Lower T cell response against SARS-CoV-2 variants of concern after mRNA vaccine and risk of breakthrough infections in people with HIV.

Abstract

OBJECTIVES:

We evaluated T-cell immune responses against SARS-CoV-2 variants of concern (VOC) after vaccination in people with HIV (PWH), and their impact on the incidence of disease.

METHODS:

A prospective cohort study. Peripheral blood mononuclear cells (PBMCs) were collected a median of 53 days after second dose of mRNA vaccine. Humoral response and T cell responses against the spike (S) glycoprotein of wild-type SARS-CoV-2 (ancestral Wuhan variant) and mutated S-protein regions found in the Delta and Omicron variants were assessed by flow cytometry analysis.

RESULTS:

In 142 PWH without preceding SARS-CoV-2 infection, bivariate correlations showed a close association between T-cell responses to the different variants. However, despite at least 70% of PWH having a cellular immune response to any variant, CD4 + and CD8 + T cell responses against VOC were lower in frequency and magnitude (-3% and -20% for Delta, -33% and -28% for Omicron variant) compared with that observed against the Wuhan strain. A higher magnitude of SARS-CoV-2 spike-specific CD8 + T cell responses against all the variants was observed in those PWH with greater immune reconstitution. Notably, 27 symptomatic breakthrough infections (19%) in the setting of Delta and Omicron transmission were observed during follow-up, associated with a significant lower humoral and T-cell response to ancestral strain and VOC. On the contrary, only one PWH with COVID-19 (4%) required hospitalization.

CONCLUSION:

A blunted T-cell response against Delta and Omicron variant is observed in PWH who received two doses of mRNA vaccine. This lower immune response is associated with breakthrough SARS-CoV-2 infections.

• Authors: José L Casado, Pilar Vizcarra, Sara Martín-Colmenarejo, Judith Del Pino, Sandra Gomez-Maldonado, Adrían Martín-Hondarza, Alejandro Vallejo
• Journal: AIDS (London, England) (AIDS) Vol. 37 Issue 6 Pg. 877-882 (05 01 2023) ISSN: 1473-5571 [Electronic] England
• PMID: 36779501 (Publication Type: Journal Article)
• Copyright: Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

Chemical References

• mRNA Vaccine
• Antibodies, Viral

Topics

• Humans
• SARS-CoV-2
• Breakthrough Infections
• Leukocytes, Mononuclear
• Prospective Studies
• COVID-19 (prevention & control)
• HIV Infections (complications)
• Antibodies, Viral