Comparative analysis of clinical and laboratory outcomes in HIV-infected patients vaccinated and not vaccinated against COVID-19


DOI: https://dx.doi.org/10.18565/epidem.2022.12.3.59-64

Kanestri V.G., Kuimova U.A., Goliusova M.D.

1) Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; 2) H-Clinic University Clinic, Moscow, Russia
Objective. To comparatively analyze clinical and laboratory outcomes after vaccination against SARS-CoV-2 infection and in its absence in HIV-infected patients on stable antiretroviral therapy (ART).
Subjects and methods. The investigation conducted in January 2021 to June 2022 enrolled 151 patients. A group of those vaccinated against COVID-19 with different types of vaccines included 100 people; a group of the unvaccinated consisted of 51 people. The investigators evaluated the safety and tolerability of vaccines, the course of HIV infection, the efficiency of ART, the presence and severity of secondary and concomitant diseases, including COVID-19, at 2 control points at a 3-6-month interval.
Results. COVID-19 vaccines had a good safety profile in people living with HIV (PLHIV). Their adverse reactions were mild and required no additional medical intervention. Vaccination did not worsen the course of HIV infection or reduce the efficiency of ART, and it was associated with an increase in the absolute and relative number of CD4+ lymphocytes with an undetectable viral load. The chances of getting sick with COVID-19 without a full course of vaccination in PLHIV were 4.8 times higher, whereas those of getting seriously ill were 15.8 times higher than in the unvaccinated people of this category. Comorbidities increased the risk of COVID-19 infection.
Conclusion. Further investigations are needed to evaluate the efficiency of COVID-19 vaccines to protect against severe disease, hospitalization, or death in this population.
Keywords: COVID-19, vaccination, HIV
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Literature

1. National Institutes of Health. Coronavirus disease 2019 (COVID-19) treatment guidelines. Published December 2020. https://www.covid19treatmentguidelines.nih.gov


2. Brown L.B., Spinelli M.A., Gandhi M. The interplay between HIV and COVID-19: Summary of the data and responses to date. Curr. Opin. HIV AIDS 2021; 16(1): 63–73. doi: 10.1097/COH.0000000000000659


3. Wiersinga W.J., Rhodes A., Cheng A.C., Peacock S.J., Prescott H.C. Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19). JAMA. 2020; 323(13): 1239–42. doi: 10.1001/jama.2020.12839


4. Logunov D.Y., Dolzhikova I.V., Shcheblyakov D.V., Tukhvatulin A.I., Zubkova O.V., Dzharullaeva A.S. et al. Safety and efficacy of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine: an interim analysis of a randomised controlled phase 3 trial in Russia. Lancet 2021; 397(10275): 642–3. doi.org/10.1016/S0140-6736(21)00234-8


5. Department of Health and Human Services. Panel on Antiretroviral Guidelines for Adults and Adolescents: interim guidance for COVID-19 and persons with HIV. Updated February 2021. https://clinicalinfo.hiv.gov/ en/guidelines/covid-19-and-persons-hiv-interim-guidance/interim-guidance-covid-19-and-persons-hiv


6. Duly K., Farraye F.A., Bhat S. COVID-19 vaccine use in immunocompromised patients: A commentary on evidence and recommendations. Am. J. Health Syst. Pharm. 2022; 79(2): 63–71. doi: 10.1093/ajhp/zxab344


7. Polack F.P., Thomas S.J., Kitchin N., Absalon J., Gurtman А., Lockhart S. et al. Safety and efficacy of the BNT162b2 mRNA COVID-19 vaccine. N. Engl. J. Med. 2020; 383(27): 2603–15. doi: 10.1056/NEJMoa2034577.


8. Baden L.R., El Sahly H.M., Essink B., Kotloff K. Frey S., Novak R. et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N. Engl. J. Med. 2021; 384(5): 403–16. doi: 10.1056/NEJMoa2035389.


9. Food and Drug Administration. Vaccines And Related Biological Products Advisory Committee briefing document: Moderna COVID-19 Vaccine. Published December 2020. https://www.fda.gov/media/144434/download


10. National Institutes of Health. Janssen investigational COVID-19 vaccine: interim analysis of phase 3 clinical data released. Pulished January 2021. . https://www.nih.gov/news-events/news-releases/janssen-investigational-covid-19-vaccine-interim-analysis-phase-3-clinical-data-released


11. Liu Y., Han J., Li X., Chen D., Zhao X., Qiu Y. et al. COVID-19 Vaccination in People Living with HIV (PLWH) in China: A Cross Sectional Study of Vaccine Hesitancy, Safety, and Immunogenicity. Vaccines 2021; 9(12): 1458. doi: 10.3390/vaccines9121458


12. Vallée A., Fourn E., Majerholc C., Touche P., Zucman D. COVID-19 Vaccine Hesitancy among French People Living with HIV. Vaccines 2021; 9(4): 302. doi: 10.3390/vaccines9040302


13. Куимова У.А., Беляева В.В., Козырина Н.В., Кулабухова Е.И., Голиусова М.Д., Наркевич А.Н. Анализ факторов, оказывающих влияние на готовность к вакцинации от коронавирусной инфекции: результаты опроса пациентов, инфицированных ВИЧ. Эпидемиол. и инфекц. болезни. Актуал. вопр. 2021; 11(3): 28–33. doi: https://dx.doi.org/10.18565/epidem.2021.11.3.28-33


Kuimova U.A., Belyaeva V.V., Kozyrina N.V., Kulabukhova E.I., Goliusova M.D., Narkevich A.N. [Analysis of factors influencing the readiness for coronavirus vaccination: results of a survey of HIV-infected patients]. Epidemiоlоgy and infectious diseases. Current items 2022; 11(3): 328–33. (In Russ.). doi: https://doi.org/10.18565/epidem.2021.11.3.28-33


14. Levy I., Wieder-Finesod A., Litchevsky V., Biber A., Indenbaum V., Olmer L. et al. Immunogenicity and safety of the BNT162b2 mRNA COVID-19 vaccine in people living with HIV-1 Clin. Microbiol. Infect. 2021; 27(12): 1851–5. doi: 10.1016/j.cmi.2021.07.031


15. Frater J., Ewer K. J., Ogbe A., Pace M., Adele S., Adland E. et al. Safety and immunogenicity of the ChAdOx1 nCoV-19 (AZD1222) vaccine against SARS-CoV-2 in HIV infection: a single-arm substudy of a phase 2/3 clinical trial. Lancet HIV 2021; 8(8): 474–85. doi: 10.1016/S2352-3018(21)00103-X


16. Skiest D.J., Machala T. Comparison of the effects of acute Influenza infection and Influenza vaccination on HIV viral load and CD4 cell counts. J. Clin. Virol. 2003; 26(3): 307–15. doi: 10.1016/S1386-6532(02)00047-1


17. Jeger-Madiot R., Heredia M., Graff-Dubois S. Germinal centers B-cell reaction and T follicular helper cells in response to HIV-1 infection. Curr. Opin. HIV AIDS 2019; 14(4): 246–52. doi: 10.1097/COH. 0000000000000557


18. Kaneko N., Kuo H.H., Boucau J., Farmer J.R., Allard-Chamard H., Mahajan V.S. et al. Loss of Bcl-6-Expressing T Follicular Helper Cells and Germinal Centers in COVID-19. Cell 2020; 183(1): 143–57. doi: 10.1016/j.cell.2020.08.025


About the Autors

Veronika G. Kanestri, Professor, MD, Senior Researcher, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Infectionist of University Clinic «H-Clinic», Moscow, Russia; kanestri@yandex.ru; http://orcid.org/0000-0002-2234-7094
Ulyana A. Kuimova, Cand. Med. Sci., Researcher, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; ulyanakuimova@gmail.com; https://orcid.org/0000-0002-1101-151X
Marina D. Goliusova, Infectiologist, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Moscow, Russia; mad2501@yandex.ru; https://orcid.org/0000-0002-5325-6857


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