SARS-CoV-2 mRNA vaccination and short-term changes in viral load and CD4/CD8 T-cell counts in people living with HIV

Alessandra Vergori; Alessandro Cozzi-Lepri; Alessandro Tavelli; Valentina Mazzotta; Anna Maria Azzini; Roberta Gagliardini; Ilaria Mastrorosa; Alessandra Latini; Giovanni Pellicanò; Lucia Taramasso; Francesca Ceccherini-Silberstein; Maddalena Giannella; Evelina Tacconelli; Giulia Marchetti; Antonella d'Arminio Monforte; Andrea Antinori; Vax ICONA ORCHESTRA Study group

doi:10.1016/j.ijid.2024.107065

SARS-CoV-2 mRNA vaccination and short-term changes in viral load and CD4/CD8 T-cell counts in people living with HIV

Int J Infect Dis. 2024 Apr 19:144:107065. doi: 10.1016/j.ijid.2024.107065. Online ahead of print.

Authors

Alessandra Vergori¹, Alessandro Cozzi-Lepri², Alessandro Tavelli³, Valentina Mazzotta⁴, Anna Maria Azzini⁵, Roberta Gagliardini⁴, Ilaria Mastrorosa⁴, Alessandra Latini⁶, Giovanni Pellicanò⁷, Lucia Taramasso⁸, Francesca Ceccherini-Silberstein⁹, Maddalena Giannella¹⁰, Evelina Tacconelli⁵, Giulia Marchetti¹¹, Antonella d'Arminio Monforte¹¹, Andrea Antinori⁴; Vax ICONA ORCHESTRA Study group

Affiliations

¹ HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy. Electronic address: alessandra.vergori@inmi.it.
² Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, UCL, London, UK.
³ Icona Foundation, Milan, Italy.
⁴ HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
⁵ Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
⁶ STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy.
⁷ Department of Human Pathology of the Adult and the Developmental Age "G. Barresi", University of Messina, Messina, Italy.
⁸ Infectious Diseases Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
⁹ Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.
¹⁰ Infectious Diseases Unit, IRCCS Univesity Hospital of Bologna, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
¹¹ Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy.

PMID: 38643867
DOI: 10.1016/j.ijid.2024.107065

Abstract

Objectives: To investigate whether SARS-CoV-2 messenger RNA (mRNA) vaccination has an impact on HIV-related viro-immunological parameters.

Methods: People with HIV (PWH) in the VAXICONA-ORCHESTRA cohort who received one or more doses of SARS-CoV-2 mRNA vaccine and for whom paired measures of immuno-virological markers (viral load, clusters of differentiation [CD]4, and CD8 count 1 month before and after a vaccine dose [VD]) were available were included. Paired t-test and generalized estimating equation linear regression analyses were used to study changes over ± 1 month around the VD. Subgroup analyses were performed.

Results: A total of 510 PWH were enrolled: the median age was 55 years (interquartile range 46-60 years), the CD4 and CD8 count were 489 (287-719) and 790 (59-1104) cells/mm³, respectively, and 81% received three VDs. After a median of 28 (3-53) days from VD, CD4 count increased by +15 cells/mm³ (SD ± 129.7, P = 0.001) and CD8 by +12 (±250.5, P = 0.199) and the viral load decreased by -0.11 log₁₀ (±0.88, P = 0.001). Similar results were observed after restricting the analysis to viro-suppressed PWH, with CD4 ≤200/mm³, more than 6 months of antiretroviral therapy before VD and after excluding previous COVID-19.

Conclusions: A small significant increase in CD4 count and a negligible drop in HIV RNA were observed. Our findings are consistent with the hypothesis that SARS-CoV-2 mRNA vaccine can prime CD4 T spike-specific cells, even in the more immuno-compromised PWH.

Keywords: CD4 count; CD8 count; HIV; HIV RNA; Viro-immunological changes; mRNA SARS-CoV-2 vaccine.