In a recent study published within the International Journal of Infectious Diseases, researchers assessed the efficacy of coronavirus disease 2019 (COVID-19) vaccines in people living with human immunodeficiency virus (HIV).

Study: Immunogenicity and efficacy of COVID-19 vaccines in people living with HIV: a scientific review and meta-analysis. Image Credit: Corona Borealis Studio / Shutterstock

The morbidity, mortality, complications, and significant economic disruption attributable to COVID-19 have sped up the invention of highly effective vaccines to previously unheard-of levels. There may be, nevertheless, a shortage of data on the effectiveness and safety of vaccines within the people living with HIV (PLWH) groups since vaccine trials didn’t publish data concerning individuals living with HIV. These individuals are of particular interest because the original illness or any concomitant treatments could have suppressed or overactivated their immune systems. As well as, since viral shedding and infection have been noted to be more severe and protracted in PLWH, data on this population are urgently needed.

Concerning the study

In the current study, researchers compared the immunogenicity and effectiveness of COVID-19 vaccinations in PLWH with healthy individuals.

The team electronically searched the Cochrane Library, PubMed/Medline, and EMBASE for published articles. First, the research papers were screened by title and abstract, followed by screening the article’s full text. Then, two researchers examined each title, abstract, and full text individually.

The team conducted a meta-analysis of prospective studies that fulfilled the next requirements: patients who received a COVID-19 vaccine of any brand and sort; individuals living with HIV/acquired immunodeficiency syndrome (AIDS); articles that included and documented data related to a control group comprising individuals who are usually not HIV-infected; and studies reporting a minimum of 1 case of either seroconversion or serological titer values after COVID-19 vaccination.

The team performed a post hoc amendment to incorporate articles that reported data related to prospective observational; qualitative evaluation, or experimental studies involving human subjects, all of whom were COVID-19-vaccinated with any vaccine brand and sort; studies involving individuals living with HIV/AIDS, and studies that published seroconversion rates of PLWH either with or and not using a control group.

The setting of the study, primary and secondary outcomes, sample size, inclusion and exclusion criteria, dropout and non-response rates, and study design were all included in the info on study characteristics. Age, sex, and medical history, including immunosuppressive medication history, were all included within the participant information. Eight vaccine types and types, a dosage schedule, the variety of participants who received each kind and brand of vaccination, and the median or mean interval between doses were amongst the data related to the intervention. Assay type, antibody tested, measurement method, sample collection intervals, and the variety of measurements were among the many outcome-related variables. Seroconversion following the primary and second doses of the COVID-19 vaccine was the first consequence of interest.

Results

The whole variety of studies included within the meta-analysis of seroconversion rates was 22. Ten of the 22 studies employed messenger ribonucleic acid (mRNA) vaccines, including BNT162b2 and mRNA-1273; six used inactivated vaccines, including CoronaVac and BBIBP-CorV; five used viral vector vaccines, including AZD1222 and Ad26.CoV2.S; and one used recombinant spike protein nanoparticle vaccines co-formulated with a saponin-based adjuvant, Matrix-M. Among the many viral vector vaccines, 4 studies used AZD1222, including three where it served because the only vaccine, while Ad26.COV2.S was only utilized in one.

In comparison with healthy controls, seroconversion was documented in PLWH in seven investigations following the primary dose of the vaccination. The seroconversion rate between healthy controls and PLWH was similar. After receiving a second dose of the vaccine, seroconversion rates among the many PLWH were lower than those of healthy controls in 20 studies, including 2,068 PLWH and 4,454 healthy controls. After receiving a second dose of the vaccine, individuals’ antibody titers didn’t seem like significantly altered or decreased.

After the primary and second doses, subgroup analyses were carried out for trials including only mRNA and non-mRNA vaccines. The results of mRNA vaccinations and non-mRNA vaccines on seroconversion weren’t noticeably different after the initial dosage. After the second dose, there have been no discernible differences in the results of the mRNA and non-mRNA vaccines on seroconversion.

Overall, the study findings showed that in PLWH, COVID-19 vaccinations exhibited positive immunogenicity and effectiveness. Regardless that the seroconversion post-second vaccination was marginally lower in PLWH in comparison with healthy individuals, a second dosage is consistently related to improved seroconversion. Additional measures, similar to a follow-up dose of the mRNA COVID-19 vaccine, could enhance these individuals’ seroprotection.

Journal reference:

• Juntao Yin, Yangyang Chen, Yang Li, Chaoyang Wang, Xingwang Zhang, Immunogenicity and efficacy of COVID-19 vaccines in people living with HIV: a scientific review and meta-analysis, International Journal of Infectious Diseases, 2022, ISSN 1201-9712, DOI: https://doi.org/10.1016/j.ijid.2022.10.005, https://www.sciencedirect.com/science/article/pii/S1201971222005422