Correlates of Breakthrough SARS-CoV-2 Infections in People with HIV: Results from the CIHR CTN 328 Study

• Published in: Vaccines (Basel) 2024-05, Vol.12 (5), p.447
• Main Authors: Costiniuk, Cecilia T, Lee, Terry, Singer, Joel, Galipeau, Yannick, Arnold, Corey, Langlois, Marc-André, Needham, Judy, Jenabian, Mohammad-Ali, Burchell, Ann N, Samji, Hasina, Chambers, Catharine, Walmsley, Sharon, Ostrowski, Mario, Kovacs, Colin, Tan, Darrell H S, Harris, Marianne, Hull, Mark, Brumme, Zabrina L, Lapointe, Hope R, Brockman, Mark A, Margolese, Shari, Mandarino, Enrico, Samarani, Suzanne, Lebouché, Bertrand, Angel, Jonathan B, Routy, Jean-Pierre, Cooper, Curtis L, Anis, Aslam H
• Format: Article
• Language: English
• Subjects: Analysis; Antigens; breakthrough infection; Chronic kidney failure; Comorbidity; COVID-19; COVID-19 vaccination; COVID-19 vaccines; Development and progression; Diabetes mellitus; Health aspects; HIV; HIV (Viruses); HIV patients; Human immunodeficiency virus; humoral immunity; Hypertension; immunogenicity; Immunoglobulin G; Infection; Infections; Informed consent; Kidney diseases; Lymphocytes; Proteins; Public health; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Sexually transmitted diseases; Signs and symptoms; Sociodemographics; Statistical analysis; STD; Vaccines; Viral diseases
• ISSN: 2076-393X; 2076-393X
• DOI: 10.3390/vaccines12050447

COVID-19 breakthrough infection (BTI) can occur despite vaccination. Using a multi-centre, prospective, observational Canadian cohort of people with HIV (PWH) receiving ≥2 COVID-19 vaccines, we compared the SARS-CoV-2 spike (S) and receptor-binding domain (RBD)-specific IgG levels 3 and 6 months post second dose, as well as 1 month post third dose, in PWH with and without BTI. BTI was defined as positivity based on self-report measures (data up to last study visit) or IgG data (up to 1 month post dose 3). The self-report measures were based on their symptoms and either a positive PCR or rapid antigen test. The analysis was restricted to persons without previous COVID-19 infection. Persons without BTI remained COVID-19-naïve until ≥3 months following the third dose. Of 289 participants, 92 developed BTI (31.5 infections per 100 person-years). The median days between last vaccination and BTI was 128 (IQR 67, 176), with the most cases occurring between the third and fourth dose (n = 59), corresponding to the Omicron wave. In analyses adjusted for age, sex, race, multimorbidity, hypertension, chronic kidney disease, diabetes and obesity, a lower IgG S/RBD (log10 BAU/mL) at 1 month post dose 3 was significantly associated with BTI, suggesting that a lower IgG level at this time point may predict BTI in this cohort of PWH.