Immunogenicity and Determinants of Antibody Response to the BNT162b2 mRNA Vaccine: A Longitudinal Study in a Cohort of People Living with HIV

• Published in: Vaccines (Basel) 2024-10, Vol.12 (10), p.1172
• Main Authors: Baldovin, Tatjana, Leoni, Davide, Geppini, Ruggero, Miatton, Andrea, Amoruso, Irene, Fonzo, Marco, Bertoncello, Chiara, Finco, Mascia, Mazzitelli, Maria, Sasset, Lolita, Cattelan, Annamaria, Baldo, Vincenzo
• Format: Article
• Language: English
• Subjects: Antibodies; Antibody response; Care and treatment; Chemiluminescence; Comorbid patients; Comorbidity; COVID-19; COVID-19 vaccines; Diabetes mellitus; Diagnosis; Disease transmission; Diseases; Drug therapy; Dyslipidemia; HIV; HIV (Viruses); HIV patients; Human immunodeficiency virus; Immune response; Immune system; Immunity (Disease); Immunoassays; Immunogenicity; Immunoglobulin G; Infections; Laboratories; Longitudinal studies; Lymphocytes; Medical records; Microparticles; Morbidity; Mortality; mRNA; mRNA vaccines; Pandemics; Patients; PLWH; Protease inhibitors; Proteinase inhibitors; Public health; Risk factors; SARS-CoV-2; Seroconversion; Serology; Severe acute respiratory syndrome coronavirus 2; Subgroups; vaccination; Vaccines
• ISSN: 2076-393X; 2076-393X
• DOI: 10.3390/vaccines12101172

The COVID-19 pandemic posed significant challenges worldwide, with SARS-CoV-2 vaccines critical in reducing morbidity and mortality. This study evaluates the immunogenicity and antibody persistence of the BNT162b2 vaccine in people living with HIV (PLWH). We monitored anti-SARS-CoV-2 Spike IgG concentration in a cohort of PLWH at five time points (T0-T4) using chemiluminescent microparticle immunoassays (CMIAs) at the baselined both during and after vaccination. In severely immunocompromised individuals, a boosting dose was recommended, and participants and IgG concentration were measured in the two subgroups (boosted and not boosted). In total, 165 PLWH were included, and 83% were male with a median age of 55 years (IQR: 47-62). At T1, 161 participants (97.6%) showed seroconversion with a median of IgG values of 468.8 AU/mL (IQR: 200.4-774.3 AU/mL). By T2, all subjects maintained a positive result, with the median anti-SARS-CoV-2 Spike IgG concentration increasing to 6191.6 AU/mL (IQR: 3666.7-10,800.8 AU/mL). At T3, all participants kept their antibody levels above the positivity threshold with a median of 1694.3 AU/mL (IQR: 926.3-2966.4 AU/mL). At T4, those without a booster dose exhibited a marked decrease to a median of 649.1 AU/mL (IQR: 425.5-1299.8 AU/mL), whereas those with a booster experienced a significant increase to a median of 13,105.2 AU/mL (IQR: 9187.5-18,552.1 AU/mL). The immune response was negatively influenced by the presence of dyslipidaemia at T1 (aOR 4.75, 95% CI: 1.39-16.20) and diabetes at T3 (aOR 7.11, 95% CI: 1.10-46.1), while the use of protease inhibitors (aORs 0.06, 95% CI: 0.01-0.91) and being female (aOR 0.02, 95% CI: 0.01-0.32) at T3 were protective factors. The immunogenicity of the BNT162b2 vaccine in PLWH has been confirmed, with booster doses necessary to maintain high levels of anti-SARS-CoV-2 Spike IgG antibodies, especially in patients with comorbidities. These findings underline the importance of a personalized vaccination strategy in this population.