Mahlab-Guri Keren, Komarova Irina, Kadar Laliv, Nemet Shay, Cohen Ramon, Radian-Sade Sara, Tova Achiel, Guri Alex, Rosenberg-Bezalel Shira, Elbirt Daniel
Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel.
Allergy, Clinical Immunology and AIDS Center, Kaplan Medical Center, Rehovot 7680400, Israel.
Viruses. 2024 Nov 21;16(12):1805. doi: 10.3390/v16121805.
Variants of COVID-19 are responsible for 700 million infections and 7 million deaths worldwide. Vaccinations have high efficiency in preventing infection and secondary benefits of reducing COVID-19 hospital admissions, attenuating disease severity and duration of illness. Conflicting reports were published regarding COVID-19 among PLWH.
The aim of this study was to evaluate COVID-19 morbidity, hospitalization, and the magnitude of immunological response to sequential BNT 162b2 mRNA vaccines in PLWH regarding demographic and clinical factors.
Our retrospective study included 784 PLWH who had at least one anti- SARS-CoV-2 antibody test between March 2021 and October 2021. Half of our patients (392) had CD4 cell counts above 500 cells/µL, 40.2% (315) had 200 < CD4 < 500 cells/µL and only 9.8% (77) had CD4 < 200 cells/µL at their last laboratory workup. The mean age was 50.2 ± 12.2 years. About 90% of our patients were given at least two doses of the BNT 162b2 Pfizer vaccines; about 60% received three doses of the vaccine. About a quarter of our patients (27.6%) had COVID-19 infection. Only six patients required hospital admission. All six patients recovered from COVID-19 infection. Titers of COVID-19 antibodies were lower for patients with CD4 cell counts of less than 200 cells/µL in the first, second, and third serological tests with statistical significance. In a multinomial logistic regression, the influence of other factors such as age, sex, and previous COVID-19 infection on first COVID-19 antibody titers was not significant.
PLWH are responsive to COVID-19 vaccines. As was expected, patients with higher CD4 cell counts had higher titers of COVID-19 antibodies and lower hospitalization rate. Age, sex, and previous COVID-19 infection did not significantly affect antibody titers according to our study. Larger prospective studies with control groups are needed to further characterize immunologic response to COVID-19 vaccination among PLWH.
新冠病毒变种在全球导致了7亿例感染和700万例死亡。疫苗在预防感染方面具有高效性，并且还有减少新冠住院人数、减轻疾病严重程度和缩短病程等附带益处。关于艾滋病毒感染者中的新冠病毒感染情况，有相互矛盾的报道发表。
本研究的目的是评估艾滋病毒感染者中新冠病毒的发病率、住院情况以及针对BNT 162b2 mRNA序贯疫苗的免疫反应程度与人口统计学和临床因素的关系。
我们的回顾性研究纳入了784名在2021年3月至2021年10月期间至少进行过一次抗SARS-CoV-2抗体检测的艾滋病毒感染者。我们的患者中有一半（392人）的CD4细胞计数高于500个/微升，40.2%（315人）的CD4细胞计数在200至500个/微升之间，在他们最后一次实验室检查中，只有9.8%（77人）的CD4细胞计数低于200个/微升。平均年龄为50.2±12.2岁。我们约90%的患者至少接种了两剂BNT 162b2辉瑞疫苗；约60%的患者接种了三剂疫苗。我们约四分之一的患者（27.6%）感染了新冠病毒。只有6名患者需要住院治疗。所有6名患者均从新冠病毒感染中康复。在首次、第二次和第三次血清学检测中，CD4细胞计数低于200个/微升的患者的新冠病毒抗体滴度较低，具有统计学意义。在多项逻辑回归中，年龄、性别和既往新冠病毒感染等其他因素对首次新冠病毒抗体滴度的影响不显著。
艾滋病毒感染者对新冠病毒疫苗有反应。正如预期的那样，CD4细胞计数较高的患者的新冠病毒抗体滴度较高，住院率较低。根据我们的研究，年龄、性别和既往新冠病毒感染并未显著影响抗体滴度。需要开展更大规模的有对照组的前瞻性研究，以进一步明确艾滋病毒感染者对新冠病毒疫苗接种的免疫反应特征。
