Immunogenicity to COVID-19 mRNA vaccine third dose in people living with HIV

Vergori, A.; Cozzi Lepri, A.; Cicalini, S.; Matusali, G.; Bordoni, V.; Lanini, S.; Meschi, S.; Iannazzo, R.; Mazzotta, V.; Colavita, F.; Mastrorosa, I.; Cimini, E.; Mariotti, D.; De Pascale, L.; Marani, A.; Galli, P.; Garbuglia, A. R.; Castilletti, C.; Puro, V.; Agrati, C.; Girardi, E.; Vaia, F.; Antinori, A.; Amendola, A.; Baldini, F.; Bellagamba, R.; Bettini, A.; Bordi, L.; Camici, M.; Casetti, R.; Costantini, S.; Cristofanelli, F.; D'Alessio, C.; D'Aquila, V.; De Angelis, A.; De Zottis, F.; de Pascale, L.; Francalancia, M.; Fusto, M.; Gagliardini, R.; Gramigna, G.; Grassi, G.; Grilli, E.; Grisetti, S.; Iafrate, D.; Lapa, D.; Lorenzini, P.; Marani, A.; Masone, E.; Marongiu, S.; Mondi, A.; Notari, S.; Ottou, S.; Paulicelli, J.; Pellegrino, L.; Pinnetti, C.; Plazzi, M. M.; Possi, A.; Sacchi, A.; Tartaglia, E.

doi:10.1038/s41467-022-32263-7

In order to investigate safety and immunogenicity of SARS-CoV-2 vaccine third dose in people living with HIV (PLWH), we analyze anti-RBD, microneutralization assay and IFN-γ production in 216 PLWH on ART with advanced disease (CD4 count <200 cell/mm3 and/or previous AIDS) receiving the third dose of a mRNA vaccine (BNT162b2 or mRNA-1273) after a median of 142 days from the second dose. Median age is 54 years, median CD4 nadir 45 cell/mm3 (20–122), 93% HIV-RNA < 50 c/mL. In 68% of PLWH at least one side-effect, generally mild, is recorded. Humoral response after the third dose was strong and higher than that achieved with the second dose (>2 log2 difference), especially when a heterologous combination with mRNA-1273 as third shot is used. In contrast, cell-mediated immunity remain stable. Our data support usefulness of third dose in PLWH currently receiving suppressive ART who presented with severe immune dysregulation.