Mpox-specific immune responses elicited by vaccination or infection in people living with HIV

J Infect Dis. 2024 Mar 13:jiae138. doi: 10.1093/infdis/jiae138. Online ahead of print.

Abstract

In the recent mpox outbreak, people living with HIV (PLWH) were at high risk both for contracting infection and for suffering a more severe disease course. We studied cellular and humoral immune responses elicited by mpox infection (n = 5; n = 3 PLWH) or smallpox vaccination (n = 17; all PLWH) in a cohort of men who have sex with men. All PLWH were successfully treated, with stable CD4 counts and undetectable HIV viral loads. 11/17 vaccinated individuals had received childhood smallpox vaccination. In this group of individuals, both two-dose MVA-vaccination and natural infection evoked mpox-specific immune responses mediated by B cells as well as CD4 and CD8 T cells. This study improves our understanding of smallpox vaccination mediated cross-reactivity to other orthopox viruses, and the long-lasting durability of childhood smallpox vaccination mediated immune responses including in PLWH.

Keywords: HIV; IgG response; MVA-vaccine; T cell response; mpox recovered; mpox virus; neutralizing antibodies; orthopox virus; smallpox-vaccine.