Durability of ChAdOx1 nCov-19 (AZD1222) vaccination in people living with HIV - responses to SARS-CoV-2, variants of concern and circulating coronaviruses

This research has not been peer-reviewed. It is a preliminary report that should not be regarded as conclusive, guide clinical practice or health-related behaviour, or be reported in news media as established information.

Duration of protection from SARS-CoV-2 infection in people with HIV (PWH) following vaccination is unclear. In a sub-study of the phase 2/3 the COV002 trial (NCT04400838), 54 HIV positive male participants on antiretroviral therapy (undetectable viral loads, CD4+ T cells >350 cells/ul) received two doses of ChAdOx1 nCoV-19 (AZD1222) 4-6 weeks apart and were followed for 6 months. Responses to vaccination were determined by serology (IgG ELISA and MesoScale Discovery (MSD)), neutralisation, ACE-2 inhibition, gamma interferon ELISpot, activation-induced marker (AIM) assay and T cell proliferation. We show that 6 months after vaccination the majority of measurable immune responses were greater than pre-vaccination baseline, but with evidence of a decline in both humoral and cell mediated immunity. There was, however, no significant difference compared to a cohort of HIV-uninfected individuals vaccinated with the same regimen. Responses to the variants of concern were detectable, although were lower than wild type. Pre-existing cross-reactive T cell responses to SARS-CoV-2 spike were associated with greater post-vaccine immunity and correlated with prior exposure to beta coronaviruses. These data support the on-going policy to vaccinate PWH against SARS-CoV-2, and underpin the need for long-term monitoring of responses after vaccination.

Author list

Ane Ogbe, Matthew PaceMustapha Bittaye, Timothy TipoeSandra AdeleJasmini AlagaratnamParvinder K. Aley, M. Azim AnsariAnna BaraSamantha BroadheadAnthony BrownHelen Brown, Wanwisa Dejnirattisai, Federica CappucciniPaola Cinardo, Katie J. EwerHenry Fok, Pedro M. Folegatti, Jamie Fowler, Leila GodfreyAnna L. GoodmanBethany JacksonDaniel JenkinMathew Jones, Stephanie Longet, Rebecca MakinsonNatalie G. MarchevskyMathew MoncyAndrea MazzellaYama F. Mujadidi, Lucia ParoliniClaire PetersenEmma PlestedKatrina M PollockThurkka RajeswaranMaheshi N. RamasamySarah RheadHannah RobinsonNicola RobinsonSonia SerranoHelen StockmannTom TiptonAnele WatersHelen Sanders, Panagiota Zacharopoulou, Eleanor Barnes, Susanna Dunachie, Philip Goulder, Paul Klenerman, Gavin R. ScreatonAlan Winston, Adrian V. S. Hill, Sarah C. Gilbert, Miles CarrollAndrew J. Pollard, Sarah FidlerJulie Fox, Teresa LambeJohn Frater

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