell count, percentages of people with undetectable HIV load, and age compared with the percentages of PLWH producing a serological response. However, more research is needed to determine the effect of those factors on SARS-CoV-2 vaccine immunogenicity in PLWH.
SARS-CoV-2 vaccines show a favourable effect on immunogenicity in PLWH. However, the results are not ideal. This meta-analysis suggests that a third SARS-CoV-2 vaccine dose and good HIV treatment procedures are vital to induce a good immunogenicity in PLWH.
先前关于严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 疫苗在艾滋病毒感染者 (PLWH) 中的免疫原性的出版物报告结果不一致。此外，缺乏关于 PLWH 在接受第三剂 SARS-CoV-2 疫苗后免疫原性的荟萃分析。在本文中，我们旨在提供一项系统评价和荟萃分析，研究 SARS-CoV-2 疫苗在 PLWH 中的免疫原性，并确定 PLWH 抗体反应的潜在驱动因素。
我们使用三个数据库（PubMed、Embase 和 Web of Science）进行综述。纳入了提供 PLWH 产生免疫球蛋白 G (IgG) 抗体或中和抗体数量信息的研究。
荟萃分析纳入了 59 项研究，结果表明，10343 名 PLWH 接种 SARS-CoV-2 疫苗后，血清学反应的总体发生率为 87.09%。高 CD4 T 细胞计数和低病毒载量表明，尽管研究人群的地理位置不同，但他们的 HIV 得到了很好的治疗。当排除使用灭活疫苗（BBIBP-CorV 和 CoronaVac）的研究时，8053 名 PLWH 的汇总效应增加到 91.62%。对于第三剂疫苗，1974 名 PLWH 的汇总效应为 92.35%。此外，加权线性回归模型表明，与产生血清学反应的 PLWH 百分比相比，CD4 T 细胞计数、无法检测到 HIV 载量的人群百分比和年龄之间存在较弱的关系。然而，还需要更多的研究来确定这些因素对 PLWH 的 SARS-CoV-2 疫苗免疫原性的影响。
SARS-CoV-2 疫苗在 PLWH 中显示出良好的免疫原性效果。然而，结果并不理想。这项荟萃分析表明，第三剂 SARS-CoV-2 疫苗和良好的 HIV 治疗程序对于诱导 PLWH 的良好免疫原性至关重要。
