Humoral and cellular immunity to SARS-COV-2 after vaccination with mRNA vaccines in PLWH with discordant immune response. Influence of the vaccine administered

Abstract

Background: Data on SARS-CoV-2 mRNA vaccine immunogenicity in people living with human immunodeficiency virus (PLWH) and discordant immune response (DIR) are currently limited. Therefore, we compare the immunogenicity of these vaccines in DIR and immunological responders (IR).

Methods: A prospective cohort that enrolled 89 participants. Finally, 22 IR and 24 DIR were analyzed before vaccination (T₀), one (T₁) and six months (T₂) after receiving BNT162b2 or mRNA-1273 vaccine. Additionally, 10 IR and 16 DIR were evaluated after a third dose (T₃). Anti-S-RBD IgG, neutralizing antibodies (nAb), neutralization activity, and specific memory B cells were quantified. Furthermore, specific CD4⁺ and CD8⁺ responses were determined by intracellular cytokine staining and polyfunctionality indexes (Pindex).

Results: At T₁, all participants developed anti-S-RBD. 100% IR developed nAb compared to 83.3% DIR. Spike-specific B cells were detected in all IR and 21/24 DIR. Memory CD4⁺ T cells responded in 5/9 IR and 7/9 DIR, mainly based on the expression of IFN-γ and TNF-α, with a higher Pindex in DIR. Memory CD8⁺ T cells responded in only four participants in each group. At T₂, anti-S-RBD and nAb titers were higher in DIR than in IR. In both groups, there was an increase in specific B memory cells, higher in DIR. Six IR and five DIR maintained a specific memory CD4⁺ response. Memory CD8⁺ response was preserved in IR but was lost in DIR. In a multivariate linear regression analysis, receiving mRNA-1273 instead of BNT162b2 played a prominent role in the results.

Conclusions: Our data suggest that PLWH with DIR can mount an immune response similar to those with higher CD4⁺, provided they receive the mRNA-1273 vaccine instead of others less immunogenic.

Keywords: BNT162b2 vaccine; SARS-CoV-2 T cell response; SARS-CoV-2 specific B cells; SARS-CoV-2 vaccines; anti-S RBD IgG; mRNA-1273 vaccine; neutralizing antibodies; people living with HIV.