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Immunogenicity of AZD1222 (ChAdOx1) SARS-CoV-2 vaccine in people living with HIV

Background: People living with HIV (PLWHIV) are at increased risk for severe COVID-19 [1]. We aimed to evaluate the serological response after two doses of AZD1222 (ChAdOx1) SARS-CoV-2 vaccination in PLWHIV. Materials and methods: Participants were evaluated before the first dose (baseline) and 3 months after the second dose of the ChAdOx1 vaccine. Patient's sera were analysed using the SARS-CoV-2 IgG II Quant Architect Abbott assay [2]. An antibody concentration ≥50 arbitrary units per milliliter (AU/mL) was defined as positive (seroconversion) [2]. We also compared the immunogenicity of AZD1222 in PLWHIV to sex-matched healthcare workers (controls) who received two doses of the BNT162b2 vaccine. The study measurements were done from April to December 2021. Results: Fifty-nine PLWHIV were included: 57 men, median age 45.0 years, all receiving antiretroviral treatment and with controlled viral loads (58 with HIV RNA <50 copies/mL), 57 had >200 CD4+ cells/μL, and the median CD4 cell count was 722 (IQR 520 to 878) cells/μL (Table 1). Eight (13.6%) PLWHIV were obese (≥30.0 kg/m2), and 31 (52.5%) were overweight (excluding obese). At baseline 56 PLWHIV had an antibody concentration <50 AU/mL. Fifty-five (93.2%) patients seroconverted after vaccination. An antibody concentration between 50 and 1000 AU/mL had 36 (61.0%) PLWHIV, 18 (30.5%) had between 1000 and 40 000 AU/mL and only one had above the upper threshold of quantification (Figure 1). No severe adverse events were reported. Of 59 healthcare workers, median age 45.5 years, 50 (84.8%) had an antibody concentration between 1000 and 40 000 AU/mL 3 months after the second dose of the BNT162b2 vaccine. The median antibody concentration in AZD1222 recipients was 505.4 (IQR 196.3 to 1685.8) AU/mL whereas in BNT162b2 recipients it was 2740.9 (IQR 1328.5 to 4847.4) AU/mL (Figure 1). No participant had COVID- 19. Conclusions: Vaccination with two doses of AZD1222 in PLWHIV under effective antiretroviral treatment and a high CD4 cell count led to a moderately successful antibody response which was lower than in healthcare workers receiving the BNT162b2 vaccine. References: 1. Dong Y, Li Z, Ding S, Liu S, Tang Z, Jia L, et al. HIV infection and risk of COVID- 19 mortality: a meta-analysis. Medicine (Baltimore). 2021 ; 100:e26573. 2. US Food and Drug Administration. AdviseDx SARS- CoV-2 IgG II [Internet]. [cited 2022 Aug 23]. Available from: https://www.fda.gov/media/146371/download.

immunogenicity ; AZD1222 ; SARS-CoV-2 ; vaccine ; HIV

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