Utility of accessible SARS-CoV-2 specific immunoassays in vaccinated adults with a history of advanced HIV infection

• Published in: Scientific reports Vol. 14; no. 1; p. 8337
• Main Authors: Ferrari, Ludovica, Ruggiero, Alessandra, Stefani, Chiara, Benedetti, Livia, Piermatteo, Lorenzo, Andreassi, Eleonora, Caldara, Federica, Zace, Drieda, Pagliari, Matteo, Ceccherini-Silberstein, Francesca, Jones, Christopher, Iannetta, Marco, Geretti, Anna Maria
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 09.04.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 631/250; 631/326; 692/308; 692/53; 692/699; 692/700; Adult; Animals; Antibodies; Antibodies, Neutralizing; Antibodies, Viral; BNT162 Vaccine; CD4 antigen; Chemiluminescence; COVID-19; COVID-19 - prevention & control; COVID-19 Vaccines - adverse effects; HIV; HIV Infections; Human immunodeficiency virus; Humanities and Social Sciences; Humans; Immune response; Immunoassay; Immunoassays; Immunogenicity; Lymphocytes T; multidisciplinary; Neutralization; Nucleocapsids; Public health; SARS-CoV-2; Science; Science (multidisciplinary); Severe acute respiratory syndrome coronavirus 2; Spiders; Vaccination; Vaccines; Viremia; γ-Interferon
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-58597-4

Accessible SARS-CoV-2-specific immunoassays may inform clinical management in people with HIV, particularly in case of persisting immunodysfunction. We prospectively studied their application in vaccine recipients with HIV, purposely including participants with a history of advanced HIV infection. Participants received one (n = 250), two (n = 249) or three (n = 42) doses of the BNT162b2 vaccine. Adverse events were documented through questionnaires. Sample collection occurred pre-vaccination and a median of 4 weeks post-second dose and 14 weeks post-third dose. Anti-spike and anti-nucleocapsid antibodies were measured with the Roche Elecsys chemiluminescence immunoassays. Neutralising activity was evaluated using the GenScript cPass surrogate virus neutralisation test, following validation against a Plaque Reduction Neutralization Test. T-cell reactivity was assessed with the Roche SARS-CoV-2 IFNγ release assay. Primary vaccination (2 doses) was well tolerated and elicited measurable anti-spike antibodies in 202/206 (98.0%) participants. Anti-spike titres varied widely, influenced by previous SARS-CoV-2 exposure, ethnicity, intravenous drug use, CD4 counts and HIV viremia as independent predictors. A third vaccine dose significantly boosted anti-spike and neutralising responses, reducing variability. Anti-spike titres > 15 U/mL correlated with neutralising activity in 136/144 paired samples (94.4%). Three participants with detectable anti-S antibodies did not develop cPass neutralising responses post-third dose, yet displayed SARS-CoV-2 specific IFNγ responses. SARS-CoV-2 vaccination is well-tolerated and immunogenic in adults with HIV, with responses improving post-third dose. Anti-spike antibodies serve as a reliable indicator of neutralising activity. Discordances between anti-spike and neutralising responses were accompanied by detectable IFN-γ responses, underlining the complexity of the immune response in this population.