Bridging the gap: identifying factors impacting mRNA SARS-CoV-2 vaccine booster response in people living with HIV-1. AIDS
Chammartin et al. aimed at investigating which factors substantially impact vaccine immunogenicity after a third mRNA vaccination in people with HIV (PWH).
Serological measurements were conducted on a total of 439 PWH who had received a third dose of either mRNA-1273 (Moderna) or BNT162b2 (Pfizer-BioNTech) SARS-CoV-2 vaccine. Antibody reactivity was assessed using the multifactorial ABCORA immunoassay that defines SARS-CoV-2 seroconversion and predicts neutralization activity.
Antibody response to third SARS-CoV-2 vaccination was significantly lower among PWH with CD4+ cell count less than 350 cells/μl [ratio of means 0.79; 95% confidence interval (CI) 0.65–0.95]. Having a detectable HIV-1 viral load at least 50 copies/ml and being on concurrent chemotherapy was associated with an overall lower humoral immune response (ratio of means 0.75; 95% CI 0.57–1.00 and 0.34; 95% CI 0.22–0.52, respectively).
In sum, the study findings highlight the critical importance of optimal antiretroviral treatment for PWH, emphasizing the necessity of timely intervention to enhance and monitor the immune reconstitution and improve vaccine immunogenicity within this population. Moreover, they underscore the significance of sequential mRNA vaccination, providing compelling evidence to inform vaccine guidelines and advocate for tailored vaccination strategies for a potentially vulnerable population.