SARS-CoV-2 live virus neutralization after four COVID-19 vaccine doses in people with HIV receiving suppressive antiretroviral therapy

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DOI

https://doi.org/10.1097/QAD.0000000000003519

Language of the publication
English
Date
2023-04-01
Type
Article
Author(s)
  • Cheung, Peter K.
  • Lapointe, Hope R.
  • Sang, Yurou
  • Ennis, Siobhan
  • Mwimanzi, Francis
  • Speckmaier, Sarah
  • Barad, Evan
  • Dong, Winnie
  • Liang, Richard
  • Simons, Janet
  • Lowe, Christopher F.
  • Romney, Marc G.
  • Brumme, Chanson J.
  • Niikura, Masahirob
  • Brockman, Mark A.
  • Brumme, Zabrina L.
  • COVID-19 vaccine immunity study team
Publisher
Wolters Kluwer Health, Inc.

Abstract

OBJECTIVE: Limited data exist regarding the immune benefits of fourth COVID-19 vaccine doses in people with HIV (PWH) receiving antiretroviral therapy (ART), particularly now that most have experienced a SARS-CoV-2 infection. We quantified wild-type, Omicron-BA.5 and Omicron-BQ.1-specific neutralization up to 1 month post-fourth COVID-19 vaccine dose in 63 (19 SARS-CoV-2-naive and 44 SARS-CoV-2-experienced) PWH. DESIGN: A longitudinal observational cohort. METHODS: Quantification of wild-type-, Omicron-BA.5, and Omicron-BQ.1-specific neutralization using live virus assays. RESULTS: Participants received monovalent (44%) and bivalent (56%) mRNA fourth doses. In COVID-19-naive PWH, fourth doses enhanced wild-type and Omicron-BA.5-specific neutralization modestly above three-dose levels (P = 0.1). In COVID-19-experienced PWH, fourth doses enhanced wild-type specific neutralization modestly (P = 0.1) and BA.5-specific neutralization substantially (P = 0.002). Consistent with humoral benefits of ’hybrid’ immunity, COVID-19-experienced PWH exhibited the highest neutralization post-fourth dose, wherein those with Omicron-era infections displayed higher wild-type specific (P = 0.04) but similar BA.5 and BQ.1-specific neutralization than those with pre-Omicron-era infections. Nevertheless, BA.5-specific neutralization was significantly below wild-type in everyone regardless of COVID-19 experience, with BQ.1-specific neutralization lower still (both P < 0.0001). In multivariable analyses, fourth dose valency did not affect neutralization magnitude. Rather, an mRNA-1273 fourth dose (versus a BNT162b2 one) was the strongest correlate of wild-type specific neutralization, while prior COVID-19, regardless of pandemic era, was the strongest correlate of BA.5 and BQ.1-specific neutralization post-fourth dose. CONCLUSION: Fourth COVID-19 vaccine doses, irrespective of valency, benefit PWH regardless of prior SARS-CoV-2 infection. Results support recommendations that all adults receive a fourth COVID-19 vaccine dose within 6 months of their third dose (or their most recent SARS-CoV-2 infection).

Subject

  • Health,
  • Coronavirus diseases

Rights

Pagination

F11-F18

Peer review

Yes

Identifiers

PubMed ID
36789806
ISSN
1473-5571

Article

Journal title
AIDS
Journal volume
37
Journal issue
5

Sponsors

This work was supported by funding from Genome BC, Michael Smith Health Research BC and the BCCDC Foundation for Public Health through a rapid SARS-CoV-2 vaccine research initiative in BC award (VAC-009 to Z.L.B., M.A.B.). It was also supported by the Public Health Agency of Canada (PHAC) through a COVID-19 Immunology Task Force (CITF) COVID-19 Award (2020-HQ-000120 to Z.L.B., M.G.R., M.A.B.). Additional funding was received from the Canadian Institutes for Health Research (GA2–177713; to M.A.B.), the Coronavirus Variants Rapid Response Network (FRN-175622; to M.A.B.), the Canada Foundation for Innovation through two Exceptional Opportunities Fund COVID-19 awards (the first to C.J.B. and C.F.L., and the second to M.N., M.A.B., Z.L.B.), a British Columbia Ministry of Health–Providence Healthcare Research Institute COVID-19 Research Priorities Grant (to C.J.B. and C.F.L.). FM is supported by a fellowship from the CIHR Canadian HIV Trials Network. E.B. was supported by an SFU Undergraduate Research Award. Z.L.B. holds a Scholar Award from Michael Smith Health Research BC.

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Communicable diseases

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