Patients With HIV May Require Dose Adjustments of COVID-19 Vaccines

Inactivated SARS-CoV-2 vaccines yielded comparable positive rates of neutralizing antibodies in people with and without human immunodeficiency virus (HIV), although the magnitude of response was weaker in people with HIV. Researchers published their findings in International Immunopharmacology.

“Neutralization antibodies are critical to eliminate SARS-CoV-2, which can reduce morbidity and mortality,” they wrote. “Therefore, in order to achieve similar antiviral effects, a booster dose or dose adjustment might be needed when injecting HIV-positive individuals with inactivated SARS-CoV-2 vaccines, particularly for those with lower CD4+T cells counts.”

The study investigated the immunogenicity of inactivated SARS-CoV-2 vaccines in 24 people positive for HIV and 24 healthy people in Kunming, China.

Approximately 40 days after the second vaccine injection, positive rates of neutralizing antibodies were similar among people with and without HIV, according to the study. However, the magnitude of immunogenicity, as exhibited by levels of neutralizing antibodies, was lower in people with HIV. Low counts of CD4 and B cells were associated with the weaker response.

SARS-2-S-induced Th2 and Th17 responses were also decreased in participants with HIV, the study found.

“Recent studies have demonstrated that Th17 proinflammatory responses might also contribute to an important component of vaccine-induced immune memory. IL-4, mainly derived from Th2 cells, has crucial influence on production of immunoglobulin, particularly IgG1,” researchers wrote. “However, it is still not completely clear that lack of adequate Th2 and Th17 is responsible for weaker T-cell responses in people living with HIV. More research will be needed to confirm our finding.”

Reference:
Lv Z, Li Q, Feng Z, et al Inactivated SARS-CoV-2 vaccines elicit immunogenicity and T-cell responses in people living with HIV. Int Immunopharmacol. 2022;102:108383. doi:10.1016/j.intimp.2021.108383