Humoral and Cellular Immune Response Elicited by mRNA Vaccination Against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in People Living With Human Immunodeficiency Virus Receiving Antiretroviral Therapy Based on Current CD4 T-Lymphocyte Count
Authors: Antinori Andrea , Cicalini Stefania , Meschi Silvia , Bordoni Veronica , Lorenzini Patrizia , Vergori Alessandra , Lanini Simone , De Pascale Lidya , Matusali Giulia , Mariotti Davide , Cozzi Lepri Alessandro , Gallì Paola , Pinnetti Carmela , Gagliardini Roberta , Mazzotta Valentina , Mastrorosa Ilaria , Grisetti Susanna , Colavita Francesca , Cimini Eleonora , Grilli Elisabetta , Bellagamba Rita , Lapa Daniele , Sacchi Alessandra , Marani Alessandra , Cerini Carlo , Candela Caterina , Fusto Marisa , Puro Vincenzo , Castilletti Concetta , Agrati Chiara , Girardi Enrico , Vaia Francesco ,   for the HIV-VAC Study Group, Agrati Chiara , Amendola Alessandra , Antinori Andrea , Baldini Francesco , Bellagamba Rita , Bettini Aurora , Bordi Licia , Bordoni Veronica , Camici Marta , Candela Caterina , Casetti Rita , Castilletti Concetta , Cerini Carlo , Cicalini Stefania , Colavita Francesca , Costantini Sarah , Cristofanelli Flavia , Cozzi Lepri Alessandro , D’Alessio Claudia , De Angelis Alessia , De Zottis Federico , de Pascale Lydia , Francalancia Massimo , Fusto Marisa , Gagliardini Roberta , Gallì Paola , Girardi Enrico , Gramigna Giulia , Grassi Germana , Grilli Elisabetta , Grisetti Susanna , Iafrate Denise , Lanini Simone , Lapa Daniele , Lorenzini Patrizia , Marani Alessandra , Masone Erminia , Mastrorosa Ilaria , Mariotti Davide , Marongiu Stefano , Matusali Giulia , Mazzotta Valentina , Meschi Silvia , Mondi Annalisa , Notari Stefania , Ottou Sandrine , Paulicelli Luca Pellegrino Jessica , Pinnetti Carmela , Maddalena Plazzi Maria , Possi Adriano , Puro Vincenzo , Sacchi Alessandra , Tartaglia Eleonora , Vaia Francesco , Vergori Alessandra 
Published: April 2022

Abstract

Background
Data on SARS-CoV-2 vaccine immunogenicity in PLWH are currently limited. Aim of the study was to investigate immunogenicity according to current CD4 T-cell count

Methods
PLWH on ART attending a SARS-CoV-2 vaccination program, were included in a prospective immunogenicity evaluation after receiving BNT162b2 or mRNA-1273. Participants were stratified by current CD4 T-cell count (poor CD4 recovery, PCDR: &lt;200/mm3; intermediate CD4 recovery, ICDR: 200–500/mm3; high CD4 recovery, HCDR: &gt;500/mm3). RBD-binding IgG, SARS-CoV-2 neutralizing antibodies (nAbs) and IFN-γ release were measured. As control group, HIV-negative healthcare workers (HCWs) were used

Findings
Among 166 PLWH, after 1 month from the booster dose, detectable RBD-binding IgG were elicited in 86.7% of PCDR, 100% of ICDR, 98.7% of HCDR, and a neutralizing titre ≥1:10 elicited in 70.0%, 88.2%, and 93.1%, respectively. Compared to HCDR, all immune response parameters were significantly lower in PCDR. After adjusting for confounders, current CD4 T-cell &lt;200/mm3 significantly predicted a poor magnitude of anti-RDB, nAbs and IFN-γ response. As compared with HCWs, PCDR elicited a consistently reduced immunogenicity for all parameters, ICDR only a reduced RBD-binding antibody response, whereas HCDR elicited a comparable immune response for all parameters

Conclusion
Humoral and cell-mediated immune response against SARS-CoV-2 were elicited in most of PLWH, albeit significantly poorer in those with CD4 T-cell &lt;200/mm3 versus those with &gt;500 cell/mm3 and HIV-negative controls. A lower RBD-binding antibody response than HCWs was also observed in PLWH with CD4 T-cell 200–500/mm3, whereas immune response elicited in PLWH with a CD4 T-cell &gt;500/mm3 was comparable to HIV-negative population