B cell response after SARS-CoV-2 mRNA vaccination in people living with HIV

Jacopo Polvere; Massimiliano Fabbiani; Gabiria Pastore; Ilaria Rancan; Barbara Rossetti; Miriam Durante; Sara Zirpoli; Enrico Morelli; Elena Pettini; Simone Lucchesi; Fabio Fiorino; Mario Tumbarello; Annalisa Ciabattini; Francesca Montagnani; Donata Medaglini

doi:10.1038/s43856-023-00245-5

B cell response after SARS-CoV-2 mRNA vaccination in people living with HIV

Commun Med (Lond). 2023 Jan 30;3(1):13. doi: 10.1038/s43856-023-00245-5.

Authors

Jacopo Polvere¹, Massimiliano Fabbiani², Gabiria Pastore¹, Ilaria Rancan^{2

3}, Barbara Rossetti², Miriam Durante³, Sara Zirpoli¹, Enrico Morelli³, Elena Pettini¹, Simone Lucchesi¹, Fabio Fiorino¹, Mario Tumbarello^{2

3}, Annalisa Ciabattini¹, Francesca Montagnani^{4

5}, Donata Medaglini⁶

Affiliations

¹ Laboratory of Molecular Microbiology and Biotechnology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
² Department of Medical Sciences, Infectious and Tropical Diseases Unit, University Hospital of Siena, Siena, Italy.
³ Department of Medical Biotechnologies, University of Siena, Siena, Italy.
⁴ Department of Medical Sciences, Infectious and Tropical Diseases Unit, University Hospital of Siena, Siena, Italy. francesca.montagnani@unisi.it.
⁵ Department of Medical Biotechnologies, University of Siena, Siena, Italy. francesca.montagnani@unisi.it.
⁶ Laboratory of Molecular Microbiology and Biotechnology, Department of Medical Biotechnologies, University of Siena, Siena, Italy. donata.medaglini@unisi.it.

Abstract

Background: Limited longitudinal data are available on immune response to mRNA SARS-CoV-2 vaccination in people living with HIV (PLWHIV); therefore, new evidence on induction and persistence of spike-specific antibodies and B cells is needed.

Methods: In this pilot study we investigated the spike-specific humoral and B cell responses up to six months after vaccination with two doses of mRNA vaccines in 84 PLWHIV under antiretroviral therapy compared to 79 healthy controls (HCs).

Results: Spike-specific IgG persisted six months in PLWHIV with no significant differences compared to HCs, even though a significantly lower IgG response was observed in patients with CD4⁺ T cells < 350/mmc. The frequency of subjects with antibodies capable of inhibiting ACE2/RBD binding was comparable between PLWHIV and HCs a month after the second vaccine dose, then a higher drop was observed in PLWHIV. A comparable percentage of spike-specific memory B cells was observed at month six in PLWHIV and HCs. However, PLWHIV showed a higher frequency of spike-specific IgD^- CD27^- double-negative memory B cells and a significantly lower rate of IgD^- CD27⁺ Ig-switched memory B cells compared to HCs, suggesting a reduced functionality of the antigen-specific memory B population.

Conclusions: The mRNA vaccination against SARS-CoV-2 elicits humoral and B cell responses quantitatively similar between PLWHIV and HCs, but there are important differences in terms of antibody functionality and phenotypes of memory B cells, reinforcing the notion that tailored vaccination policies should be considered for these patients.

Plain language summary

SARS-CoV-2 vaccination has been demonstrated to protect people from severe COVID-19 and death. This is achieved through the induction of a specific immune response that recognizes and responds to the virus. Limited data are available on the immune response to SARS-CoV-2 vaccination in people living with HIV (PLWHIV). In this study, we evaluated the immune response up to six months after vaccination with two doses of vaccines in PLWHIV being treated with the standard antiretroviral therapy. We show that the immune response observed in PLWHIV is broadly similar to that in healthy subjects but that there are some differences in the cells induced as part of the immune response. We therefore suggest that specific vaccination policies should be considered for these PLWHIV.