Booster Vaccination Against SARS-CoV-2 Induces Potent Immune Responses in People With Human Immunodeficiency Virus
Fidler S., Fox J., Tipoe T., Longet S., Tipton T., Abeywickrema M., Adele S., Alagaratnam J., Ali M., Aley PK., Aslam S., Balasubramanian A., Bara A., Bawa T., Brown A., Brown H., Cappuccini F., Davies S., Fowler J., Godfrey L., Goodman AL., Hilario K., Hackstein C-P., Mathew M., Mujadidi YF., Packham A., Petersen C., Plested E., Pollock KM., Ramasamy MN., Robinson H., Robinson N., Rongkard P., Sanders H., Serafimova T., Spence N., Waters A., Woods D., Zacharopoulou P., Barnes E., Dunachie S., Goulder P., Klenerman P., Winston A., Hill AVS., Gilbert SC., Carroll M., Pollard AJ., Lambe T., Ogbe A., Frater J.
Abstract Background People with human immunodeficiency virus (HIV) on antiretroviral therapy (ART) with good CD4 T-cell counts make effective immune responses following vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There are few data on longer term responses and the impact of a booster dose. Methods Adults with HIV were enrolled into a single arm open label study. Two doses of ChAdOx1 nCoV-19 were followed 12 months later by a third heterologous vaccine dose. Participants had undetectable viraemia on ART and CD4 counts >350 cells/µL. Immune responses to the ancestral strain and variants of concern were measured by anti-spike immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA), MesoScale Discovery (MSD) anti-spike platform, ACE-2 inhibition, activation induced marker (AIM) assay, and T-cell proliferation. Findings In total, 54 participants received 2 doses of ChAdOx1 nCoV-19. 43 received a third dose (42 with BNT162b2; 1 with mRNA-1273) 1 year after the first dose. After the third dose, total anti-SARS-CoV-2 spike IgG titers (MSD), ACE-2 inhibition, and IgG ELISA results were significantly higher compared to Day 182 titers (P < .0001 for all 3). SARS-CoV-2 specific CD4+ T-cell responses measured by AIM against SARS-CoV-2 S1 and S2 peptide pools were significantly increased after a third vaccine compared to 6 months after a first dose, with significant increases in proliferative CD4+ and CD8+ T-cell responses to SARS-CoV-2 S1 and S2 after boosting. Responses to Alpha, Beta, Gamma, and Delta variants were boosted, although to a lesser extent for Omicron. Conclusions In PWH receiving a third vaccine dose, there were significant increases in B- and T-cell immunity, including to known variants of concern (VOCs).