The following is a summary of “People With Human Immunodeficiency Virus Receiving Suppressive Antiretroviral Therapy Show Typical Antibody Durability After Dual Coronavirus Disease 2019 Vaccination and Strong Third Dose Responses,” published in the April 2023 issue of Infectious Diseases by Lapointe et al.

For a study, researchers sought to characterize the longer-term humoral responses to 2-dose COVID-19 vaccines in people living with human immunodeficiency virus (HIV) (PLWH) receiving suppressive antiretroviral therapy and to assess the initial response to a third dose. 

They measured the antibodies against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein receptor-binding domain, angiotensin-converting enzyme 2 (ACE2) displacement, and viral neutralization against wild-type and Omicron strains up to 6 months after 2-dose vaccination and 1 month after the third dose in 99 PLWH and 152 controls.

The study found no evidence of lower antibody concentrations or faster rates of antibody decline in PLWH compared to controls after accounting for various factors. Moreover, there was no evidence of poorer viral neutralization in PLWH after 2 doses, nor evidence that a low nadir CD4⁺ T-cell count compromised responses. Post–third-dose humoral responses were substantially higher than post–second-dose levels, though Omicron-specific responses were consistently weaker than responses against the wild-type virus. Nevertheless, post–third-dose responses in PLWH were comparable to or higher than controls. An mRNA-1273 third dose was the strongest consistent correlate of higher post–third-dose responses.

The findings indicated that PLWH receiving suppressive antiretroviral therapy mount strong antibody responses after 2- and 3-dose COVID-19 vaccination and underscored the immune benefits of third doses in light of the Omicron variant. The study suggested that PLWH receiving suppressive antiretroviral therapy should be included in COVID-19 vaccination campaigns and highlighted the importance of third doses for everyone, particularly in emerging variants.

Reference: academic.oup.com/jid/article/227/7/838/6603521