Vergori Alessandra, Cozzi-Lepri Alessandro, Matusali Giulia, Cicalini Stefania, Bordoni Veronica, Meschi Silvia, Mazzotta Valentina, Colavita Francesca, Fusto Marisa, Cimini Eleonora, Notari Stefania, D'Aquila Veronica, Lanini Simone, Lapa Daniele, Gagliardini Roberta, Mariotti Davide, Giannico Giuseppina, Girardi Enrico, Vaia Francesco, Agrati Chiara, Maggi Fabrizio, Antinori Andrea
HIV/AIDS Unit, National Institute for Infectious Diseases L. Spallanzani, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy.
Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute of Global Health, University College London, London NW3 2PF, UK.
Vaccines (Basel). 2023 Nov 22;11(12):1739. doi: 10.3390/vaccines11121739.
(1) Background: Waning of neutralizing and cell-mediated immune response after the primary vaccine cycle (PVC) and the first booster dose (BD) is of concern, especially for PLWH with a CD4 count ≤200 cells/mm. (2) Methods: Neutralizing antibodies (nAbs) titers by microneutralization assay against WD614G/Omicron BA.1 and IFNγ production by ELISA assay were measured in samples of PLWH at four time points [2 and 4 months post-PVC (T1 and T2), 2 weeks and 5 months after the BD (T3 and T4)]. Participants were stratified by CD4 count after PVC (LCD4, ≤200/mm; ICD4, 201-500/mm, and HCD4, >500/mm). Mixed models were used to compare mean responses over T1-T4 across CD4 groups. (3) Results: 314 PLWH on ART (LCD4 = 56; ICD4 = 120; HCD4 = 138) were enrolled. At T2, levels of nAbs were significantly lower in LCD4 vs. ICD4/HCD4 ( = 0.04). The BD was crucial for increasing nAbs titers above 1:40 at T3 and up to T4 for WD614G. A positive T cell response after PVC was observed in all groups, regardless of CD4 ( = 0.31). (4) Conclusions: Waning of nAbs after PVC was more important in LCD4 group. The BD managed to re-establish higher levels of nAbs against WD614G, which were retained for 5 months, but for shorter time for Omicron BA.1. The T cellular response in the LCD4 group was lower than that seen in participants with higher CD4 count, but, importantly, it remained above detectable levels over the entire study period.
(1) 背景：初次疫苗接种周期（PVC）和首次加强剂量（BD）后中和及细胞介导免疫反应的减弱令人担忧，尤其是对于CD4计数≤200个细胞/mm³的艾滋病毒感染者。(2) 方法：在四个时间点[PVC后2个月和4个月（T1和T2）、BD后2周和5个月（T3和T4）]测量艾滋病毒感染者样本中通过微量中和试验检测的针对WD614G/奥密克戎BA.1的中和抗体（nAbs）滴度以及通过酶联免疫吸附测定法检测的IFNγ产生量。参与者根据PVC后的CD4计数进行分层（低CD4，≤200/mm³；中CD4，201 - 500/mm³，高CD4，>500/mm³）。使用混合模型比较CD4分组中T1 - T4期间的平均反应。(3) 结果：纳入了314名接受抗逆转录病毒治疗的艾滋病毒感染者（低CD4 = 56；中CD4 = 120；高CD4 = 138）。在T2时，低CD4组的nAbs水平显著低于中CD4/高CD4组（P = 0.04）。对于WD614G，BD对于在T3时将nAbs滴度提高到1:40以上以及直至T4至关重要。在所有组中均观察到PVC后T细胞反应呈阳性，无论CD4情况如何（P = 0.31）。(4) 结论：PVC后nAbs的减弱在低CD4组中更为明显。BD成功地重新建立了针对WD614G的更高水平的nAbs，其维持了5个月，但针对奥密克戎BA.1的时间较短。低CD4组中的T细胞反应低于CD4计数较高的参与者，但重要的是，在整个研究期间其仍保持在可检测水平以上。
