People with Human Immunodeficiency Virus receiving suppressive antiretroviral therapy show typical antibody durability after dual coronavirus disease 2019 vaccination and strong third dose responses

This study investigates the humoral immune responses of people living with HIV (PLWH) on suppressive antiretroviral therapy (ART) for up to 6 months post second dose and one month post third doses of the COVID-19 vaccine.  The study concluded that adult PLWH with well-controlled viral loads and preserved CD4+ T-cell counts mount strong and functional antibody responses to 2- and 3-dose COVID-19 vaccination, including to Omicron.

The study was done in 99 PLWH and 152 individuals without HIV (controls).  PLWH and controls were broadly similar in age (median age 54 years for PLWH and 47 years for controls) and number of chronic conditions, but the PLWH group included more participants who were male and more who were white. 80% of PLWH participants and 88% of controls had received a third dose, on average 6.3 months after their second dose. All third doses were mRNA vaccines, and more PLWH than controls received mRNA-1273 (70% vs 59%, respectively)

Key Findings

• Antibody levels naturally declined over time after the second vaccine dose. However, the rate of decline and the overall antibody levels were similar in both PLWH and controls after accounting for sociodemographic, health, and vaccine-related factors. This indicates that being HIV-positive does not negatively affect the long-term antibody response.
• Even those PLWH with previously low CD4+ T-cell counts did not show impaired antibody responses after two vaccine doses.
• The third vaccine dose significantly boosted antibody levels beyond what was achieved after the second dose. While responses to the Omicron variant were generally weaker than those to the wild-type virus, PLWH had comparable or even higher antibody levels than controls after the third dose.
• Receiving the Moderna vaccine for the third dose was strongly associated with higher antibody levels.

Overall, this study supports the effectiveness of COVID-19 vaccination in PLWH and underscores the importance of booster doses for maintaining strong immunity against COVID-19.

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